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Hip and Groin
Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 9:12AM Reply | Return to Index | Report Post
My marathon training was going very well until just last week. I stepped on some uneven ground and felt a strange sensation in my left hip flexor/groin. It actually felt like a good stretch at the time, but began getting sore after that. I took a day off and reduced the intensity of my runs, but it appears that the injury has decided to linger.

I can't tell whether the pain is principally in my hip flexor or groin. Here are some characteristics of the pain:
- The pain hurts the most when I am pulling on my pants in the morning, and I am standing on my left leg and pulling my right leg through the pants. It does not really hurt at all when I am not bearing weight with my left leg.
- It feels better as a warm up, but does not get completely better. The first mile or two of my run is slow and uncomfortable (about a 4 or 5 on the pain scale) and I have a bit of a limp. However, after that, the pain moves down to about a 2 or 3. I don't limp during the remainder of the run, but my pace is slower than prior to the injury.
- It hurts more to run downhill than uphill (uphill does not hurt much at all). Uneven surfaces don't feel good.
- Walking sometimes hurts, and sometimes doesn't. If I've been sitting at my desk for a long time and get up, walking is awkward.

Has anyone had anything similar to this type of injury? Do you have any advice for dealing with it?
umbrella fight
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 9:17AM - in reply to Hip and Groin Reply | Return to Index | Report Post
If it were me, I would go straight to my applied kinesiologist because she can fix this sort of thing 9 times out of 10.
Where do you live?
Google "applied kinesiologist" plus the name of your city and find one.
DO NOT run your marathon with this "minor" problem. You might injure yourself for months or years by favoring one leg during the marathon.
Hip and Groin
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 9:36AM - in reply to umbrella fight Reply | Return to Index | Report Post
Thanks - just made an appointment.
j0nathan
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 10:10AM - in reply to Hip and Groin Reply | Return to Index | Report Post
That's insane dude, that describes what I'm dealing with to a T. Started about 10 weeks ago, and got worse and worse, to the point where I am in week #2 of no running PERIOD. I never made an appt with a doc, but I wish I did. It was so hard to determine if the injury was in my groin or hip flexor, but my symptoms match yours exactly, perhaps higher on the pain scale. Hopefully you will be able to train through yours with some good rehab. I let my pain progress to the point where I had to completely stop, and have cancelled a race next month. There are some intense stretches that help, so maybe ask the doc about those. Good luck.
Hip and Groin
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 1:19PM - in reply to j0nathan Reply | Return to Index | Report Post
Thanks. Hopefully it won't come to that point. I'm planning on taking it as easy as I can over the next few weeks as part of my taper. I'll see what my doc says today.
Breakfast of Champions!!
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 2:18PM - in reply to Hip and Groin Reply | Return to Index | Report Post
Does it hurt when you crunch your trunk, do ab work...if so then you may have a sports hernia/athletic pubalgia.
Hip and Groin
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 2:27PM - in reply to Breakfast of Champions!! Reply | Return to Index | Report Post
Nope, ab work/crunching feels fine.
Turbo
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 4:36PM - in reply to Hip and Groin Reply | Return to Index | Report Post
could be psoas as it's an under appreciated source of hip flexor pain felt in the groin. Google it for some simple ways to check psoas tightness or dysfunction.
Neliah2507
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 6:15PM - in reply to Turbo Reply | Return to Index | Report Post
Do you have a tight inguinal ligament? And do you have any minor lower back pain on the affected side? Does it hurt to bend to either side or ache?

It sounds possible that you overstretched the psoas major (causing minor microtears) and then allowed that injury to become somewhat acute by finishing your run. This would create more microtears and cause you to have more inflammation. If you did stretch the Psoas Major, it fits your pain pattern (especially when you describe it hurting to stand on the affected leg and bend over slightly to put on your paints). Your PM's function is to bend your torso towards your legs in a closed-chain scenario (foot planted).

It sounds like you keep moving in and out of an acute phase of healing and a subacute phase and cannot get past those tissue stages because you continue to run on it. I realize the pain is not a 8-9/10. I still think it would be in your best interest to not just "take it easy" but to STOP running. Find an activity that does not cause any aching/tightness/etc. If the muscle feels tired after the first 5 minutes (may not hurt any worse) still stop doing that activity. While you don't sound like you have a grade II-III tear or strain, you do sound like you are progressing slowly into a gradual state of inflammation which to be quite honest, is not good. It's much harder to get rid of a chronic inflammation problem than it is to rest a strain/tear for X amount of weeks. The rehab is pretty black and white.

