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Lower ab / groin area soreness. Thoughts on how to strengthen?
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Hi all,

My lower abdominal and groin area has been experiencing some soreness weakness. Once I get going in a workout I become less aware of it.

This issue developed during a heavy running training block.

I feel it most when I raise my knees or when I squeeze my ankles together.

It appears to be getting worse, not better.

Doing some googling, I think it might be hip abductor related.

Has anyone else experienced this issue? What worked for you?

PS - the PT I trusted moved away and I haven’t yet found anyone to replace her.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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A steady dosage of yoga through the week addressed this with me. If core strength is the culprit yoga helps address that. If mobility is causing this, yoga will address that. The other real benefit that I didn't expect is that strength around my feet and ankles as well as balance is much improved which has helped significantly for trail running.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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SBRinSD wrote:
Hi all,

My lower abdominal and groin area has been experiencing some soreness weakness. Once I get going in a workout I become less aware of it.

This issue developed during a heavy running training block.

I feel it most when I raise my knees or when I squeeze my ankles together.

It appears to be getting worse, not better.

Doing some googling, I think it might be hip abductor related.

Has anyone else experienced this issue? What worked for you?

PS - the PT I trusted moved away and I haven’t yet found anyone to replace her.

try stretching your psoas and abductor
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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I strained my adductor kicking a soccer ball and lost an entire season of racing. I couldn't swim, bike or run without pain/discomfort. I resolved it through PT, strength work both in the core and surrounding joint structures, stretching (adductor, glutes, hamstrings, hip flexors) and massage (very painful massage). I have heard that this is an injury that, if not treated properly and allowed to heal, can haunt you for a very long time. I took more than 6 months off from nearly all activity other than PT and then very slowly eased back in. To this day, if I'm not diligent in stretching and keeping the surrounding structures strong, I can feel the pain coming back. I'm in my late 40s which I am sure plays a role but hopefully for your sake you find resolution sooner. Moral to the story, if there is one, is that this is an injury that cannot be rushed. Best of luck to you.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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Otitis Pubis, google it.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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I'd try to figure out a root cause. S, B, or R?
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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Core, functional strength and stabilizer muscle work.

Found this issue popping up as I got "more mature".

Since making strength sessions as important as SBR, no real issues since.

https://drive.google.com/...dXc/view?usp=sharing

Ryan
http://www.SetThePaceTriathlon.com
http://www.TriathlonTrainingDaddy.com
I got plans - https://www.trainingpeaks.com/...dotcom#trainingplans
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [TriJayhawkRyan] [ In reply to ]
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Seems like there is a consensus

How often do you do this routine?
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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I aim to do 2 to 3 strength sessions a week.
Some may be more simplified to 15 minutes.
Some are full on strength for 45 minutes.
I have created 20 different workouts and which I do depends on my other training for the week.

I also do no strength on a transition (rest) week and during race prep and taper.

Ryan
http://www.SetThePaceTriathlon.com
http://www.TriathlonTrainingDaddy.com
I got plans - https://www.trainingpeaks.com/...dotcom#trainingplans
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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You might want to check that you don't have a hernia. I had one and my symptoms were similar and in the same region.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [Paolo55] [ In reply to ]
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Hello Paolo55 and All,

Also if hernia investigate no mesh surgery ....

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My son used this doctor for hernia repair and thought well of the outcome.

Doctor Petersen has hotel rooms reserved nearby at reasonable rates.

Cheers, Neal

+1 mph Faster
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [TriJayhawkRyan] [ In reply to ]
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TriJayhawkRyan wrote:
Core, functional strength and stabilizer muscle work.

Found this issue popping up as I got "more mature".

Since making strength sessions as important as SBR, no real issues since.

https://drive.google.com/...dXc/view?usp=sharing

only one comment on this: not always the soreness appears in the weak muscle, but the stronger. If the problem is caused due shorten Psoas, core work will help but it will not solve the issue.

check the shorten muscle and strength it, do it a lot, during the soreness... strength it even up to 3 times per day.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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SBRinSD wrote:
Hi all,

My lower abdominal and groin area has been experiencing some soreness weakness. Once I get going in a workout I become less aware of it.

This issue developed during a heavy running training block.

I feel it most when I raise my knees or when I squeeze my ankles together.

It appears to be getting worse, not better.

Doing some googling, I think it might be hip abductor related.

Has anyone else experienced this issue? What worked for you?

PS - the PT I trusted moved away and I haven’t yet found anyone to replace her.


Hi, are you still dealing with this problem? Just curious as I have had osteitis pubis in the past, and am dealing with a groin strain (or adductor tendonopathy) right now.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [eye3md] [ In reply to ]
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Yes, it’s a minor issue now... but still there.

I get some relief from tucking my knees into my chest and holding for 15-20 seconds at a time.

I don’t think I ever got to the bottom of it.

I was pretty much fine through my Tri season.

