Groin and Hip Flexor Pain

by Kay
(United Kingdom)


I had bilateral hip arthoscopies last year. My right hip was done in May 2014 and then the left in July 2014.

My hip pain actually began in November 2013. The pain was migrating to my right knee. My sports doctor injected me with corticosteroid in January 2014 after a MRI which showed a labral tear. They advised to continue to progress into my running as the steroid begins to work.

I was running ok for about 6 weeks but then movement became restrictive. I had to stop my sprint training and was only able to run at a gentle pace without aggressive movement. After contacting my sports doctor he referred me to a hip specialist who carried out MRI scan on the Right hip. I was diagnosed with Femoroacetabular Impingement or FAI. After the surgery I was told they had to shave off this bone that was causing damage to my joint. They said the surgery went well.

2 months later I had the left hip done (which was also showing signs of FAI). Touch wood my left hip has done well.

I followed the rehab correctly for both hips. About 2 weeks after getting the left hip done I began to feel pain in my right groin and hip flexor especially when getting in and out of a car and bed. My surgeon diagnosed me with psoas tendon irritation which he said will settle in a few weeks. It did not settle.

Since August 2014 until December 2014 I have a numerous physio sessions, soft tissue work and 1 Ostenil injection into the right joint and one corticosteroid into the right joint and when they failed to work I have had a corticosteroid into the tendon sheath. It still has not fully settled.

I am now feeling pain in my right gluteal muscle especially when sitting down for a while and top of the right hamstring. When I do the exercise 'good morning' I feel my right leg pulls up. There is restrictive movement around the hip compared to the left.

I was told 2 years ago that my right leg is 1cm shorter than my left therefore have been wearing insoles since. I am now wondering if the insoles are the cause of this?

I have seen so many physios and they all telling me different things! I have become depressed. I do not want any more surgery. I know strength is an issue, but I am afraid that I may cause more damage if I push to hard.

I have not ran since May 2014. I have been told by my physios and surgeon that I can start running soon, but I am afraid.

I would be grateful if you could advise.


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Jan 19, 2015
Possible Hip Flexor and TFL Dysfunction
by: Stephen from Lower Back Pain Answers

Hi Kay,

Your symptoms may be caused by a combination of Hip flexor and TFL Dysfunction. If you haven't read my articles about these issues, it may be helpful to so do. Links above.

Leg-length discrepancy is often caused by a torsion in the pelvis, not a real difference in the length of the legs. Torsion patterns can be corrected by identifying whether the right or left hip is anterior when tested in a supine position (standing assessments are inaccurate), and then stretching the opposite side.

Once the anterior hip is identified, a lunge stretch such as I show here (see Hip Flexor Stretch on this page) can begin to help correct the problem. Here's the re-patterning to emphasize:

If the right hip is anterior then a lunge stretch with the right leg forward, left leg back, is emphasized in order to stretch the leg hip flexor.

If the left hip is anterior, you emphasize the opposite.

("Emphasize" means stretch that side in a 2:1 or even 3:1 ratio with the other side)

You may be correct that the insoles (if artificially correcting the leg-length discrepancy) may be contributing to the problem. They would just hold the body in an imbalanced place.

I apologize if the above seems a bit complicated. It's difficult to evaluate problems with being able to evaluate the individual in person.

You might also consider my DVD program which is specifically designed to relieve hip flexor (Iliopsoas) dysfunction.

I hope this helps!

All the best,
Stephen @ LBPA

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Stephen O'Dwyer, cnmt

Neuromuscular Therapist & Pain Relief Researcher

Stephen O'Dwyer, CNMT


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