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Injuries and Rehab Tell us where it hurts! Do a quick search before asking about your shoulder injury to make sure your question hasn't already been answered (about 50 times), and read the sticky post first.

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Old 02-20-2007, 04:40 PM   #1 (permalink)
Caroline
Junior Member
 
Join Date: Feb 2007
Posts: 2
Default Chronic groin injury

Hello,

I have had groin pain for almost a year now. I’m going to summarize my problem then give more details about how it started and what I have done since the injury.
The pain has changed and sometimes even gotten better. It started getting better after I had ART (Active-release technique). When I first started the ART it was hard to open my hip out (meaning turning the knee out to the side). It felt tight and I would feel a locking and/or pinching feeling in the hip. This got better each time and even now is much better but still a little tight and occasionally get that sharp pinch. My inner thigh (groin area) was the originally site of injury and by the time I went for ART I only felt it when I would squeeze my thighs together. After about 6 weeks of ART my adductor started getting sore. It would seem better after the ART but a couple days after it would start hurting again. At the time I don’t remember what would aggrevate it but now I’m certain that it is movement or stretching. I stopped the ART and went to a joint rehab and sport med. clinic in LA. They do prolotherapy and laser light therapy. It seems better after the treatments but seemed worse after the exercises they gave me to do. The exercise that I think triggered it was hip flexion (lying on back and raising knee up using a band on foot for resistance). The second time I tried to do it without resistance and still aggravated it. The third time I was attempting to do a hip flexor stretch. It is hard to tell what I can and cannot do because it doesn’t happened right away it is after the stretch or exercise that I notice something is wrong.

I did have x-rays and MRI both showed nothing.

I also saw a sport medical doctor after about 5-1/2 months since initial injury. He said I had athletic pubalgia. He said do nothing for 6 months, no stretching or any kind of exercise. If it doesn’t get better he would recommend special type of surgery in Germany. He didn’t write this in the report but said that he felt there was probably a small tear that didn’t show on the MRI.

After about 6 weeks of doing nothing it didn’t seem like it was getting better so that is when I decided to do the ART.

Could something like this really heal with no stretching or exercise for 6 months?
Does anybody have any suggestions on what might be going?

Some history about the me and the injury.

I am 38 female adult figure skater. I have been skating for 7 years.

In April 2006 I stopped skating because of pain to my left adductor. The pain started gradually over about 2 weeks. Mostly occurred when attempting a single axel. I have been trying to learn this jump for years. The stress on the body was from the take off. I got a sharp pain when I would try to attempt that jump so decided I would take time off from skating. It was mostly only painful to touch and adduction. I had some massage and then a month later it seemed better. It wasn’t until I tried to skate that I could tell it wasn’t better and still hurt when I skated.

I then tried some acupuncture and physical therapy. The PT did deep tissue work and it seemed to be worse after. It was now hurting a lot to sit, mostly aching in my left buttock. It didn’t improve and the PT recommended I see orthopedic dr.and get MRI.

For 3 weeks before I went to the doctor I didn’t do anything… no PT, no stretching and it seemed better but still hurt to sit and felt locking, occasionally pinching and limited range of motion when trying to open hip (turn knee out). Doctor suggested I skated again before getting an MRI in the hopes if something was wrong it would show up better if aggravated.

So 3 months after originally injury I skated for about 1 hr a day for 3 days each day it seems a little sore (tight) but not really that painful to skate. It would get very sore after skating. The day before the MRI when I tried to skate I got the sharp pain again in inner thigh so I stopped. I had x-rays and MRI in July and both were unremarkable.

The doctor just recommended PT. This was a different PT and they did ultrasound. It didn’t help. I also got chiropractic adjustments and massage. 2-1/2 months of that still in pain. That is when I went to the sports medical doctor who told me I have pubalgia.

Since going to the Joint rehab clinic I have had another set of MRI with contrast and again unremarkable.

Oh I meant to mention that I have been a client of Alwyn Cosgrove. This was about 3 years ago and I was always doing off-ice training to stay in good shape. I do know there must have been a weakness to this left adductor area because I have injured the same area before I think at least 2 times in the last 7 years I had to stop skating because it hurt. The first time it recovered in about 2 weeks the second time was about 6 weeks.

Look forward to any suggestions.

Thanks,
Caroline
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Old 02-20-2007, 08:07 PM   #2 (permalink)
Bill Hartman
Bill Hartman Certified
 
Join Date: Apr 2003
Location: Indianapolis
Posts: 2,175
Default

Are you still seeing AC?

Lie on your back and do a straight leg raise on each side and compare.

If the affected side feels weak and your back arches a little when you do the affected side compared to the unaffected side, I have a good idea where to go with things.

I'm assuming that squatting reproduces pain as well, but forward lunge is okay?

Have they ruled out a sports hernia?

Bill
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Old 02-20-2007, 10:48 PM   #3 (permalink)
Caroline
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Join Date: Feb 2007
Posts: 2
Default

Hi Bill,

I haven't seen AC in a while but I e-mailed him about 3 months after my injury when it didn't seem like it was getting better. He recommened a a guy he uses locally that does ART (Dr. Bruce Hall) and he gave me your e-mail to contact you.

The sports medical doctor I saw in Sept. did say it was sports hernia. He is the one that said I should do no stretching or exercise for 6 months. I had hard time accepting this because it seem like he wasn't certain no conslusive diagnositc test, he said there was none. Then I tried the ART and since it seemed to help I didn't think it could be a sports hernia. However, talking to different chiropractors and doctors I get confusion on what really is a sports hernia. Is there any way to really know if it is?

I'm not sure about the back on the leg raise but I image it is off.
When I sit my butt and hamstring on the inside hurt and it pulls on my lower back.
It doesn't hurt to do squat but I imagine doing lunge would.

Thanks,
Caroline
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Old 02-21-2007, 11:09 AM   #4 (permalink)
Bill Hartman
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Join Date: Apr 2003
Location: Indianapolis
Posts: 2,175
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I'm confused. Did you actually do the tests? If not, could you try them.

Unfortunately, there is not definitive test for a sports hernia. However, if that is the case, surgery tends to be fix and stretching will only aggrevate it. That's not to say you don't have some other stuff going on causing the butt, hamstring, etc. It may also be a compensation for the groin symptoms.

Has anyone worked on your hip external rotators (piriformis to be exact) or taught you to stretch 'em? Any glute max activation/strengthing exercises?

Bill
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