PSOAS HIP FLEXOR Pain/Tightness ... Weakness

Triathlon Forum
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Super Newbie Triathlete, 5 months training high volume with naturally embedded high intensity intervals, can produce sub 40 minute 10K and FTP of 260 on the bike. 30 Years old 160 lbs

Have had problems with early onset fatigue/weakness/pain of medial glute on long hilly rides (3+ hrs/50+miles)

Also have had problems with hip flexor pain and tightness resulting from higher intensity run efforts.

Recent coaching efforts has moved me from high volume (high intensity intervals) to low volume high intensity interval work to improve power and speed in the offseason.

PT have told me in the past that I have weakness in hips and hamstrings which I want to address by doing only core/hip training for 2-4 weeks minimum… Coaches vehemently disagrees, advocates ART Physical Therapy (regular 50$ 2x week) and pro bike fit (300$)

aka more money spent on regular maintenance. I have spent 8 K on bike, another 10K on apparel in the last 3 months making sure I have everything to train through the NY winter inside and out. I am not looking to spend this additional money 1. because i don’t have it at the moment 2. because I don’t believe regular physical therapy cannot be 1. completed primarily at home 2. is or should become a required part of any sustainable training regiment.

I have done tons of research both on experimentation on my own body with time/effort to fatigue/pain/tightness of the areas I am having an issue with (Hip Flexor, Medial Glute PSOAS)

I have also done mountains of research (books, online ect) on the myriad of different fixes to some of these problems.

I have apparent weaknesses on my left side (medial glute, hip flexor, core) and I only have problems on this one weak side. I refuse to accept that overtraining on a balanced (strength/muscular enduarnce hip/core) body would result in these same one sided issues I am having and have redirected all priorities to restoring balance and improving overall strength in core/hips above all other multi-sport training goals right now

This has erupted major conflict with coaches. I refuse to continue doing training efforts I know will result in injury. Coach is absolutely and personally offended by my unwillingness to walk the plank for him and just continue mindlessly against the grain of my bodies limitations. Looking to terminate coaching services as a result of such a personal response to the occurrence of an injury and reluctance/unwillingness to adhere to sessions which i know will precipitate and aggravate pain/injury symptoms.

Because I know only what I know about training, injuries ect I would love for some feedback from anyone with the experience to warrant providing feedback TIA :slight_smile:

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  1. Your coach is an idiot. Fire him immediately.
  2. If you have only been training for 5 months, and you are at a legit “high volume”, you are doing too much too soon. It takes a long time for connective tissue to respond to training stimulus (months, years) while aerobic and muscular adaptations occur much more quickly. Think long term.
  3. How did you establish this “weakness”.
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I was coached for the last 1 month under a new coach who has moved me off high volume to deal with my apparently massive overtraining, directly to high intensity low volume schedule, which has been disastrous to maintaining a sustainable training schedule. In the defense of the newer coach he’s provided me with far more time (uncharged) and is nearly unmatched in enthusiasm for my training and performance, perhaps even to much. I’ve tried desperately to latch onto the low volume high intensity bandwagon, so much so that I often catch myself running sub 7 min/miles immediately off the rip on some of my runs. It took me months to be able to even control my pacing to the point I could achieve 10+ mile run training sessions. That pacing self-control was lost as I attempted to settle on a “higher intensity” mode of training. Which is absolutely my own fault but regardless I’m having great difficulty with injury at present. I believe jumping from high volume with naturally embedded interval work into outright high intensity focused training occurred to abruptly and my inability to adjust the appropriate intensity mentality has become a problem.

Prior to the last month I was coached by two different coaches from another coaching group, one who was severely unqualified to coach (as per athletic community) whilst the other lacked any apparent enthusiasm for the sport and was inclined to push me into 1 on 1 sessions at a 100$ a clip which I just couldn’t justify the value for the cost of the session.

I established the weakness of hip flexor/hamstring/core through previous assessments by a physical therapist, as well as conducting ta variety of core/hip exercises and tests where I was able to consistently produce premature fatigue in the left side hip flexor/core/hamstrings.

The weaknesses are quite glaring. They are additionally pronounced in my running stride which conveys vastly different stride mechanics between my right and left side (left side being the issue).

I have moved off a 150-250+ mile a week volume total between run and bike to about 50-75 miles a week on the bike or less, and about 10-15 miles on my runs (at coaches adamant request) . I believe the coach knows the fundamentals of coaching better than some but also believe his belief that he knows my body better than I do is a glaring and fundamental error of logic and reason that conflicts with my own personal ideology which places my own gut instincts ahead of virtually all other components within the coaching equation. I won’t walk the plank for any coach, I love the duress of hard long brutal training that leaves me crying for mommy at the conclusion but at the same time I know well in advance when a particular session is not going to bode well for me in the debilitating injury department. When acting on coaching guidelines I will tend to ignore these cues from my body to push through for the sake of completing the session but will do so at the expense of my body and my ability to train in successive days.

