Hi all,

Looking for alternatives to squats due to bilateral hip impingement and arthritis.

Just met with a hip specialist today and ran through the medical options with him.

Currently am on a program of Uflexa, (sp) injections directly to the joint.  My next option would be for arthroscopic surgery to mill off the bone spurs.  The doc gave that about a 60% chance of success due to the arthritis to alleviate the pain.  Last option is hip replacement which at 52 I'm a little hesitant.

The really disappointing thing the Sports Medicine doc did keep saying though was with the way my hips are anatomically, to stop squatting.

Since lifting is my best weapon against diabetes, stopping lifting isn't a really good long term option hence the need to replace squats with something equally effective at working the body but without flexing the hip joint.

Any information and suggestions will be greatly appreciated.

Semper Fi

What did the Sports Doc say about alternatives?

That would be the place to ask first probably, someone that knows what's going on inside of you enough to know what is a safe alternative and what isn't.

The doc said bad words like, "no squats", try an elliptical, a treadmill or recumbent exercise bike.  I told him he really should stop swearing.

Neither a treadmill, elliptical, or exercise bike will really do what I need.  The progressive overload of lifting kicks the snot out of my blood sugar.  Steady state cardio really doesn't work for me as my body got to efficient when I was long distance cycling.

Hence my search for a weight based exercise that I can substitute for squats.

Semper Fi

I think you are going to have to try out a variety of lifts and see what feels right. Couple that with becoming a master of your condition. I don't have what you have and haven't trained with anyone with it. So I have no first hand experience.

I broke my pelvis when I was 19 and was told I had arthritis, chronic pain, etc. Heavy squats fixed that after a decade of just living with the suck.

How do squats feel for you? Low rep high weight? Vice versa? Have you tried box squats? Those can take some pressure off the hips. You can also look into powerlifting gear like briefs or a sqaut suit for hip warmth/support. You have options.

Thanks Anvil,

Already embracing the suck with the pain, it just is what it is.  But when it starts affecting daily life and work, something needs fixed.

I've discovered Inzer knee wraps and have been using them religiously when I squat, they seem to keep the knees fixed and don't allow much if at all in external/internal knee rotation.  Wrapping the knees keeps the pain down below the level of "chew through the bar and use lots of Marine Corps language" to more a solid unpleasant ache.

My current game plan is to give the Euflexxa injections some time to work and try some box squats to keep from going below parallel, (I'm not an A2G guy).  I'll probably back the weight down and add reps/sets to see how that goes.

If I can buy some time with the Euflexxa injection, (think 3 in 1 oil for the joint) I can put off the arthroscopic cleanup of the impingement for a couple of years which should push out a possible hip replacement 5 to 10 years.

I'm just hoping that there is something out there that will give me the same workload as squats but spare the hips so I can keep lifting without looking like those bad gym photos of the guys who skip leg days and so I can continue kicking the piss out of diabetes as the alternative really isn't much of an option.

Semper Fi

Yeah I would just play around with things and go by feel. I think you might really benefit from a pair of briefs. I'd look at the power pants or groove briefs if I were you, Inzer.

I would also look at your diet. Cut out inflammatory foods. Make sure you are getting enough protein and fats. Then make sure whatever carbs you are eating are clean. Keep us posted as you try things out.

Thought about PRP for him, but I doubt that PRP is covered by our insurance.  It was enough of a miracle that they agreed to cover the Euflexxa hip injections!

Prolotherapy pulled me out of a wheelchair after an accident wrecked my back. If you find the right Wizard, it's amazing what they can do!

Fish/Flax Oil helps Arthritus, I wanna say atleast 4000mg.

I'm only 28, but I have arthritis in a few spots from injury/overuse back when I played football.

I noticed once the Oils kick in, my joints feel well lubricated. Also the over all pain/inflammation doesn't feel bad.

You might have to change to specific exercises that isolate the muscle groups until you figure out which range of motion causes little to no pain.

Your best weapon against diabetes is a diet that doesn't jack with your blood glucose level.

What about interval work on the bike, elliptical, or running?

I was leaning this way too, squats are fucking fantastic but what you eat has a lot more bearing on diabetes.

