Cycling and Hip Flexor

[Jason E]

So I thought I was sore on day one, now a few days later I realize something is up with my right Hip Flexor. Gonna see if I can get an appointment, as its irritating as all frack, but in the short term immediate... RICE.

I'm thinking that with some easy stretching and a little discomfort I can throw my leg over the bike, but I am thinking, possibly wrongheadedly, that once I'm on the bike I'll be fine. Go easy, warm up, feel good.

Am I wrong? I know I should not be doing wind sprints and jump rope barefoot on concrete, but how is cycling on the road back from this irritation? Is it more irritating, or helpful?

If it is worse then resting that's fine, but how long am I going to be off? A week? 3? I would rate this as a mildly irritating pain that gets worse later in the evening.

JE

[bargainguy]

I'd stay off the bike for a little while at least. Last thing you want is for this to become chronic. Have you done any particularly difficult training lately?

We're talking three muscles in the hip flexor -- iliacus, psoas & rectus femoris. The last one is part of the quads. First two attach to the spine & pelvis / femur. Sometimes you can overcompensate with the quads if you're not flexible enough and/or don't have enough core strength and are really trying to push it, which leads to tight muscles in general & eventually strain if you go too far.

I'd favor your RICE approach (although compression in this area might not be easy), and if it were me, I'd starting taking a fairly large dose of your favorite anti-inflammatory (naproxen, ibuprofen, aspirin -- acetaminophen not so much) to kick down the inflammation as much as possible while you're healing. Others may disagree with the anti-inflammatory approach but I've found this most helpful at least for myself. Don't forget to drink plenty of liquids while you're taking anti-inflammatories so that you don't put a large strain on your kidneys.

Once you're off the bike and not doing anything particularly strenuous for a couple days, you can do some gentle stretching & let the pain guide you as to how far to go. Then you can start working on core strength & flexibility so you don't go here again. I don't think anyone can give you a timeline on returning to the bike, let your pain or lack thereof and your overall general constitution guide you.

Good luck!

Don

[Louis]

Then you can start working on core strength & flexibility so you don't go here again.

So other than going to a PT, how does one figure out the best way to accomplish this for the hip flexors?

[bargainguy]

Doesn't just have to be a PT. Any number of professionals can help with this.

A chiropractor who specializes in sports can help with any misalignment or balance issues. Some personal trainers have a good working knowledge of core strengthening, training & flexibility. A sports medicine clinic can evaluate you and engage you in different modalities based on what they perceive to be the issue, which will be more specific than any "over the phone" consultation like this.

You can do some stretching exercises for hip flexors on your own. Knee to chest is one, either singly or both legs at a time. Standing hip flexor stretch -- one foot in front of the other, slide both hips forward without rotating & keep the back straight, you'll feel a pull on the hip of the back leg.

These will help the flexibility part. As to core strength, lots of different ways to go, but anything working the abdominals will help. I'm old school situps and leg raises with holds here. Increase gradually and don't try to do 100 situps in a row if you haven't done one in awhile, you will regret it!

Don

[Ti Designs]

Have you added and varus (tilt of the foot to the outside), changed the Q factor of the bike or changed to a pedal system with more lateral stability? I ask because in doing fittings and trying to get better knee alignment, there's often a trade-off with hip flexor issues.

[Jason E]

Have you added and varus (tilt of the foot to the outside), changed the Q factor of the bike or changed to a pedal system with more lateral stability? I ask because in doing fittings and trying to get better knee alignment, there's often a trade-off with hip flexor issues.

No, I am an idiot and was going jump rope with my 7 year old daughter. Pushed it cause Im dad.

I appreciate the advice, I'll skip this weekend and work In seeing someone in short order.

Great advice all around, thanks.

[Ginger]

A million opinions on the internet...

So...you mention day one...did you go out too hard on the first day back on the bike outside after sitting at the computer all winter? Or did you swing your leg over your bike with enthusiasm? Hyper extension could do it too. Or have you been doing standard situps? Back on the bike immediately withut much of a clue will just irritate it more.
*The jump rope post came in while I was posting this...that explains much...*

See a pt or a massage therapist and get your hip flexors released, all of them, if they don't know what you're talking about, get off the table. A good one will listen to you then do their own investigation...ask them what they find. Your hip flexor might be trying to protect a muscle that isn't firing. Oh...and the first time,when they're really tight, releasing them will hurt if they're doing it right. The second time it's not so bad. Pay attention to what they do and ask them to show you how to release them yourself. I can release most of mine while I'm walking. Go to the massage therapist who does know once a week for a couple months until your hip flexors, and odds are your itb and periformis are calm again.