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Just make sure you get any trucker hats that the coach may owe you prior to firing him.

5

I’m owed a few actually…

6

I had a feeling that might be the case.

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Aside from the GREAT advice of making sure to collect all relative apparel from said coaches, do you have any additional, perhaps specific advice regarding muscle imbalance, or adjusting to a low volume high intensity training regiment without provoking unwanted, training disrupting injuries …

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Coache advocates ART Physical Therapy (regular 50$ 2x week) and pro bike fit (300$)

aka more money spent on regular maintenance. I have spent 8 K on bike, another 10K on apparel in the last 3 months

You spent 18k on gear and don’t want to spend $300 on a bike fit?

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have already had a bike fit done at two separate bike shops, one was done for no charge from my personal bike shop(where i work) the other was done for about 250$ and its adjustments from the original fit were at or below 1 mm in any direction. I don’t believe based on what I know that the difference between a bells and whistles bike fit are vastly superior to those of a less scientific bike fit done using a plumb and an angle finder. Could a bike fit improve my overall comfort on the bike, absolutely. Could bike fit be resulting in a pain/tightness primarily precipitated by a running effort … NO it can’t.

Thank you for making the observation that I’m being cheap, I was just thinking the same thing…

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psoas treatment, I used a foam roller grinding into that area. After swims, in the pool high leg front and back kicks, leaving the leg hanging in the back. I am back in the game. This injury almost put me out for good. To maintain fitness I was biking more and doing stairmaster (no holding railings)

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If it’s the same hip flexor/psoas pain I was getting earlier in the year, try looking at your cleat position on the bike. If it’s too ‘toey’ then move it more midfoot, or even jam it back as far as you can go. That’s the way I have my shoes & cleats set up. That way, you will engage the glute more and consequently need less recruitment of the hip flexor. Less hip flexor means less psoas irritation, which was the case for me anyway. Worth a shot maybe

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  1. too much, too soon
  2. you don’t trust your coach, might as we’ll get rid of him
  3. hip flexor psoas is due to over use and usually from a change in use of the muscle and connecting tissue
  4. art and bike fit sounds reasonable. You need to treat current injury and mitigate mechanism of injury. Bike fit can be more scientific than eyeball.
  5. this one you’ll hate. Stop all activity, start therapy. It will take at least a month.
  6. get off high interval training. Once per week per discipline is enough, rest should be base training (saw your profile and desire to do IMLP).
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  1. too much, too soon, absolutely agree, I had previously experienced bouts of this injury earlier in my training when attempting very high volumes or very high intensities to soon. I am literally no more than 5 solid months of training into Triathlon Training. However this most recent injury was generated from multiple consecutive high intensity run efforts
  2. absolutely do not trust my coach… trust him in his superior knowledge of training to that of my own, but do not trust him in the slightest regarding his responses to my feedback about my body, actually find it almost bizarre the way he responds to the feedback I have been giving him about becoming injured, he was personally offended …??? and has been giving me nearly endless $h%it about not completing training sessions because of injury … This is/was to be perfectly honest the end of what limited amount of trust I had in him
  3. Agreed and have a pretty decent understanding of the mechanisms of the muscle and its connectors,
  4. the ART and bike fit are reasonable options, I’m just in a state of annoyance over the injury and wanted to deal with it first and foremost
  5. I know I need a break but I will only take as much time off as I absolutely need to … I won’t push myself through the injury but will likely hammer my core/hip flexors with strengthening exercises any time I get a glimpse of daylight from the pain I’m having

***6. getting off high interval training,… can you elaborate on why … aside from the obvious of increased chance of substantial injury ect ect … I have literally had to listen to about 10 hours of why I have to be doing tons of high intensity in place of my more volume based training and would love to hear why this is right or wrong … or both… the point of the HIT was to build my speed and power in the off-season, this is sound logic but there are some flaws in the logic when explored in depth

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High intensity training. A lot of different opinions on ST and the world about training methods.

First, I believe your goal is 140.6 distance correct? IMLP in 2015? Second, you are 30 years old? Third, I have no knowledge to your athletic background nor what god given gifts you were born with.

Those facts given, it’s my firm belief that high intensity is great if you have the ability to recover quickly from each training session. I won’t go into testosterone levels, but I will assume you are average. This means that you need to recover well, not just rested and ABLE to perform the next day, but actually fully recovered. If you are injured, I assume you are not fully recovering after each high intensity session.

