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  1. #1
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    Psoas/Hip Flexor Strain

    Has anyone dealt with this before? Not sure how I this happened as it just showed up one day about three weeks ago. Overuse injury? Hernia (although only the bike seems to aggrivate it) ? The pain runs along the crease where the leg meets the groin (mid way down) and runs up to and over the top of my hip to the outside. Kind of a burning achy sensation.

    I stayed off the bike for a few days and it felt better overall. Nex,t I tried a couple of days of 30-60 minute flat pavement spins on the MTB and that caused some minor discomfort and then yesterday tried a 90 minute road ride on once again mostly flat roads and that flared it up intensely. After a long night of burining type pain, I feel 60% better today. Now however I have to face the cold hard fact that I may have to be off the bike completely for some time? Does anyone have any recovery stories for dealing with this? My mind is playing tricks with me now as the notion keeps coming to me that my season is over

  2. #2
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    Quote Originally Posted by rocdog View Post
    Has anyone dealt with this before? Not sure how I this happened as it just showed up one day about three weeks ago. Overuse injury? Hernia (although only the bike seems to aggrivate it) ? The pain runs along the crease where the leg meets the groin (mid way down) and runs up to and over the top of my hip to the outside. Kind of a burning achy sensation.

    I stayed off the bike for a few days and it felt better overall. Nex,t I tried a couple of days of 30-60 minute flat pavement spins on the MTB and that caused some minor discomfort and then yesterday tried a 90 minute road ride on once again mostly flat roads and that flared it up intensely. After a long night of burining type pain, I feel 60% better today. Now however I have to face the cold hard fact that I may have to be off the bike completely for some time? Does anyone have any recovery stories for dealing with this? My mind is playing tricks with me now as the notion keeps coming to me that my season is over
    Go see a doc?? Maybe research some appropriate stretches that target that area too??

  3. #3
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    I am a physical therapist, and it is almost impossible to accurately diagnosis anything over a message board. That being said from what you wrote is not likely a strain of the iliopsoas or hip flexor especially given the biomechanics when riding a bike. Because it gets better with rest and it doesn't sound like there was a specific event that caused the injury, it is likely an overuse/tendonitis type injury.

    You hit the nail on the head with rest. These type of injuries may take 2-6 days of rest from the aggravating activity for healing to continue. During this time ice is also helpful. From that point it gets tricky because without having an actual diagnosis it will be hard to know what exercises to do to continue the healing and prevent the condition from returning.

    If after the rest/ice period the problem continues or comes back you should see a doctor for referral to a physical therapist.

    Good luck, I hope this helps a little or at least gives you a direction to go.

  4. #4
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    Quote Originally Posted by carrollu View Post
    I am a physical therapist, and it is almost impossible to accurately diagnosis anything over a message board. That being said from what you wrote is not likely a strain of the iliopsoas or hip flexor especially given the biomechanics when riding a bike. Because it gets better with rest and it doesn't sound like there was a specific event that caused the injury, it is likely an overuse/tendonitis type injury.

    You hit the nail on the head with rest. These type of injuries may take 2-6 days of rest from the aggravating activity for healing to continue. During this time ice is also helpful. From that point it gets tricky because without having an actual diagnosis it will be hard to know what exercises to do to continue the healing and prevent the condition from returning.

    If after the rest/ice period the problem continues or comes back you should see a doctor for referral to a physical therapist.

    Good luck, I hope this helps a little or at least gives you a direction to go.
    Yeah, my gut feeling is that it is indeed tendonitis. I won't have insurance coverage again until late August so I don't want pay the doc $120.00 to tell me what you just did. So, thanks so much. There is a great PT I use when needed and I won't hesistate to call him if need be.

  5. #5
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    Quote Originally Posted by rocdog View Post
    Yeah, my gut feeling is that it is indeed tendonitis. I won't have insurance coverage again until late August so I don't want pay the doc $120.00 to tell me what you just did. So, thanks so much. There is a great PT I use when needed and I won't hesistate to call him if need be.
    I recently had similar issues and I "think" it came down to fit. I "think" there were two culprits here.

    I'd recently built up a new commuter that was slightly large but definitely workable. I had put in a setback seatpost as that's all I had laying around in the oh so popular 26.8 size (it's an older Bianchi Axis). So while I had reasonably close measures (seat height, tt length, drop and even saddle nose to stem) I was riding further back or in Bike fit speak, I'd closed my hips.

    Similar issue with my new (used) Anthem. I'm right on the line between Small and Medium and opted for a small. Well, to make that work, I found that I had to drop the bars and scoot the seat back.

    For shorter rides, I didn't really notice it too much but a few weeks ago I'd gone out on a 6+ hr ride and could barely use the stairs as my hip flexors were fried. Also had some groin area tightness.

