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Hip Flexor Injury Won't Heal [13 Months Now]
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Wondering if anyone else has dealt with this issue or has any advice. A little over a year ago I was doing a lot of Zwifting/Yoga/Strength Training. Putting in ~250 miles a week on Zwift, racing ~2 times per week. Yoga and some strength training daily. The strength training was body weight only, lots of glute bridges and planks, jump squats etc. Overall, fitness was good, but muscles were always a little tight, especially hamstrings. I overdid it one week on Zwift and raced a few days in close proximity. I was up out of the saddle sprinting and I felt something happen on front side (Right leg) of hip flexor, and it kind of wrapped around my side and into lower back. Stopped riding immediately and took it easy for a few days, and have been dealing with what seems like a classic hip flexor injury since then (but that was over 13 months ago).

I have done months of Airrosti, stretching, strengthening, yoga. I have not cycled in at least 8 months, and no running or swimming - almost everything I do seems to aggravate the injury, even yoga. At this pointy, my only exercise is walking ~5 miles per day listening to podcasts. Saw an orthopedic surgeon who did a dye injection MRI to check for labral tears (he did not find any). Eventually got a steroid injection into the bursa of hip flexor which did seem to help with pain, but a general weakness/imbalance is still present. The injection seems to have worn off, and still feels like a hip flexor injury.

I cannot seem to shake it, but really want to get back on the bike SOMEDAY. Hoping someone out there has dealt with similar and somehow resolved it?
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Re: Hip Flexor Injury Won't Heal [meatface] [ In reply to ]
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So if you've seen doctors do you have a diagnosis for what the injury was, specifically? As in, which muscle or muscles were strained (I'm guessing psoas or iliacus) and how severely, and/or whether you have tendon or ligament injuries as well, or some other uncommon linked injury (e.g., an avulsion fracture of the lesser trochanter)? Where does it still hurt?
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Re: Hip Flexor Injury Won't Heal [twcronin] [ In reply to ]
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I don't really have a diagnosis. Orthopedic surgeon said it must have been the hip flexor because the injection made it feel better (he didn't tell me which muscles, and didnt seem interested I guess since there was no surgery to be done). I should have noted he also had me do a MRI of lower back and didnt see anything there either. Both physical therapists I saw (1 Airrosti guy, 1 more Chiro style) kind of gave up and said it should have healed itself by now. So I never really got an official diagnosis from anyone. My symptoms: pain/weakness on right side in the crease on front side where quad meets the crease. I have tried slowly going back to running, and pain got worse each day until it became unbearable. Same with cycling. Even with walking, by the end of my walk it is really dragging and feels weak to lift leg. Super frustrating injury.
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Re: Hip Flexor Injury Won't Heal [meatface] [ In reply to ]
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You need to have your back examined and possibly your right hip. MRIs won’t answer your questions, but a good clinical exam from a PT will. Also, it’s really hard to tell from your mechanism of onset and pain description what might be going on. I’m sure there are many here eager to help if you can provide a more detailed history.
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Re: Hip Flexor Injury Won't Heal [meatface] [ In reply to ]
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I have torn labrums in both hips and had really good luck with pretty basic PT exercises, haven't had lingering pain in my hips in years but still continue to do some strength exercises. Probably took upwards of a 18 to get it completely cleared up (minimal break in running/cycling).


It sounds like you have something else going on though since your MRI was clean. Ever give thought to a sacral fracture? No experience with that myself nor am I a Dr but symptoms sound like that could be a possibility.
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Re: Hip Flexor Injury Won't Heal [hobbyjogger] [ In reply to ]
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hobbyjogger wrote:
It sounds like you have something else going on though since your MRI was clean. Ever give thought to a sacral fracture? No experience with that myself nor am I a Dr but symptoms sound like that could be a possibility.

Pretty sure a fracture would show up on an MRI. Also, pretty sure the Ortho would have considered a fracture...and, apparently is leaning towards an unspecified soft-tissue injury. These are notoriously difficult to diagnose with imaging---particularly in the complex lower-abdominal and hip structures.
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Re: Hip Flexor Injury Won't Heal [meatface] [ In reply to ]
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Maybe some focus on flutter kicks and scissor kicks will help to strengthen it.

https://www.strava.com/...tes/zachary_mckinney
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Re: Hip Flexor Injury Won't Heal [meatface] [ In reply to ]
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You really need a diagnosis. You'd probably be better served by a Sports Medicine doctor.

I've been through something similar in the same general area. A few years ago, I pulled my groin while treading water at swim exit waiting to climb out the ladder the day before an Oly race. I did the race anyway with enough drugs to mask any pain. After the race, and the drugs wore off, I could barely walk. Lots of pain in the lower left abdomen, adductor muscles coming up the inside of the leg, and in the crease about midway between the illiac crest and the pubic bone. I saw a Sports Medicine doctor (who treats the Dallas Stars hockey team---these types of injuries are very common in Hockey Players), and was diagnosed with Athletic Pubalgia/Sports Hernia. I saw a PT for about 4 months, and was given TONS of trunk stabilizer exercises to do. Only minor improvement while seeing the PT before my insurance "ran out". It took a long time to build up to being able to do many of these without pain. Any that caused pain, we'd hold off on and try again in a week or two. AFter my insurance ran out, I continued these for another 6 months or so on my own. It took a long time to get back to being able to run for more than 5 minutes---I didn't even try for 6 months...after that it was gradually adding a minute a day week-by-week. It was a year, before I could run for more than 30 minutes...more or less.

Here's the thread where I posted the exercises that I was given for my diagnosis. But, you should definitely see a Sports Med doc, and get a good diagnosis before starting anything. With an injury like this, you need a progressive plan of easy (least likely to do more harm) to more difficult (more likely to build strength) exercises...whereas the healthy can just jump right in. The general rule is not to cause more pain.

https://forum.slowtwitch.com/forum/?post=6957106

Good luck!
Last edited by: Tom_hampton: Aug 4, 20 9:42
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Re: Hip Flexor Injury Won't Heal [meatface] [ In reply to ]
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I had an injury that was also totally self inflicted (kicked a ball and somehow hit the field surface way too hard). That was in the beginning of 2017.
It nagged for good 2 years and finally went away this year.

Next races on the schedule: none at the moment
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Re: Hip Flexor Injury Won't Heal [meatface] [ In reply to ]
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FWIW, your symptoms are not aligning with a soft-tissue injury/pathology.

I would rule out peripheral neurological component by a qualified sports medicine M.D. as others suggested or a physiatrist that works in sports medicine that can do peripheral nerve testing. I am partial to the later;)

If you do not get a differential diagnoses you are shotgunning.

My spidey sense says you may have an impingement syndrome compromising a portion of the femoral nerve.

Cheers!
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