For antinflammitory, fish oil (nordic naturals, microfiltered, about three teaspoons a day, you stink like fish even with the flavored stuff, but it works for me. Hope it works for you because it's better than filling yourself with drugs...unless you like that sort of thing.)

learn the appropriate stretches for all the muscles around the hip,(Bob Anderson's stretching book is an old chestnut, but it's well known for a reason) and start doing them gently once the flexors calm down. If the PT is good, they'll give you exercises and stretches to do. Even the massage therapist should be able to show you what you can do to help yourself. Make sure you stretch all the muscles around the hip gently...You may have to keep it up for months.

Yes with core strength, but I disagree with the standard situps, and leg raises. So many people do them with their hip flexors. Aggrevates the situation. Stop those for about 14 days. go to a pro and make sure you're doing your core stuff right.

Take your time...7 to 14 days off the bike if they're really really bad...because that's how long anything takes to heal...(between 14 days and 8-15 weeks. :) but with the hip flexors, as long as you maintain once you're back on the bike...a shorter time is more likely...)

And no. I'm not a professional at all, I just have hip flexors that have abused me for many years. :) And I asked my first question because it takes just one overstretch while getting on your bike to give you a week or two of pain in the hip flexor if it's gonna be crabby.

Good luck!

[tele]

Good advice above!

I did something similar early last year to one of my hip flexors. Ending up spending a month off the bike cause even when I thought things were getting better I pushed it back on the bike and prolonged the healing. Went to pt which was ok, some good stretches and all, but then got started doing core/weight training and I believe my overall strength has improved--which has led to hip flexors being stronger etc....

It really sucks to stay off the bike but it is necessary to let things heal.

[benb]

I have not hurt my hip flexors but a few years ago when I landed in PT with a knee injury the PT immediately noticed my hip flexors showed an extreme lack of flexibility and said it is very common with cyclists because we spend so much time bent forward. (And they tighten up even more if you're stacking cycling on top of a desk job.)

I've been working hard on keeping them flexible ever since.. we all should. It seems to help a lot with knee issues to say nothing of the hip itself.

If you've managed to actually pull one.. definitely think about flexibility as you rehab it.

[bargainguy]

A million opinions on the internet. Isn't that what makes the web great?

What the previous poster is talking about is myofascial release, or MFR. The fascia around the muscle becomes so restricted that normal muscle function is impossible, and pain/inflammation often result. Release the fascia and you let the muscle work normally.

That's great -- if that's what it is, and I'm not convinced yet. Surprised the poster didn't know the term for the correct therapist here, as not all massage therapists and PT's are certified in MFR; most are not. It requires quite a bit of specialized training beyond the norm.

My wife is certified in MFR, and she says that there are many possibilities here other than fascial restriction. Not only could you have hip flexor strain, you could also have hip flexor tendinitis. Anyone who's had tendinitis of any sort knows how aggravating it can be. It needs to be treated gently.

I knew I'd stir up some controversy with the anti-inflammatory suggestion. Personally, I find NSAID's much more effective than fish oil especially in the short term, but to each his own.

As to situps and leg raises, I didn't mean do them immediately. If you disagree with this as a general rule, well, I can live with that. You can do whatever core strength exercises feel right for you. These work for me.

Don

[sc53]

Yo Ginger! :p So great to hear from you!! Glad you are still checking in. Hope life continue to be good down under!! :hello:
A million opinions on the internet...