It’s also my belief that high intensity needs to be eased into. 1 session of each discipline once per week. As you build into the sport, you can go to 2 each. But every workout? Not recommended.

Most of us have been in your shoes. Some of the better AG athletes on here did it the same way. We found a new cool sport we could try, we did pretty well at it, liked it, and decided to heavily invest in it. We worked hard and saw fast results. Maybe got by for a year like that. Then the injuries started. And we bought doctors, training tools, massages, supplements, magnetic bracelets and squatty potties. And we all have stepped away at some point due to boredom, injuries, or frustration, and most of us came back stronger. Why? We needed to recover.

I know you don’t want to hear that it takes time, but it does. I know, you are different. We all were.

IMLP is in July. You have time to do it right. Get rid of the injury, completely, then start back up. LD training involves a LOT of volume and SOME high intensity training.

A friend that goes to Kona every year in the 40-44 ag (actually ages up this year), does all LSD with the occasional high intensity. Sub 10 at IMLP every year. Usually top 5. He runs 9 pace or slower on most of his runs. IMLP, 7:15 or faster. Swimming, on the 1:30, at best in training. Always a sub hour guy at IMLP. Cycling, 4 hours or more on the trainer on the weekends, 2 hours a few times per week, some times intervals, some times just turning over the pedals. In the spring and summer the long rides (100+ miles) are usually constant power, not up and down, but steady. Maybe a few intervals inside. He’s usually top 3 in his AG for the bike. I marvel at how slow and consistant he is in training and then how he can hammer it in a race.

The point is, you can hammer your muscles every day, and they typically recover because they get pretty good blood flow. Tendons and ligaments, not so much, so it takes longer for them to repair. When they break down, you don’t notice it because your body will try to compensate and use other muscles or soft tissues to balance you out. But then they get injured too because you haven’t stopped and it just gets worse. Give your body time to rest in between hard sessions.

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How exactly is the weakness showing up?

I had this odd situation where I could bike fine (and quite well actually) , but the second I began to run (regardless if it was off the bike or a stand alone run), my left leg would buckle underneath me on my very first step.

After seeing a bunch of different people I finally found someone that diagnosed the problem on the spot (after jambing his finger into my left glue and me nearly hitting the roof) .
Tight medial glute meant pressure on the nerve which meant my left leg just wasnt firing and would buckle beneath me. Some stretches, manual therapy as well as nerve flossing had me sorted within the hour.

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If you’re the type who does a lot of research when you get a problem like the one you presently have with your hip/psoas - and it’s pretty clear you’re quite resourceful (a good thing) - then you can accomplish a lot at home with a foam roller and a massage ball. So your PT is partly right. That said, I have found that one of the most beneficial training tools I have is an excellent working relationship with a good massage therapist. So I see where your coach is coming from when he advocates weekly ART. I don’t think you need to go twice a week, whether it’s ART or deep tissue (read: painful) massage, but once a week or every two weeks during your peak season will be extremely useful in minimising the probability of injury. Your massage therapist can give you a lot of feedback about where things are tight, scar tissue they feel as they work around particular groups, and changes from week to week. Finding a good massage therapist, which means one with strong hands and who has a sixth sense when it comes to locating problem areas, and seeing them weekly to work on the psoas and hip flexors will help address that particular problem and probably help you become more aware of any weaknesses you have. You can then go home and continue to work on those areas with a foam roller or whatever works. Massage therapists tend to be less expensive than PT, at least where I live.

As for your coach, it doesn’t seem to me that he’s wrong. However, I do find his behaviour odd, and that would be enough for me to question how well he receives feedback and adjusts his own plans for his athletes.

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I’m curious how you have spent 10K on apparel in the last three months. That seems peculiar.

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Weighted step ups.
Get a platform that’s stable and about 14" high. I cut down an old heavy, heavy coffee table. Start with no weight then got to 3 lb then 5 lb ankle weights. try to maintain about 22-24 steps per minute. do a minute each leg. do this for an hour. yes, an hour or more. be sure to do a complete step up - put R foot on platform, step up, put L foot on platform, step down with R foot, step down with L foot, repeat.

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Is this thread a wind up?

My advice would be to a) stop people fleecing you of your cash and b) establish whether your Physio is decent and, if he is, stop pretending that you or your coach know your body more then he does c) stop jumping from one method of overtraining into another method of overtraining and then wondering why your body is not able to deal with it.

Start at the bottom and work your way up, not the top and fall down.

“… I love the duress of hard long brutal training that leaves me crying for mommy at the conclusion …” I think you missed your true calling … CrossFit. Triathlon requires a bit more grey matter than that.

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Check out this site for some stretches. The first stretch has really helped me open up my hips for running, as I have biked more that run recently. http://www.runnersworld.com/health/move-those-hips