Hip Flexor Injury.The hip flexor injury is one I see on a regular basis. It is one of those injuries that frequently get misdiagnosed as something else!
However, I rarely fail to spot it as I suffered from it myself five years ago!
Your hip flexors are made up of three main muscles:-
- Iliacus - which attaches from your iliac crest to your femur.
- Psoas major - which attaches from your lumbar vertebrae to your femur.
- Rectus femoris - which is the only one of your quadriceps muscles that crosses your hip joint, and hence it is involved in both knee and hip movements.
The most common type of hip flexor injury that I see happens as a result of them being too tight. When your hip flexors become too tight they can pull your pelvis forward into an anteriorly tilted position. This, in turn, places excess pressure on your lower back often resulting in lower back pain.
When your pelvis is tilted too far forward, it eventually causes your tummy muscles to weaken over time. This is because no one muscle works alone, they work as a team, so if your hip flexors are injured there will be other muscles affected also, the usual ones being your abdominals and bum muscles!
So, if you have a hip flexor injury you must attend to your tummy and bum muscles as well.
It is very difficult to know when your hip flexors are tight. I call them the "silent but deadly" muscles! The most common symptom of hip flexor injury is lower back pain or pain at the front of your hip. However, there are many other possible causes of lower back pain and anterior hip pain so always seek a qualified therapist's advice to ensure a correct diagnosis!
Each bone in your body is designed to be in a very specific position. It is your muscles and ligaments that hold your bones in these correct positions. They are like the cement around the bricks! If your muscles become tight the result is often that the bones attaching to the affected muscle are pulled out of alignment. This faulty alignment causes excess pressure on the affected joints often resulting in pain and stiffness.
So, when your hip flexors are tight they pull your pelvis out of alignment, placing excess pressure on your back and hips, often resulting in back or hip pain.
Treatment of hip flexor injuries will as always depend on the cause. I always aim to remove the cause of your hip flexor injury and then continue to fully resolve your injury with manual treatment techniques.
Treatments include stretching, soft tissue release techniques, strengthening exercises and trigger point therapy. A chartered physiotherapist or physical therapist will guide you on the most effective treatment of choice.
Once the diagnosis is correct the treatment will be quick and effective in most cases. A correct diagnosis is the key! Always seek the advice of a medical professional experienced in hip flexor injuries.
Recently I treated George with a hip flexor injury. George was a 37 year old engineer. He complained of right sided lower back and hip pain. It had been present for three months but was slowly getting worse.
Six months ago George changed jobs. He had been a field engineer which involved a lot of walking and moving around. Since then his job changed to a desk job where he was working on a computer for nine hours a day.
When I assessed George I found that he had a big arch in his back known as a lordosis. When he was sitting he sat with his pelvis tilted forwards which, in turn, increased the depth of his lumbar lordosis. His hip flexors were tight and overactive and many trigger points were palpable.
His weight was hanging on his lower back as he sat. George stood in a similar posture.
As a result of his posture, his hip muscles were being held in a shortened position and over time had become too short, which then effected the movement of his hip and lower back. In this lordotic posture his abdominal muscles were not being asked to work so they had become weak and inhibited. Similarly his bum muscles were lazy!
The cause of George's pain was primarily his posture. To help him correct this I released some tension in his hip flexors and showed him how to do the same using stretches and trigger point techniques. I taught him how to sit with his pelvis and spine in their correct position and I gave him some strength exercises for his bum and tummy!
After two sessions his pain had reduced by 50%. I advised him to continue his home programme and asked him to come back to me 4 weeks later. At this stage he was pain free with almost full length in his hip flexors. I suggested that he continue the hip stretches and I increased the strengthening program for his bum and tummy muscles.
Overall George did very well!! Identifying the cause of Georges hip flexor injury was the key to the quick resolution of his pain. George's posture was the main cause of his condition and with early detection was easily resolved. Poor posture is a very common cause of hip flexor injuries. Always seek an expert's advice with hip flexor injuries.
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Further References:Lower Back and Hip Pain
Hip and Leg Pain
Chronic Hip Pain
Lateral Hip Pain
Hip Surgery Recovery
Arthritis Hip Pain
Hip Pain at Night
Back Pain Overview
Back Pain Products
Back Pain Types
Back Pain Management
Specific Back Pain
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