Question: I’m trying to recover from a strain that seems to fall between being a groin strain and a hip flexor strain. It is a pain in the front/inside part of the hip. It came on during a easy morning run. No sudden stops or changes of direction preceded it. Is this a place where one can get an overuse injury? I find I can bike and powerwalk uphill but, after four days, running still tweaks it. I know you can’t diagnose this but, in general terms, what would you prescribe to speed healing, keep up fitness, and what can I do to help prevent its return?
Answer: I have found the following critical in recovering from and preventing hip adductor-hip flexor strain:
First, avoid the type of running that aggravates it (i.e. faster paced runs, uphills, downhills) and cross-train if all types of running make it worse. Easy five to fifteen minute runs on a mildly inclined treadmill (2-5%) can sometimes be done after or in the middle of a cross-training session to work on specific strengthening and ensure a smooth transition to running. Do not worry about pace or think you have to get a workout with this short run!
Second, strengthen your core with abdominal stabilization exercises (i.e. plank variations, etc.). Work on endurance 30-60 seconds for each exercise and do a 10-20 minute routine one to two times per day. A weak core forces the hip adductors and flexors to overcompensate and overuse strains develop. These exercises should be pain free! Add more core stabilization exercises with more leg movements as core strength improves.
Third, tight hamstrings can cause the hip flexors and adductors to work harder. Due to the large amount of sitting most of us do, we often develop tight hamstrings and hip flexors. Incorporate daily stretches of the hamstrings and try to take more standing, walking and stretching breaks during long bouts of sitting. In addition, lightly stretching the hip flexors and hip adductors should be done early on so thescar tissue forms strong, aligned bonds. I like to use the Active Isolated Stretching method. I have also found yoga warrior and triangle poses to be highly effective. Do NOT stretch into pain! All flexibility exercises should be pain free.
Fourth, make sure to strengthen the hip adductors and flexors with resistive exercises via gym equipment, pulleys, or elastic bands and tubing. Start with a very light resistance and one to two sets of high repetitions (20-40). Make sure these are pain free. Add resistance as strength improves continuing to work on endurance with high reps.
As with any injury, make sure it is properly diagnosed by a health professional and a specific rehab plan is established for your injury.