    After sitting on all of these next to a mirror and then placing them next to each other I can see small differences in my position relative to the bottom bracket and handlebars. If you imagine a triangle formed around the contact points (pedals, seat & bars), the angle on the seat is what I'm talking of. That angle seems larger on both my other bikes (road, tt & cx).

    I'm waiting on a new seatpost for the commuter before getting back on that but after roughly a week of riding my road bike and religiously stretching out my hip flexors I've had little issue since.

    After doing some searches, it seems that riding bikes and sitting at a desk has some correlation with hip and lower back issues stemming from the Psoas. I'm not a doctor and I can't really be sure of the correlation between my bike position and my symptoms but...???

    anyone want/need a low mileage small 2009 Anthem x2

  6. #6
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    I had a similar problem last fall and through the winter. I got a proper bike fit, massages, researched stretches, and iced it. Took a few days off after the massage. After learning the correct stretches, I would do them 3-4 times a day, and directly after a ride. I would also try to ice it after a ride. I feel pretty good now, only minor discomfort.

  7. #7
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    You probably have typical cyclist strength imbalances. I know I do.

    If I do a little bit of hamstring strength and flexibility work, along with some full ROM "strength" work (light goblet squats, romanian (straight leg) deadlifts) my hips don't hurt at all.

    Go on youtube and google "couch stretch" and "table top stretch" and the mobility WODs for those areas will come up - and help a bunch.

    One more thing - foam roller. Those things suck, but they help.

  8. #8
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    One more thing - i think a physio who recommends ice and rest for an overuse injury is nuts.

    You're an athlete, and you intentionally "overuse" some of your muscles and tendons for your sports. Treating the symptoms via rest and ice won't do anything to heal your underlying condition. Figure out what in your body is screwed up (tight, weak, bad ROM, inflexible) and fix it.

    Rest and Ice will get you nowhere. (not a doctor, but I play one on the internet.)

  9. #9
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    Quote Originally Posted by playpunk View Post
    One more thing - i think a physio who recommends ice and rest for an overuse injury is nuts.

    You're an athlete, and you intentionally "overuse" some of your muscles and tendons for your sports. Treating the symptoms via rest and ice won't do anything to heal your underlying condition. Figure out what in your body is screwed up (tight, weak, bad ROM, inflexible) and fix it.

    Rest and Ice will get you nowhere. (not a doctor, but I play one on the internet.)
    Good advice! You are right. I know my abs/oblique/core is weak and have been working on strengthening those areas as of late. I also agree in regards to the hamstrings. I was doing deadlifts earlier in the season (back in April) and my body was bulletproof. I felt strong and balaced and solid. Then as training volume increased my core/strength work all but stopped for a while. Now I guess I am paying the price. I am feeling 80% better than the date of my original post which is a good thing. All though I am planning to keep off the bike for a few more days, it has given me more time to work the other areas. Thanks again.

  10. #10
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    Had the same EXACT issue a couple of months back. It came after 6 mo. of hard training. I tried stretching, massage, time off, then more time off, adjustments to fit, etc. all to no avail. I finally sucked it up and went to see the chiro. It turns out it was an issue with one of the discs in my lumbar spine. 3 treatments including traction, electro stim, ultra sound and manipulation and I am feeling straight and pain free. I had always been a little skeptical of chiros, but now I am a believer.

  11. #11
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    Quote Originally Posted by playpunk View Post
    One more thing - i think a physio who recommends ice and rest for an overuse injury is nuts.

    You're an athlete, and you intentionally "overuse" some of your muscles and tendons for your sports. Treating the symptoms via rest and ice won't do anything to heal your underlying condition. Figure out what in your body is screwed up (tight, weak, bad ROM, inflexible) and fix it.

    Rest and Ice will get you nowhere. (not a doctor, but I play one on the internet.)
    It is a good thing you only play a doctor. There is a big difference between an overuse injury and the overload principle used for training, as outlined by the American College of Sports Medicine, which I think you are trying to reference using your limited knowledge of physiology.

  12. #12
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    For me, the hip pain turned out to be arthritis -- probably not the same cause for your pain but goes to show how varied the problems can be. Two orthopedic doctors reviewed x-rays and MRI images of my hip and agreed on the diagnosis. I'm not all that old at 44, but decades of endurance training (running, rowing, cycling) may have exacerbated the problem and brought on the arthritis sooner in life.

  13. #13
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    I have been fighting a similar (sounds very much the same) problem. My SI joint was significantly rotated. My hip adductor was spasming. I went to 2 PT, chiro and masssage. the chiro adjusted and recommend massage. Masseuse did some crazy sit bones area massage and front side of my spine area through my stomach massage but it made a lot of difference. I'm still not 100% but making progress. As far as each specialist, it is about finding the right tool for the job. You just have use common sense and intuition to decide where to start and who is on right track.
    Oh sh!+ just force upgraded to cat1. Now what?
    Best thing about an ultra marathon? I just get to ride my bike for X hours!

  14. #14
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    hips

    stretching,massage,and foam rolling are your friends

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