I’m about to ramp my running up again and will see if it gives me more trouble again.

Wish I could be of more help.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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SBRinSD wrote:
Yes, it’s a minor issue now... but still there.

I get some relief from tucking my knees into my chest and holding for 15-20 seconds at a time.

I don’t think I ever got to the bottom of it.

I was pretty much fine through my Tri season.

I’m about to ramp my running up again and will see if it gives me more trouble again.

Wish I could be of more help.



If it starts getting worse, as you amp up the running again, I'd strongly suggest an appointment with a sports med doc and an MRI. Hip and groin issues are notoriously difficult to diagnose because there are so many parts to that region, and more than one can be affected. With you having groin and lower ab pain, you may have athletic pubalgia (this is a strange term and can be confused, or used, interchangeably by some with sports hernia or osteitis pubis). I had lower ab pain, without groin pain. My MRI showed "bone edema" at the pubic symphysis (osteitis pubis). I was told I could do anything that did not cause pain so I kept cycling but could neither run nor swim. It took right at six months (of no running) before I could even try to run pain free again.

I feel like I can attribute almost all of my recent injuries to lack of strength training. Through the years, I thought my running and cycling kept me in good condition (both strength and fitness wise). Unfortunately, it did not, and I developed weaknesses to many smaller muscles and my core. I'm still battling injuries here and there but I believe this is because I will be playing catch up with my strength training for a long time to come. Best of luck to you as you start running again.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [eye3md] [ In reply to ]
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I was diagnosed with Athletic Pubalgia going on 2 years ago, now, by a respected Sports Med Doc here in Big D. I injured myself in a stupid race that thankfully has been cancelled. The run course was basically 4 laps up/down the side of a hill with a 10% final section to/from the top.

I spent 3 months in 3x weekly PT sessions, and another 3 on my own doing every kind of stabilizer and core strengthening exercise you can imagine. Hip stabilizers in all planes using bands...then using bands standing on pillows...then stronger bands, rince and repeat. Exercise ball work, static and dynamic, planks, planks with arm/leg and arm+leg raises. Pelvic tilts with and without a ball to squeeze, and on and on. There were also a bunch of stretches, as well. I can't even remember them all now. At one point I had so many exercises it took 2 1/2 hours to get through them all.

After 3 months, I was still having issues and was still unable to run. I quit paying money for the PT, but kept up the routine for another 3 months. At 4 months I started running like 5 minutes a day, increasing that 2-5 minutes a week as tolerated. By the 6 month mark, I was back to running normally...with only occasional mild discomfort. 2 years out, and I rarely (but occasionally) can tell its still barely there.

I guess I don't know what my point is, ecept maybe that there is "hope" at the end of that tunnel.

One of the interesting things that came out of this is that it altered my running form. I used to run with both feet in the same track (like running on the white line). Now, I tend to run like each foot is just outside the white line (so maybe 6" apart). This wasn't a concious change, but I my wife noted it watching me on the treadmill several months down the road.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [SBRinSD] [ In reply to ]
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Go slow with trying to strengthen that area. Like seriously slow.

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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [Scotthb] [ In reply to ]
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Interesting... get this too.


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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [Tom_hampton] [ In reply to ]
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Tom_hampton wrote:


One of the interesting things that came out of this is that it altered my running form. I used to run with both feet in the same track (like running on the white line). Now, I tend to run like each foot is just outside the white line (so maybe 6" apart). This wasn't a concious change, but I my wife noted it watching me on the treadmill several months down the road.


Interesting you would write this. For folks who are dealing with this condition, as well as Runner's Knee, its not unusual to have foot or leg crossover while running. As you stated, your feet use to be on the white line, but now they are on each side of it. For me, I would get scuff marks on the side of my calf where the other foot would occasionally rub against it. All of these are related to a weakness of the glute medius. As you did all of your PT work, you most likely strengthened your glutes and this is partly why your running gait changed. That is a positive direction to be heading IMHO.
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [eye3md] [ In reply to ]
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eye3md wrote:

Interesting you would write this. For folks who are dealing with this condition, as well as Runner's Knee, its not unusual to have foot or leg crossover while running. As you stated, your feet use to be on the white line, but now they are on each side of it. For me, I would get scuff marks on the side of my calf where the other foot would occasionally rub against it. All of these are related to a weakness of the glute medius. As you did all of your PT work, you most likely strengthened your glutes and this is partly why your running gait changed. That is a positive direction to be heading IMHO.

Likewise, except mine was the medial malleolus, I did it so often I'd get bruises, or raw spots if I wore low cut socks. So, I have always worn mid calf socks scrunched down to cover my ankle to give me a little cushion. This simply doesn't happen anymore. I was noting that myself the other day while running on the treadmill...that I simply couldn't remember the last time I kicked myself in the ankle.

