I’m 20 years old, and I compete in Olympic Weightlifting. I’m also a first year med student in Calgary, Alberta.
I have a snapping hip on my right side, my dominant leg. I’m quite sure it’s the psoas. I also pronate more on my right side, or have less of an arch than my left. I have a piriformis that’s way more active that the glutes, which can seem “thick”, and it can be hard to get a true glute activation. The TFL and adductors get tighter on that side as well. My hips used to be incredibly healthy- I won the 100m city finals back in high school, competed in martial arts, etc. Now the hip on the right side seems “dead”- it doesn’t have explosive flexion capabilites. Sometimes I also get really tight in internal rotation and flexion, like my psoas is being jammed.
Footwear: been wearing Vibrams for a while, just switched to Frees for outside, as it just started snowing up here :(. Probably not good because of the heal.
Training- Olympic Weightlifting shoes have a heal. I’m considering an orthotic to counteract this in case my feet/ hips are overworked. Good or bad idea? Generally training exacerbates the problem… hip will be more dead and snappy post training, piriformis will be worse. Not too bad if I don’t go high volume and keep good technique.
Do you think this is a movement impairment/ alignment issue, an underlying tendinopathy, or both?
It is very challenging to put a name to what you are dealing with.
I would think the best place to start is to have someone roll your hip around and see if there is a passive restriction. If the limitations are present in supine and/or prone, we have to consider a joint or soft tissue restriction, which will be best served by manual therapy or some form of mobility training. You can foam roll to the cows come home, which is also a good idea, but may not be as efficient for a short-term result.
As a lifter, I might suggest there a spinal component to the hip symptoms. Fixing the hip’s expressions is part of the fix, but we should also look at the spine to see if a reset is needed there as well. Sometimes it may be a manipulation or some reversion to inner core training like segmental rolling.
With feet standing together, can you twist to each side. Are they different?
Then take the your right foot up onto like a 6″ step and rotate again. Is either direction any different when you take the right hip out of it?
I don’t think the shoes are a big deal in this. If the heels you wear are just for training, you are countering them with the Vibrams and Frees. The Frees are excellent choices. Don’t worry about whatever heel they may have.
My assumption is always that it is a movement impairment syndrome, and I am just guessing that movement to be multi-segmental rotation.
Do you have the book Movement? All of the breakouts for MSR are in there, and that should be able to pinpoint where your problem lies.
Sorry I can’t be of more help, but diagnosis by Internet is not easy for me.