So, I've got Iliopsoas strain...what do I do?

Here’s the lowdown. The MD diagnosed me with an iliopsoas strain. I’ve got a scheduled 1/2IM the weekend of March 21. I want to see if my plan to compete in that is feasible…

  • for the last 4 months, I’ve been running, almost exclusively. I’m in very good run shape right now. Very good = 15K is about 62 minutes. On a perfect day, maybe 60. Before I stopped running (mid-last week), I was consistently putting in 35 mile weeks. While that’s not superman, I was running great, ready to have a great A road race (that’s since been derailed…).
  • for the same time period, I’ve done plenty of core and strength training. Obviously, I pushed it too hard with these two and am in the situation I’m in.
  • I have not done much swim or bike at all in the last 4 months.
  • I’m going to try to schedule some PT to help with recovery.

So, for the next 4 weeks, I’m thinking I should take off from running, completely. Schedule would look something like this:
Monday AM - Hard Swim
Tuesday AM - Bike Intervals
Wednesday AM - Hard Swim
Thursday AM - Bike intervals
Friday AM - Hard Swim
Sa AM - Easy bike, no more than 90 minutes
Su - off
*Stretch every AM and PM, 15 minutes minimum per session.

All bike rides (unfortunately) will be done on the trainer. Intervals will progress as follows. I’ll do each of these workouts THREE TIMES, then move to the next one.
2x12
3x10
2x15
3x12
2x17
3x14
By the time I’m at my last set of 3x14, I’ll be two weeks from race day.

All swim w/o will be at public pool, and based on my most recent Oly plan. I did this, and I was in the best swim shape of my life. I’m very confident that I’ll be close to this shape come March 21.

Once I get to 4 weeks out, I’ll start back running 4-5x/week, three miles each day. Work back slowly for four weeks, and probably try to get an 8-10 miler a week to 10 days out from race day. If I don’t feel good with that, I’ll not follow that plan. (BarryP, you might get a PM from me.)

What do you guys think??

One bump only, promise.

Your plan looks well put together to try and help you work through the issue while not taking tons of time off. You’ll have to really listen to your body and PT as you try to add workouts while your muscle/tendon are still inflamed.

Onto my answer though. More than likely, the running is the main culprit as is sitting for extended periods of time without stretching the hip area. Potentially improper warm-up as well. So now the damage is done, but is biking and swimming the best things for it?

Because the tissue is inflamed, any activities that use the muscles (iliacus and psoas major) will potentially be aggravating. So make sure you continue to baby it and rest/ice/massage it after workouts.

Back to the workouts. Lots of kicking during swimming may use those muscles a bit, so a pull buoy is recommended or light kicking. On the bike (my specialty), your position will be very important (especially if intervals are being performed). The iliopsoas muscle group is most notably responsible for hip flexion (bringing knee toward chest) during cycling and running. So a position that is to low or long in the front or to far back in the seat will result in a tight hip angle and make hip flexion extremely difficult for the iliopsoas muscles in such a shortened position. Therefore, checking your position will be crucial to not continue any more irritation.

Secondly, the psoas major portion of the muscle also attaches to the lumbar vertabrae (lower spine) and is also responsible for back extension. This one is often a cause for issues that people don’t even know about. When your position is to low or long and is often compounded by a weak core (specifically transfers abdominals and back muscles) then the psoas muscle will contract to help use your spine as a fishing pole and try and pull all of your weight backward. This is noted by a prominant hump in either the upper or lower back. This will continue the aggravation at the tendon while biking, especially during intervals.

So the recommendation is to find a reputable bike fitter in your area who understands this concept as well as tri bike fitting (usually comes up more often on road bikes modified to a tri bike setup), and get a fit performed that will take into account the distance you are racing and your injury. Probably something where your bar is closer and higher. Continue the stretching (don’t overdo it) and strengthening along with lots of core stability type work.

I hope that helps and good luck

Ryan Ignatz, MS
F.I.S.T and Serotta Certified Bike Fit Specialist and SBCU Masters BG Fitter

Colorado Multisport
2705A Spruce St
Boulder, CO 80302
303-324-5954
ryan@coloradomultisport.com
www.coloradomultisport.com

Where Triathlon Lives

Well, i wont agree with the first responder. I m a bit alarm by your plan :wink:

if you have a injury and you want to jump in 3 hard swim and interval bikes right away, that just sounds very irealistic and not the best way to be back on your feet.

First off, it takes time before your body can go into 3 hard swim, you dont take 4 months off and jump back into like that. The secret of improvement and good racing is consistancy, your program sounds more like a heroic effort.

I would suggest you

-Start for 3-4 weeks with some relatively lower intensity swimming. 3X
-get on the bike and see if it flare up the injury or not… riding, some steady state, but nothing too hard at first other than short 1min repeat at threshold with same amount of rest.
-water running. I dont ssee the point of been 4 weeks away from running. If you want to do this half ironman, 3 water run a week, challenge yourself hr wise and i would be suprise if it take 4 full week for complete recovery.

and you dont start back running at 4X5 times a week…that s how injury happen. You start with 2…then 3…and build up slowly never doing more than 10% increase from week to week in milage. Those arent fun guide line to follow, but they are the gold run to long lasting good performance and improvement.

Heroic effort and workout dont have there place in a triathlete s program if he cares about the outcome in races… consistant steady work…

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