Be Your Best: Hip flexor injuries can be uncomfortable, but most times are easily treatable

(Dr. Brian Sokalsky, DO, is at the helm of Jersey Shore Sports Medicine in Ocean City and is a board certified family physician with special training in sports medicine. Once per month, Glory Days Magazine publisher Dave O’Sullivan talks with Dr. Sokalsky about various sports injuries, treatments and prevention methods.) Glory Days Magazine reader Laura emailed in a question about how her daughter, who is a 15-year-old lacrosse player, can deal with a pull or strain of the psoas, or hip flexor. The psoas is a long muscle that basically connects the lower vertebrae column with the thigh bones. It wraps inside the pelvis and connects to the inner thigh, which is sometimes why people confuse this type of injury with a pulled groin. “That’s one of the main hip flexors. There are two muscles that merge to form one big tendon, and those are the two main muscles that flex the hip. That kind of attaches in the groin, so you can get some groin pain with that,” Dr. Sokalsky explains. “The hip flexors attach to the inside of the thigh bone, so sometimes people will describe it as groin pain. When you’re watching sports and they say somebody has a groin pull, that’s a different set of muscles that is aggravated.” Sokalsky said treatment of this type of injury really depends on how severe the injury is. It’s the type of injury that can be rectified with rest followed by some good physical therapy, he said. “It depends on the severity of the injury and how recent it is. If it’s something that just happened, a week or two of rest to let it start healing and then some therapy with some gentle stretching and strengthening exercises to build the strength back up,” Sokalsky suggested. “If it’s something she has been dealing with for a long time, then usually there is some weakness from the injury and the surrounding muscles kind of compensate and they typically become tight and spasm, so you need a more thorough course of physical therapy to balance everything out.” So what causes injuries to the hip flexor? Sokalsky said generally these types of injuries happen because of an imbalance in muscle strength. For instance, lacrosse players spend a lot of time practing their shooting, which is the same repetitive motion that favors one hip over the other in order to create the torque necessary to have a lively shot on goal. Brian Sokalsky is a doctor specializing in sports medicine. His office is located in Ocean City. To contact Dr. Sokalsky, call 609-545-8553 “It can be lack of flexibility. It could also be something as simple as not warming up properly so the muscles are tight. Often times there are some underlying muscle imbalances. The opposite hamstring might be tighter than the side of the injury, there can be some tightness in the glute muscles or the lower back. There can be some strength imbalances where one quadriceps is stronger than the other,” Sokalsky said. “So, often there is some underlying flexibility or strength imbalances that lead to the injury.” Sokalsky said hip flexor injuries certainly need to be monitored even after the athlete begins to feel like he or she is back to full strength. It’s an injury that carries some risk of reoccurance, particularly if the athlete doesn’t take the right measures to strengthen the area and add more flexibility. “Once you injure a muscle like that, you are at increased risk of reinjuring it, but with a good course of therapy to correct those flexibility and strength imbalances, the odds of it happening again do go down,” Sokalsky said. “If all you do is let it rest until it feels better and then you go right back out to play without any good therapy, or you go and do just a couple of strengthening exercises just for the hip flexor, if you don’t correct the underlying cause, most likely it’s going to happen again.” Sokalsky said this type of injury is quite common among high school-aged athletes, particular in sports such as lacrosse, baseball and soccer, where there is a lot of starting and stopping, a lot of explosive moments. “It’s very common. Hip flexor, groin, hamstring, all very common injuries. Particularly in that age because they are growing, so they often have some lack of flexibility as the muscles and tendons catch up to the growing bones,” Sokalsky said. Sokalsky said, however, that young athletes tend to bounce back quickly from this type of injury. “Many times it’s a relatively new injury, so those compensations that I was describing earlier haven’t set in, so it’s usually a pretty quick recovery,” Sokalsky said. “They are healthy, they heal better, and they are generally flexible. It’s generally a quicker recovery than if someone in their 30s or 40s suffers an injury like this. [adsense]