So...you mention day one...did you go out too hard on the first day back on the bike outside after sitting at the computer all winter? Or did you swing your leg over your bike with enthusiasm? Hyper extension could do it too. Or have you been doing standard situps? Back on the bike immediately withut much of a clue will just irritate it more.
*The jump rope post came in while I was posting this...that explains much...*

See a pt or a massage therapist and get your hip flexors released, all of them, if they don't know what you're talking about, get off the table. A good one will listen to you then do their own investigation...ask them what they find. Your hip flexor might be trying to protect a muscle that isn't firing. Oh...and the first time,when they're really tight, releasing them will hurt if they're doing it right. The second time it's not so bad. Pay attention to what they do and ask them to show you how to release them yourself. I can release most of mine while I'm walking. Go to the massage therapist who does know once a week for a couple months until your hip flexors, and odds are your itb and periformis are calm again.

For antinflammitory, fish oil (nordic naturals, microfiltered, about three teaspoons a day, you stink like fish even with the flavored stuff, but it works for me. Hope it works for you because it's better than filling yourself with drugs...unless you like that sort of thing.)

learn the appropriate stretches for all the muscles around the hip,(Bob Anderson's stretching book is an old chestnut, but it's well known for a reason) and start doing them gently once the flexors calm down. If the PT is good, they'll give you exercises and stretches to do. Even the massage therapist should be able to show you what you can do to help yourself. Make sure you stretch all the muscles around the hip gently...You may have to keep it up for months.

Yes with core strength, but I disagree with the standard situps, and leg raises. So many people do them with their hip flexors. Aggrevates the situation. Stop those for about 14 days. go to a pro and make sure you're doing your core stuff right.

Take your time...7 to 14 days off the bike if they're really really bad...because that's how long anything takes to heal...(between 14 days and 8-15 weeks. :) but with the hip flexors, as long as you maintain once you're back on the bike...a shorter time is more likely...)

And no. I'm not a professional at all, I just have hip flexors that have abused me for many years. :) And I asked my first question because it takes just one overstretch while getting on your bike to give you a week or two of pain in the hip flexor if it's gonna be crabby.

Good luck!

[deechee]

I have hip flexor issues which cause back problems for me. I sit at a computer all day. Getting up and walking around once an hour helps a lot. That said, the last time it got really bad I would do 1-2 hour walks (walk home from work) and I found that kept my fitness up and opened up the hips. (I also live in a hilly area.)

Working on everyday posture helps a lot too.

[Ti Designs]

No, I am an idiot and was going jump rope with my 7 year old daughter. Pushed it cause Im dad.

I'm not so good with jump rope injuries...

[Climb01742]

i also have hip flexor issues, particularly on my right side. the human body is a complex and mysterious thing. perhaps the single best piece of 'wisdom' i've picked up over the years regarding injuries is, where it hurts isn't always where the cause is. example: i see a great chiro regularly and 9 times out of 10 when my right hip flexor is screaming, he works on my left side (with special emphasis on my left shoulder) and without ever touching my hip flexor, the discomfort and weakness is 100% gone. go figure. my point is: we often treat symptoms without getting at causes, and causes can be far from the symptom. try to find someone who will look at your entire kinetic chain, and all the X-pattern muscle relations that criss-cross the body. hope you find help!

[MadRocketSci]

i was a sprinter in hs and suffered an avulsion fracture due to an overly twitchy hip flexor during a 200m race (still managed not to come in last :)). Before that, the flexor was nagging me with some inflammation, tightness, and a little soreness. I'm not sure how i could've prevented the injury, but i'm guessing that additional stretching of the muscle, trying to strengthen it slowly with some circular leg lifting motions, and RICE might've helped.

I still do some of those thing now just as part of a stretching routine and haven't had any problems, so just don't push it too hard when its feeling wonky and you hopefully won't have problems. If it's still bugging you i'd consult a PT.

http://www.mayoclinic.com/health/avulsion-fracture/AN00200

[firerescuefin]

i also have hip flexor issues, particularly on my right side. the human body is a complex and mysterious thing. perhaps the single best piece of 'wisdom' i've picked up over the years regarding injuries is, where it hurts isn't always where the cause is. example: i see a great chiro regularly and 9 times out of 10 when my right hip flexor is screaming, he works on my left side (with special emphasis on my left shoulder) and without ever touching my hip flexor, the discomfort and weakness is 100% gone. go figure. my point is: we often treat symptoms without getting at causes, and causes can be far from the symptom. try to find someone who will look at your entire kinetic chain, and all the X-pattern muscle relations that criss-cross the body. hope you find help!

^^^This...more likely a symptom than a cause IMO.