A funny side story....as I progressed through PT, they would add new exercises every week or two. They never said to replace previous ones with the new ones...just "you can start doing these, too." So, I just kept tacking them on to the routine. As I said above, it got to the point that it took all evening from dinner until bed time to get through them. One day I asked the PT, if I could stop doing some of them because they were taking so long to get through.

She looked at me funny, and asked why they took so long. So, I explained that she'd added a ton of them, and it took a long time to get through them ALL every night.

She laughed out loud at me and said, "Triathletes!!" Then, she proceeded to explain that the list of exercises were "options" of things to do on different days....maybe doing each exercise 2-3 times a week, but not the entire set Every. Single. Day.

So, I made a spreadsheet classifying each exercise by its primary muscle group, and devised 3 routines with a balance from each group. Then I took THAT back to here for "approval". She just shook her head and said, "yes, that's fine."
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [Tom_hampton] [ In reply to ]
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Whoa!! Talk about eye opening. I do this ALL the time. What PT workouts are you doing?
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [BrentwoodTriGuy] [ In reply to ]
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BrentwoodTriGuy wrote:
Whoa!! Talk about eye opening. I do this ALL the time. What PT workouts are you doing?


From memory as a start (I'll edit with more when I get home and find the sheet):


NOTE: All motions are done SLOWLY. typically 1-2s in each direction, or whatever. the point is always to keep everything still that isn't specifically being moved. Tighten your core muscles, hold trunk/hips stable, perform movement without moving trunk/hips, repeat on alternate side. That's pretty much the pattern throughout. Coordination, strength, and stability.


NOTE2: Many of these were painful for my injury when we first tried them. In which case, we would delay their use for another week or two (or find an easier version) until I could do them without pain the following day.

NOTE3: these were prescribed to me for my specific condition (athletic pubalgia), and based on an in-person assessment of my muscular weaknesses. YMMV. if you have an injury, see a doctor and a PT for your specifics.

Theraband looped around ankle, stand straight on opposite leg, with leg extended pull to foot to midline in in all 4 planes:
1. from front to midline.
2. Fron rear to midline.
3. From side to midline (adduction).
4. From midline to side (abduction).
Repeat each (1-4) 10-20 times on both legs. Advanced version: stand on a thick folded blanket of something unstable.

Sit on an exercise ball. Back straight, hips centered on ball, feet shoulder width apart, hands resting in lap. Alternate Lifting each leg (one at a time), and hold for 5s. Keep back straight, hips aligned. The idea is to not "move" when you lift each foot. Repeat 20 times for each foot.

Standard elbow planks. Hold position 30s, rest, repeat 10 times.

Side Planks. Lift into position, hold 30s, rest, repeat 10 times.

Planks in a push-up position. Hold position 30s, rest, repeat 10 times.

Planks in a push-up position, lift one arm and hold 5s. Switch arms 5s, rest, repeat 10 times.

Planks in a push-up position, lift one leg and pull knee to opposite arm under body. Hold 5s. Switch legs, repeat 10 times.

On all fours. Lift one leg and slowly extend straight back. Key here is to hold your hips, and spine in the same alignment as if you were still on all fours. Think like you have a glass of water in the small of your back. Bring leg back, and switch legs. Repeat 10 times.

On all fours. Lift one leg like a dog peeing on a tree. Key here is to hold your hips, and spine in the same alignment as if you were still on all fours. Think like you have a glass of water in the small of your back. Bring leg back, and switch legs. Repeat 10 times.

Lay on back, with knees bent. Place a soft 6" ball between your knees. Squeeze and hold for 5s. Repeat 30 times.

Lay on back, with knees bent. Place a soft 6" ball between your knees. Squeeze and, and pull knees to chest. Hold for 5s. Repeat 30 times.

Take a blue theraband, and tie it in a loop about shoulder width apart. Loop around both ankles. side step, slowly. Step with the leading foot, put foot down, left trailing foot and slowly move back to shoulder width. Each step sequence should take about 2s. Take 5 steps right, and then 5 steps left. Continue stepping for 2 minutes.

With same blue theraband, do monster walk for 2 minutes. Basically, you take wide steps holding tension on the theraband the entire time.

Exercise Ball roll outs. This is harder to describe. You start on your knees with the exercise ball in front of you, almost touching your chest. Then you push off with your feet, and roll the ball with your chest, and torso. You walk out with your hands as the ball rolls back to your ankles. You hold your abs stiff so your body doesn't sag. Once the ball gets to your ankles, stop and hold for 5s. then walk your hands back until the ball is back to your chest. Repeat 10-20 times.

...more to follow....
Last edited by: Tom_hampton: Sep 17, 19 15:43
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Re: Lower ab / groin area soreness. Thoughts on how to strengthen? [Tom_hampton] [ In reply to ]
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I did a handful of these exercises with nothing more than a band to try and activate the muscles before I went for a 8 mile run.... and wow, I was actually a little sore on the glute medius the next day! Definitely going to continue!
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