T Nation

Hip Flexor Pain

I have been having extreme pain in my hip flexor after periods of sitting down, i.e. after driving, or just sitting period. After standing up i get a sharp pain where my hip meets my buttox… I am going to the doctor soon, but i was wondering if anyone has heard of this type of injury.

Where your hip meets your buttocks is not your hip flexor. It might be the hip extensor group particulary the hamstrings. Be more specific as to where the pain is. Hip flexors are anterior to your pelvis and are comprised of several muscles. In faith, Coach Stronski.

Sounds potentially like sciatic impingement.

Thanks Coach Stronski for the quick response. The pain itself seems to be on the outer edge of the buttux on the left side. The pain seem to be intense for about thirty seconds or so, at which point it then subsides, although lately it has never been going away 100%. The pain also seems to have an impact on my calve. The pain in my calve is only present though after the pain in the “hip area” leaves. This has been going on for a few months now, but it progressivly getting worse. Being used to aquiring sore joints, at first, i just thought of it as a little pain that would just go away in time, but it has not. The reason i thought i may have something to do with the hip flexor is because of the fact that it only seems to be present (at least intensly) after standing up after a period of sitting. Like I said i have an appointment with the Doc the first week of December, but it I an curious what this could be. All of the research points to the hip flex, but then again, as an accountant, it is rather tough for me to understand what the hell all of the medical jargon means in the reasearch. Thanks again.

It could be a tight illiopsoas muscle. This muscle goes from your femur (thigh bone) through your abdomen and attaches to your lumbar spine/discs. By what you describe, pain with standing, no pain with sitting, when you stand the psoas must lengthen as the femur and lumbar spine are moving away from each other. If the psoas is short the lumbar spine will go into lordosis with rotation towards the side that is tight. This will cause impingement of disc(s). It could also be your IT band. Which is a broad band of tissue that goes from your hip area, down the outside of your leg to the lateral aspect of your knee. It could also be your sciatic nerve involvement as you report pain is refered to your calf. It could come from your lower back or a short piriformis. Or I could be completely wrong. See a chriopracter (sp) and/or ART specialist. In faith, Coach Stronski. Now where did I put my little hat?

Coach Stronski has some good ideas. Ultimately you need someone to evaluate you. The referred pain to the calf is consistent with piriformis tightness or spasm causing pressure on the sciatic nerve, which lies directly beneath the piriformis. The psoas muscle being tight will affect the discs when you stand up (i.e. extend the hip) and potentially produce some referrals to the hip and calf. (Impingement is probably not the word to discribe this as the disc is not caught between other structures, but rather the increased pressure on the disc may cause a disc bulge that impinges on a nerve root, or the rotation of the vertebral body may narrow the foramen and impinge on the nerve root.) The IT band involvement is not as intuitively obvious as a culprit; I’d have to think more on the mechanics here. One other possibility is bursitis. It makes sense that in standing up that a bursa (of which there are several in the general area you describe) would likely be impinged momentarily and produce a pain for 30 seconds if it is already inflamed. This might explain the gradual onset of the pain and the fact that it now does not fully resolve–the bursa has become increasingly irritated and inflamed. This would still not explain why a calf referral occurs after the hip pain subsides, but there are some pretty odd myofascial pain referral phenomenae. If you are seeing an MD and don’t see some results, consider an osteopathic physician or physical therapist with a sports background. Osteopathic physicians have a more “holistic” approach to the body than MDs and are much more attune to the subtleties of soft tissue problems (like myofascial pain). I’m not as familiar with chiropractic theory, but I would again look for a chiropractor with a sports background (and one who specializes in ART would more likley be one of these from what I understand about ART). Just think twice about a chiropractor who thinks he can cure cancer with chiropractic (I’ve seen it claimed!) and wants you receiving manipulations for months on end. Manipulation should be a relatively short term intervention.

Could a 2 mm bulge at L4, L5, and S1 cause a pain down my left buttock and hamstring?

Yes. But consider other factors as posted above as well.

Coach Stronski, just wondering…do you drive the same car as coach Davies, wear the same type of boxers, and have a dog that ironically has the same name as John’s, or did you just steal his “Coach” pretitle and his “In Faith” closing remarks? John, if you’re reading this, look out the window, I think stronski is in your bushes.

Why can’t I call myself Coach? I like to be called Coach. I have a stong faith. Both in my religion and in my practice. Has Davies trademarked that title and closing? It’s just funny that an adult has to add a “Coach” moniker and a “In faith” slogan for someone to identify him. Does Davies have to call himslef Coach so he looks credible. Perhaps this is his way of branding himself. Although we all know the best way of advertising is word of mouth. And recently his word has not been his bond. By the way I do have one of his little hats.

In no ways am I an expert. I have done my research and workout on a regular basis. I too have been having problems with hip flexor. The things that have helped me best was…A. Rest the hip flexor (do not perform any movements that incorporate it until the pain goes away) B. Get some anti-inflammatories (celebrex, vioxx, or even over the counter alleve), next start incorporating some hip-flexor stretching exercises after doing your warmup and after your workout. C. Next I would ice it after your workouts or after driving or really any time you feel pain. D. DMSO also helps me with inflammed joints. Like I said I am no expert look at what some of the other guys have to say, I am sure many of them are more knowledged than me, but the following I just told you has helped me out tremendously. Good luck.