For the last year and a half I have had a nagging pain in my left hip whenever I train quads. Every type of IT band pain I research seems to deal with the outside of the knee.
The strange thing is that the band doesn’t hurt during deadlifts, good mornings, kettlebell swings, etc… (hip movements) It is only when I contract my quads. Even leg extensions make it hurt (in the hip).
I don’t understand the relationship between quads and IT-band and I am quite certain that I do not have an outer quad tear as it has been over a year.
My chiropractor has done graston to get rid of some scarring and has given me an ever increasing list of rehab exercises that don’t seem to change anything. I’m very frustrated because I haven’t had a decent leg workout in a long time and quads are looking flat.
Any idea about what could be causing this? Thanks in advance…[/quote]
What does your chiro think the cause is?
Have you seen any other specialists such as an ortho?
Going back to the last year and half (or even two years) describe the typical leg workouts that you performed.
“Left hip” is somewhat vague. If you can, be more precise regarding where the pain is.
On what part of the hip did the chiro perform the graston? Was there any relief - even temporary?
Has your chiro mentioned any other issues?
Thanks for the response. I will answer accordingly…
My chiro thinks it’s my glutes not firing on my left side that is causing the pain. Ever since doing kettlebell swings my glutes have gotten much bigger and stronger, so I can’t imagine this being a problem.
He is the second ART certified chiro I have seen about this. The only reason I switched is because the last guy didn’t do graston.
My leg workouts have been mostly front squats, as back squats hurt it more. I do heavy kettlebell swings for glutes and hams. I finish with one leg leg press or leg extension for my left side as that quad is always understimulated (from the pain).
It hurts along the IT-band. During training, it is more in the middle of the length of my thigh. Sometimes at night when it hurts, it’s closer to the glute.
The graston did relieve it some, but then it quickly came back. The only real relief from the graston was that there was no longer any pain except during training or if I had to run.
I asked him if he thought it might be a quad tear. He said no because a tear would not last this long.
He asked me recently if it hurt during deadlifts. I told him no and he made a face like my answer wasn’t normal. I still think it’s strange that even the leg extensions would make it hurt. I can’t find any IT-band pain that is associated with quads, only hip joint muscles. I guess I’m hoping to find someone who has had the same problem.
One possible explanation is irritation of the L4 nerve.
The vastus lateralis (VL), rectus femoris (RF), vastus medialis oblique (VMO) are innervated by L2, 3, 4.
The adductor magnus, longus, and brevis are innervated by L2, 3, 4. It is debatable just how much they contribute in a bilateral squatting pattern. They play a larger role in unilateral work. Regardless, it’s something to be aware of.
This may explain why direct quad work such as leg extensions and front squats bother you. The leg extensions obviously recruit the VL, VMO, RF. The squats recruit the VL, VMO, RF, and the adductor complex.
Now let’s look into why hip extension movements are NOT troublesome.
You mention kb swings and deads. Semimembranosus/tendinosus, biceps femoris long/short heads are innervated by L5, S1, S2.
The glute max is innervated by L5, S1, S2.
This may be why those movements are not troublesome. Yes, the the quadriceps complex play in a role eccentrically decelerating the kb swing. They also play a role in knee extension of the deadlift. Furthermore, the adductor magnus can also assist in hip extension. However, the empirical evidence that kb swings and deads do NOT cause you trouble lead me to suspect that their involvement is NOT SIGNIFICANT enough to act as a trigger.
And the only unilateral movement you say you’ve been doing are leg press and leg extensions. Because the nature of these movements require little to no stabilization, the glute medius and minimus may not be working as much. This is relevant because the glue medius and minimus are innervated by L4, L5, S1.
As you can see, the common denominator is the L4.
The following MIGHT be what’s taking place:
- Activities in which the quads are the agonists cause an irriation of the L4
- The pain radiates upward, along the L4, which could explain why you sometimes feel it at the hips, as this is where the glute medius/minimus are. And don’t forget the med/minimus are innervated by L4 (as well as L5, S1)
- Your selection and execution of hip extension work do not activate the muscles that are innervated by the L4 enough to cause a trigger. Don’t misunderstand me here. There is some activation of the muscles innervated by the L4 but just not enough.
I suggest that you get tested for possible nerve compression or irritation. You’ll need to see a specialist and pray that he actually gives a damn and doesn’t just look at you as his next Mercedes payment.
Let me know what you think and how this pans out. As a strength/conditioning coach, I am very curious as to the outcome.
Chronic pain can often be a puzzle wrapped in paradox sprinkled with irony. I hope I’m not leading you down the wrong path. However, based on the information you provided, I believe that it cannot hurt to at least eliminate the possibility of an issue with the L4 nerve.
Wow! Thanks for all your help. I will look into it. I should probably start by mentioning this to my chiro.