Training with Hip Pain | My New PT Routine

by mary on February 23, 2013

I signed up for Sectionals and booked a series of physical therapy appointments on the same day. It may seem odd– wouldn’t you be resting if you needed PT, not ramping up for a big competition?– but it made sense in my world.

I’d had some hip pain at night that I didn’t understand and worried that it might get worse from training hard over the next couple of months. After needing physical therapy twice for patellofemoral pain I’ve gotten warier of overuse injuries that creep up on you and thought this could be one. I wasn’t sure this deserved a visit to my sports medicine doctor, but I made myself go, and he praised me for coming in before I had a bad enough injury that it would force me to stop training. He knows me well.

My doctor said that the hip joint itself seemed fine and thought the pain was referred from the lumbar spine. This surprised me since the pain was unlike sciatica and my back itself didn’t hurt.

So off to the PT and also the massage therapist. We have a really good massage therapist who does myofascial release. He’s been doing massage for decades and is making noises about retiring. Please, not too soon! Neither the PT nor the massage therapist was too convinced that this problem was necessarily from my spine– I hope it’s not! I’ve been doing simple stretching and strengthening exercises from the PT– sorry about the lack of video or at least good photos, I don’t have time to make those right now but I’ve linked to a few video demos.

Here’s my daily PT. These exercises are designed, in part, to address a few issues that my doctor noted: less flexibility in the right quad than the left, and limited ability to do a backbend. He also wanted me to improve my flexibility in general, though in most aspects it’s above average already. In addition to these exercises, I also get into a stretch position and then use a massage tool on the stretched muscle, a technique that I came up with myself.

Lower trunk rotation for AM warmup, 2 or 3 minutes

Modified, much easier variation of cobra pose, keeping forearms on floor even in raised position, 10-15 times for 3 seconds, 2–3x/day

Cat-camel (cat-cow) stretch, 5-10 times for 5–10 seconds, 1–2x/day

Mid-thoracic stretch: Child’s pose with arms outstretched in front, then stretching both arms to one side, then the other. 2 times, 20-30 seconds, 1–2x/day. (Note: I do not hold the stretch this long as my massage therapist warns against long stretches. I just do it for a short while, with more reps, to get the lengthening I need.)

Hip flexor stretch, choice of stretches, I chose the one I do from the edge of a table.

Quadriceps stretch, choice of stretches: prone, side-lying, standing. I do a prone quad stretch, and have added pressing my quad into resistance (of my own arm, or my husband helping me) and then stretching the leg out by pressing it toward the hip.

Hamstring stretch, choice of stretches. I do this various ways, and may start using a stretching strap that we have for this.

And my strengthening exercises, to be done twice a week:

Spiral (arabesque) five times on each leg. Bridge pose, pressing the hips up as much as possible, held ten seconds. Repeat x 10.

Bridge pose, with band wrapped around knees. Once in bridge, externally rotate legs and hold for ten seconds. Repeat x 10.

It’s been a challenge spending the time to do the PT when I’m also trying to get in my skating, but I know it has to be done. And as always, it’s a reminder that it’s good to find the time to stretch. Stretching tends to fall to the wayside until something like this forces me to acknowledge that I should have been continuing to stretch and strengthen off-ice all along.

I’ve already seen results and I’m sure I’ll get through my competition without this becoming a major issue.

{ 7 comments… read them below or add one }

Mireya from myhealthyeatinghabit February 25, 2013 at 4:47 pm

Hi Mary,
Sorry to see that you’re having to do therapy, but it sounds as if you’re on the right track. Which are the specific exercises to improve the flexibility in the right quadriceps? Recently my right side has been a little tight too.

Reply

mary mary February 26, 2013 at 6:50 am

Hi Mireya, for the quad it’s mainly the quadriceps stretch. I’ve added a link for you to a quad stretch using the principles that our massage therapist recommends. You hold your leg back by the foot, then contract the gluteus to provide some resistance for the quad to stretch against, then relax the glute and gently pull the leg back toward the back of the hip. Each stretch is very short, just a couple of seconds, but as you do a series of them you’ll get an increasing amount of flexibility. The video show a standing quad stretch, but you can also do it side-lying or prone. I also hold my quad in the stretch and use a massage tool on it while it’s stretched. That is a technique I came up with myself, so I can’t say whether it would be recommended for anyone else.

Reply

Hip Pain NJ April 3, 2013 at 1:04 pm

Maintain good flexibility and strengthening the pelvis and Core muscles. Also improve any bio mechanical imbalances of the ankle, knee and hip. If you stand on one leg and you notice your pelvis/hip slightly shift to the side you may have decreased stability of the hip and back muscles. Strengthen the gluteus and core muscles to help in reducing the likelihood of injury.

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mary mary April 5, 2013 at 11:27 pm

All good advice! I found that strengthening my ankles (both have been sprained in the past) was helpful for my knee issues and I’m sure it’s useful for things further up the chain like hips, too. They are all connected!

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Angie Blackwell August 18, 2013 at 10:21 pm

I find that the use of a stability disc or board can be used to progress exercises that will improve the strength and balance of both the ankles, knees,pelvis and core. And I totally agree with stretching the surrounding area as well as strengthening it.
Thank you for sharing !

Reply

mary mary August 18, 2013 at 11:03 pm

We have a stability disc but I admit I’ve never gotten into using it. I do get a whole lot of one-legged balance through my figure skating, and I have an off-ice edge trainer that also works my one-legged balance with me in my skates. The missing link is the ankles– they don’t get much work, being in the stiff boot while I balance. I should do something about that!

Reply

Hip Pain NJ November 12, 2013 at 3:09 pm

You should design your workout regimen by identifying the minimum amount of weight needed to activate the body’s adaptive responses so that you can get massive muscles. All you are required to do is to activate your centuries-old evolutionary response system by slightly stressing yourself beyond your present capacity. Anything beyond this, and you will only work to increase how long you will need to recover.

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