Personally, I would do the following:

1. RICE as much as possible for take next 72 hours. Take NSAIDs then wean off them within 5-7 days.
2. Begin gentle PROM movements and Passive stretching (having someone help you is best). You can lay supine and have them just move your leg around through all the ranges of motion. It doesn't have to be in a certain order. It just needs to be passive, gentle, and ideally for 20-30 minutes of just relaxed movement.
3. Massage the entire area yourself 2-3 times a day (I realize it's time consuming but it works wonders for hip flexor inflammation). You cannot palpate the entire muscle but you can work on the surrounding area, loosen up your groin, and also your abdominal wall. This will really help to relax the area in general and promote healing.
4. Once you have zero pain during passive stretching movements or only feel pain near the end range of motion it's OK to start doing more active stretching and exercises to begin strengthening the area.
J.R.
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 6:44PM - in reply to Hip and Groin Reply | Return to Index | Report Post
Soak a washcloth in icewater, and press it onto the injured area.

As the injury gets cold (5-10 seconds), move your legs gently, and keep pressing the icewater washcloth where you feel any pain.

Do this several times a day, always with the icewater, always with the gentle movement of your legs. You should be 90 percent better in 2 or 3 days.
1-900-blonde
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/20/2012 7:05PM - in reply to J.R. Reply | Return to Index | Report Post
Sorry - but you might have a labral tear. Not a good thing.
Hip and Groin
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/21/2012 8:15AM - in reply to 1-900-blonde Reply | Return to Index | Report Post
Had an appointment yesterday with an ART doc. The appointment was extraordinarily painful. However, for about an hour afterward, I could walk without pain, and felt great. This morning, I have been a bit sore while walking around. Perhaps that's due to inflammation from the appointment. I have another appointment on Monday. Not planning on running today.
umbrella fight
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/21/2012 8:41AM - in reply to Hip and Groin Reply | Return to Index | Report Post
How did you find the ART doc? Is that similar to an applied kinesiologist?
Hip and Groin
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/21/2012 10:34AM - in reply to umbrella fight Reply | Return to Index | Report Post
I found the doc because I had gone to him before and he had successfully treated one of my prior injuries. He is an Active Release Therapist -- I am actually not sure what an applied kinesiologist is.
J.R.
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/21/2012 12:50PM - in reply to Hip and Groin Reply | Return to Index | Report Post
Crazy - you could have been healed by now.
Hip and Groin
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/22/2012 7:52AM - in reply to J.R. Reply | Return to Index | Report Post
Well, it's looking less and less likely that I'll be able to run the marathon. My hip/groin has continued to regress despite taking two days completely off. It hurts to walk more than it did before. I tried lightly using the stationary bike and then attempting to jog on a treadmill. Immediately upon attempting jogging I was limping and in pain. And the pain was probably higher on the pain scale than before. I'm going to try to swim/aqua jog as much as I can to stay fit, but I doubt I'll be ready for a marathon in two weeks and two days.
1-900-blonde
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/22/2012 9:03AM - in reply to Hip and Groin Reply | Return to Index | Report Post
Very common - labral tears - been there. Your symptoms are suggestive. Google hip labral tear and/or femoroacetabular impingement. Nick Willis, Tyson Gay and Lisa Dobrisky had them. Sorry about the marathon. Agree you should bag it.
Hip and Groin
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/22/2012 9:07AM - in reply to 1-900-blonde Reply | Return to Index | Report Post
If it's a tear, I suppose I need surgery, right? How long is the recovery time?
1-900-blonde
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/22/2012 9:53AM - in reply to Hip and Groin Reply | Return to Index | Report Post
A small tear can usually be dealt with with PT. A larger tear (which I had) can only be fixed surgically which depending on the extent, can take a minimum of 12 weeks to up to a yr to fully heal. You would need a MR arthrogram to diagnose.

I dont wish to throw a wet blanket on what is hopefully a more minor problem, but labral tears are underdiagnosed. Keep aquarunning. Easy backstroke kicking is also beneficial for strengthening, and stay off the roads.
Hip and Groin
RE: Acute Hip Flexor and/or Groin Injury - Three Weeks Out from a Marathon 3/22/2012 10:15AM - in reply to 1-900-blonde Reply | Return to Index | Report Post
Well, if the wet blanket is wet becauase it was floating in ice water, and I can use it to massage my hip, then I don't mind.
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