Interval biking has a lot of benefits of a squat

The diet is pretty reasonable currently, we eat low carb, lots of protein and good fats for the most part.  There is room for improvement and after doing some research on inflammatory foods and anti inflammatory foods I'll be tweaking my diet in that direction.

Interval training on the bike might be something I work into my routine in the future.  Steady state long distance did wonders for dropping weight but as the body got efficient at it, it stopped dropping my blood sugar like I wanted it to.  That's the beauty of progressive overload and weight lifting, my body never gets a chance to get used to it and it continually pulls my blood sugar down where I want it.

Semper Fi

I was one of the PRP test cases. I'm a walking miracle, I can say that for sure.

It cost everything I had, but, I'm moving on my own ten years after the fact. When it was all said and done, I think it was roughly $60k . I'd do it again without a second thought.

I had surgery for this roughly a year ago at 30yo, PT and shots never helped. The physical therapist and doctors say I can squat just nothing past parallel. If you can get it fixed surgically do it it feels so much better. I'll still have to have them replaced some time in the future but it does feel so much better after surgery.

While it is not a squat, I would look up "Terminal knee extensions". They can be done with a 2 inch band purchased from Amazon and any stationary object.

The are really great for getting a nice quad workout when you can't squat. I use them as a warm up.

If you have access to a gym that has a squat rack with safety rails, you could do partials like seen in this video... https://www.youtube.com/watch?v=KSU_MyQJ30Y

Obviously you may need to move the safety bars up a few notches. Also, you could utilize techniques like negatives on the up and\or down motion to recruit more muscle fibers. Makes for a great workout without needing too much weight.

Hope you find something that works.

What about deadlifts? Similar to the safety rail squats seen above...you could do partial dead lifts (start and shin or knee height). While not 100% quads, it's still a great multi-joint movement that will burn tons of calories.

Deadlifts are part of my normal routine, absolutely love them.  Nothing burns out a bad day at work or frustration like deads.

That said, they do still mess with the hip, notice it when I am pulling heavy.

Here lately the hips have been so much of a problem due to work that now it's changed the way I walk and my low back and knees are starting to complain.

I've changed my squat over to a box squat, (actually an empty bucket).  It was just the right height to allow me to go to parallel but not beyond.

Next Friday is my next injection of Euflexxa into the joint capsules, still have another series of injections to go then a six to twelve week wait to see if it does any good.

Thanks for all the tips and suggestions so far.

Semper Fi

Due to issues with both shoulders, I switched to dumbell squats.  More range, less total weight but still all the benefits of the A2G back squats I did previously.  No belt, knee wraps, just chalk.

Have you looked at a safety squat bar aka yoke bar? It puts your shoulders in a safer position where you actually hold onto a couple handles in front of your body.

Would the Bulgarian split squat cause you issues also?

Just an update.

The Euflexxa injections seem to be working.  I had my last series about three weeks ago and the pain seems to be better.  I've got several more weeks to go to see just how well the injections do.

If the Euflexxa works, I'll put of surgery as long as possible.

Semper Fi

I get some occasional hip impingement due to a couple years of heavy wide stance low bar squatting. High bar and front squat feel perfectly fine which is why I'm assuming it was the low bar that did it, it built up into some considerable discomfort that never went away. RDLs, stiff leg deads, sissy squats, leg extensions (Properly), weighted pushes/pulling, and weighted climbs should be easy on the hip.

In any which case, what personally feels comfortable to me are sumo deads with more of a squat stance since it loads on the posterior chain first and I don't get discomfort while still working the quads some. Light Bulgarian split squats and lunges also feel perfectly fine as well as step ups. Another option may be heavy sled pulls or pushes. Really though the right answer is to work something out with the sports doc. If your hip is legitamtely shot sometimes there isn't an option and you have to think of health over exercise. My dad was in the spot at your age with his shoulder and he kept poking around for alternatives when he should have listened to the sports doc. By time he did eventually get his shoulder replaced he had to go to a number of different surgeons before he could find one that would operate because there were so many bone spurs and not enough joint left to work with in the first place. Now he's at the point where he listens but it took the surgeon explaining that he won't get another replacement and if it collapses he's looking at amputation.

Get a second opinion from another sports doc but if it is truly that bad I'd say it might be best to switch to the mentality of exercise for mobility and joint health and put strength/performance of your lower body on the backburner.