Pain Came Back with a Vengeance

by Jamie
(Michigan, US)

I am a 34 year female, I was pretty active prior to my injury. I was involved in a motor vehicle accident almost 14 months ago.

I was at a complete stop with my foot on the brake and was rear-ended by a truck going approximately 45-50 mph. My pain started in my low back and within a week spread to my right hip and leg.

My doctor ordered an MRI of my back and found 2 herniated discs at L5 & S1. I completed 3 months of physical therapy with some relief to my back region but not my hip, at which time I was referred to an orthopedic surgeon who ordered an MRA, which found a labral tear. I underwent labral repair in March 2013.

After 2 months of recovery time, with a daily regimen of stretching & strengthening exercises I had a significant decrease in pain. I slowly started to return to my daily activities such as work, short walks etc. Approximately 6 weeks after resuming activities my pain came back with a vengeance.

It would start in the groin area and radiate out around my hip bone and into my lower back and buttocks and also radiate down my thigh and at times in my lower abdomen. The pain can be relieved with narcotic pain relievers & rest but never completely goes away.

Upon physical exam I had significant weakness in the right hip with limited ROM. My surgeon then ordered a steroid injection of the Iliopsoas bursa. I had this done approximately 4 weeks ago. At first I had no relief but then for 4 days I had absolutely no pain. After that it was back.

After consulting with my surgeon he has recommended a Iliopsoas tendon release or lengthening as he feels we have exhausted all other options.

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Oct 31, 2013
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Fits the Profile of Iliopsoas Syndrome
by: Stephen from Lower Back Pain Answers

Hi Jamie,

This definitely fits the profile of Iliopsoas Syndrome/Dysfunction.

It’s not just the “tendon,” however, that likely needs treatment but both muscles that comprise the iliopsoas — the iliacus and the psoas.

The “tendon” is just the portion where these muscles join to form a common attachment. The tendon may also require direct treatment but just not exclusively.

One quick strategy you might try is to simply perform an iliopsoas stretch to see if it brings relief. But I wouldn't use a static stretch because this can provoke the protective stretch reflex. Rather I would encourage you to use the Active Isolated Stretching method I demonstrate here. Scroll down to Hip Flexors Stretch, 3rd stretch down the page.

My preference for this type of method is outlined in my article about Static Stretching vs Active Isolated Stretching here.

If that is either not successful or only partially successful then odds are good you will require manual therapy for these muscles with a qualified therapist.

You could search for one here.

Or you might consider learning how to perform self-massage for these muscles. Self-massage for the iliopsoas comprises Phase 1 of the 4-Phase protocol I outline in my 2-Disc DVD set, Healing the Hidden Root of Pain: Self-Treatment for Iliopsoas Syndrome.

The 4 Phases covered include:

Phase 1 — Self-Massage
Phase 2 — Somatic Movement & Diaphragmatic Breathing
Phase 3 — Active Isolated Stretching
Phase 4 — Toning & Strengthening

I hope this helps!

Best,

Stephen @ LBPA

Apr 22, 2015
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Auto Accident
by: Ellen

Thank you for posting your story, Jamie! I was in a similar auto accident 6 months ago. Sitting at a stop sign with my foot on the break, checking both ways before moving, when I was rear-ended by a pickup truck. I am guessing they were going 40+ mph since they claimed they "couldn't stop in time" and I know how fast one has to be going on that road to not be able to stop.

Ever since my accident, even after all other pain has mostly subsided, I have a persistent nagging pain, stiffness, limited range of motion, etc. in my left hip and groin area. Sometimes the pain goes down to my knee. It gets worse if I dare exercise. Not necessarily while exercising but in the hours and days after.

I finally got a PT to give it a name today. Up until now, the doctor's I'd been seeing for treatment really didn't delve into it even though I kept complaining of pain in this area above everything else.

So frustrating but at least I know there is some treatment for it now.

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