Psoas causing back pain?

[mickymoko]

Hi, newbie here`Had BHR in Birmingham with Mr Treacy in November last year`Everything went fantastically well as he said it would`Started back on weights after 8 weeks,no squats or heavy loading and started cardio two months ago. Started a walking program,walking 25 miles a week and HIIT on Stationary bike and Step machine two months ago.Experienced no problems at all.

Introduced kettlebells a month ago,started to notice psoas tendon slipping over pubic bone around this time,no pain but an unusual feeling as though it was loose,not tight.Was working out last weekend on kettlebells and felt something go in that area, not especially painful but obviously not right.Then got a lot of pain and stiffness  in lower back had to take high doses of anti inflammatories and back has been really stiff and sore.

Now unable to bend,put socks on etc, sitting is unpleasant although walking helps.Have been looking at some stretching exercises for the psoas but was wondering if anyone else has experienced this or could give advice before I consider PT. I am particularly concerned that I have undone all the previous good work and loosened the psoas.I realise that it is only a matter of days ,although there have been signs of improvement, i am still worried ,particularly as the psoas now seems to be slipping a lot.Advice much appreciated

[chuckm]

mickymoko, you are the second BHR person this week who has reported pain and/or injury while using kettle bells.

An injured or painful psoas tendon (part of the hip flexor group) is not likely to improve with any stretching or exercise. Only rest. Especially for a hip resurfacing patient. 

For a BHR person, the psoas moves (rubs) right across the BHR device. It sounds like the injury has caused the psoas to tighten up in order to protect that area. The result is restricted hip extension which puts strain on lower back. Use pillows under your legs when you sleep. Even if you are a side sleeper every time you roller on your back it will strain your low back and you will feel it all the next day.

Be very careful consulting PT. I've read posts here that PT's were having BHR patients doing leg lifts and psoas stretching despite discomfort - something that only makes it worse.

Rest and then very gradual stretching and exercise. Never do either if there is any pain during or after.   

chuckm

[einreb]

The  psoas is attached to the vertebra of the lower back, so it certainly could be related.

I'm three years post op.  I've been doing a kettle bell class once a week for the last 2 years.  IMO, its been a huge help in my recovery and being overall stronger now than I've ever been.

For those exercising with any weights, its really important to use proper form.  Good kettle bell movements are typically best taught by someone certified (Strongfirst Level 2 as an example). 

Resurfaced in November of 2013?  You're only 6 months out... take it easy! I still focus on form and speed rather than higher weight.  You can develop explosive power using kettle bells with relatively low weights.

-Bernie

[oldsoccerplayer]

I'm the other person chuckm was referring to experiencing lower back pain on the op side that I think is related to the kettlebells class.
I started going to the class relatively early in the recovery process (don't remember exactly) before the 6 month mark while stomping and deep squatting were not allowed. It looked like a good fit because the exercises don't require you to stomp on your leg and I could modify the squatting moves to not go too deep. I also started with very light weights and don't remember feeling any pain or discomfort.
It seems like the problems started after the 6 month mark when I was allowed to do the deep squats and more so when I started going to heavier weights. I'm now going back to lighter weights for any moves that require bending / squatting while using the heavier ones for arm exercises.
I think it's improving, the class is only once a week so I'll see how it goes.

[chuckm]

The fact that tight hip flexors (psoas is one of the muscles) can cause back pain is not just because it originates along the lower spine. It is because of physics. If the hip cannot fully reach extension due to tight hip flexors, you would not be able to stand up straight or lie flat. You would be bent at the waist on that side. The only way to stand up straight when the hip is not fully extending is to gain the motion through the low back flexing more. That's why for so many hip arthritis patients who symptoms are loss of extension they have low back problems. 

Chuckm

[oldsoccerplayer]

I don't know enough anatomy to go into the same level of detail as others do, I can just say 'it hurts' and point to the general area of pain.
After experiencing some lower back pain on the op side I took a couple of weeks off from exercising. When I went back to the kettlebells class I used a lighter weight and was careful with the squats. I'm also now following the "if it hurts, don't do it" rule rather than the "work through it in the hope that it will go away" one. There are some moves (in this and other fitness classes I do) that seem unrelated to the op area but cause that pinching feeling I get sometimes. When that happens I just stop doing that exercise or go to a modification that doesn't hurt.
So far things have improved, I was able to go full out at soccer on Sunday, had sore muscles all over my legs afterwards but didn't feel much in the back.
There is this recurring cycle of feeling better which leads me to push harder than I really should, then having to rest for a bit while I recuperate and recalibrate. I am sure I am not unique in going through this.