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    atmetal's Avatar
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    Hip flexor injury?

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    I'm pretty sure I have a torn hip flexors, one on either side. I looked at pics of hip anatomy and it seems to make sense based on the location of pain that I have. However, I haven't ruled out abductors yet. I can't seem to find any resources backing me up. First of all, every article seems to be geared towards runners. I don't run, and but I do squat along with lunges as an accessory movement. This was not an injury that happened instantly. Instead, the pain gradually got worse. I didn't think it was an injury, so I ignored it. The second thing I keep reading is that a symptom is pain when lifting the knee/leg up towards the abs. While I do feel the slightest pain while doing that, it actually hurts more during external rotation. Can I get some light shed on this please?

    Also, while on the subject, my strength training routine (Wendler 5/3/1) will have to be modified. For some reason, deadlifts don't hurt (and obviously bench and overhead press is fine), so I'll continue as normal with that. But I tried out the leg press to see how that felt and it was pain free. I don't expect to make any gains on leg press, I'm just going to maintain what I can, but it got me wondering. How can a free weight squat hurt so much, even on my light warmup weights, and the leg press can be pain free? As far as I'm aware, the only thing the leg press lacks is lower back and core engagement, nothing to do with hip movement.

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    I've had issues with hip flexor injuries in the past. I think it's more likely you have some sort of tendinitis than an actual tear. But either way, you should definitely get it checked out rather than self-diagnosing.

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    Unfortunately, Navy medicine doesn't like to check things out. Instead, you get ibuprofen and told to not do anything that hurts. I injured my lower back a several months ago (gotta love squats, lol). I had sciatica so I knew it was a disc problem. Though at first, much like this current hip injury, I didn't recognize it as an injury, so I continued to lift, which royally f***ed me. The Navy doctor prescribed Motrin and some NSAIDs and waived me from all physical activity for just one day. He didn't take it seriously and to this day I don't know the severity of the injury. Today, I'm lifting weights heavier than ever before. However, if I sit too long, my back hurts, which I never experienced before the injury, so there may still be damage. Yea, getting it checked out isn't an option, at least not for another 5 years.

    If the back injury taught me anything, it was that given time, healing will occur, but I would still like to help the healing process in order to return to full activity. I'd also like to know how to best prevent this in the future. Because I don't know how this could have even happened, squatting is a natural movement and I always made sure to warmup with light weights. The only cause that I can think of is the time spent recovering from the back injury. As a substitute for weights, I followed Convict Conditioning for a few months. The squat progression got me to the point where I was squatting with a close stance (considered harder than a normal squat because it challenges stability). Maybe this style made for under-use of the hip flexors, so when I returned to the weights, perhaps I shocked them too quickly. Sounds like a crazy theory, but what else could it be?

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    For me, an overuse injury of the hips means I just stop doing what I'm doing until it heals and I can again start exercising, usually picking up where I left off with no residual effect. I have never had any luck switching to somewhat less stressful versions or similar exercises. I recently had what I think was tendinitis of the right hip (butt cheek area). By the time I realized it was something that was getting worse rather than resolving, I was able to feel it even when walking. After a couple of months it has reached the point where I feel I can resume doing what I was doing when I injured it, but more carefully this time.

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    atmetal's Avatar
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    I read up on hip flexor tendonitis and it seems to describe me more than a strain. When you say that continued activity may make it worse, does that go for the movements that don't seem to involve hip flexors. I know the leg press is close enough to a squat that it is probably as you described, a less stressful version. But something like deadlifts... Well, one might assume it would work the hip flexors since the hips generate most of the power during DLs. But my DL is over 100 lbs ahead of my squat and yet, is pain free. So how would deadlifts fit in? One article on tendonitis said to stop all activity. That seems a bit extreme, if not vague. I was even starting to walk more as I read that walking opens up the hips and a believed it would be an excellent rehab activity.

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    eKatherine's Avatar
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    I would think if something is not bothering you at all, it should be okay to do it. And if you feel it, probably not. This latest injury has gradually resolved so I feel it during fewer and fewer activities and exercises. For me, that's the usual pattern. I have walked more than ever, and it continues to improve.

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    How can a free weight squat hurt so much, even on my light warmup weights, and the leg press can be pain free?
    It sounds like what you have going on is pretty similar to what I've got going on, only my pain is definitely present during knee-to-chest motion as well. Mine wasn't a gradual onset, either; I've been dealing with a serious injury to my left quad that made me overcompensate at the hip, and I felt my hip flexor very suddenly twinge one day while going down stairs, and now it hurts all the time and I haven't been able to squat (even air squats) for the entire week.

    Leg presses, though? No problem. And low bar back squats/box squats have also been fine. Anything with a wide stance = no pain. Anything with a proper hip-width squat stance = pain. I think it's because in a supported leg press and in a wider-stance box squat, you're primarily using the force of the posterior chain for leverage, and don't need to use the hip flexor so much for stability; whereas in true squats, the hip flexors are doing a ton of accessory work.

    Luckily, I've already been going to physical therapy for the quad injury, and my PT says I've just really irritated/strained the hip flexor muscles, primarily the TFL and psoas. He does Active Release Therapy on it twice a week and I've just been avoiding squats (the last thing I want is tendonitis or a torn insertion point), and my workouts have been otherwise unaffected.

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    Facet syndrome tends to refer pain into the groin area and could be exacerbated by a squat due to compressive and shearing forces in the spine while leg press would avoid such issues.

    Just an observation. Without an actual physical all that can be done is to throw out diferntials for you to look at. Very well could just be a simple hip flexor strain. If so some tissue work and ultrasound therapy with mobilization may speed the healing.

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    atmetal's Avatar
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    How likely is facet syndrome? That sounds pretty serious and now you have me worried.

    If it can help pinpointing what exactly this injury may be, I can add the following:
    -The left side pain only just started recently, while the right side has been present for a couple of months at least.
    -As I alluded to in my first post, I worked through this pain for quite awhile. The reason for this was because as I progressed through my warmup sets, the pain would gradually subside (making me think it was a normal part of warming up). Even when I last squatted on Monday, when the pain was at its worst, 1 rep at 245lbs still felt better than my first warmup set of 115lbs. I'm guessing this was a numbing-like effect as I upped the weight. Nevertheless, perhaps this behavior can help eliminate some options on what this injury actually is.
    -When I returned to weight lifting after my 3 month hiatus, the first routine I started was Martin Berkhan's RPT style, then I changed to 5/3/1 because it was better for recovery and cutting. In both routines, I squatted ATG, something I never did before. I recently learned that without weightlifting shoes, it is generally difficult if not impossible to squat this low properly. Sure enough, I tested it out with some plates serving as heels and it felt a lot less stressful in the groin area.

  10. #10
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    Have you tried hip flexor stretches?

    I have very tight hip flexors and they lead to:
    lower back pain
    knee pain
    hip pain.

    I had some work done on them, mainly deep tissue massage. Now I just need to stretch when I start feeling it- like sitting right now, cross legged on the couch, my hip hurts. Earlier, horseback riding, my back hurt, and my knees hurt on air squats (not weighted squats). So, this week I will make it a point to stretch that area and it will help. But yeah, somehow they relate to your core and knee and I could not tell you why, but I do the stretches and hip, knee and back pain go away.

    But it might be worth looking up hip flexor stretches online and trying some.

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