Tuesday, November 3, 2009

Groin pain and the Femoral Sheath

Last week, one of the bobsled athletes I take care of complained of some pinching pain on hip flexion, with some sharper adductor pain as well. Checking the adductor group, I couldn't really find any tightness or adhesions in the muscles themselves that would make me think that it was a concern. While there was a feeling of pinching on hip flexion it wasn't sharp and alignment of the hip/pelvis was good. Thinking the sharp adductor pain could be referral pain, I started checking structures around the pinching site in inguinal triangle. I finally found that the femoral sheath wasn't sliding under the inguinal ligament. After several passes of Active Release Technique to free up the sheath under the ligament, hip flexion was now much less irritated and upon a few strides the adductor had no pain. This was the first time I had ever felt this. Thought this was an interesting case to share. Again this shows how the site of the pain is very rarely the site of the problem.


Glenn said...

Very interesting post, and great site!

Do know of any ART's in Washington you can recommend?

I'm 44, 6', 200 lbs. Lift 5 times per weak, squat 1RM: 375 (at a PL meet in April). My left IT band is persistenly bothersome; first area to be sore after leg workout, last part to stop being sore. Sometimes still bothers me right up until the next workout. Foam roller is painful(!) but give some temporary relief. Presenting for several months now.

Glenn said...

To clarify: Washington DC (not Washington state).

Jason Ross said...

Thanks! Sounds like your really need to check two things. One is your glute max is firing and if your glute med is stabilizing. If one or both aren't up to par, your IT band will be called on a lot to stabilize the pelvis. Over time that load will cause the fascia of the IT to really shorten. Do a lot of clams, monster walks, glute bridges before rolling the IT and squat again. See if it takes some of the tension and soreness away.

I personally don't know any ART guys in DC, but the ART website will let you find some close ones. Sounds like a few ART sessions will get rid of the adhesions that have built up, and the corrective strategies should keep them from coming back

Glenn said...

Thank you!

I've got a pretty big, muscular butt (ha) from all the squatting I do, so I will be surprised if my glutes aren't functioning properly. But I will definitely do what you suggest. Thanks again.

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