Sensitive groin / psoas at 10 months

[whyme]

Hi,
At 10 months I feel very well and back into swimming and cycling, improving all the time.
Most of the hip muscles are pretty much recovered and as strong as in the other hip.
However, the groin / psoas / hip flexor is still weaker and sensitive to changes in activity, intensity or duration. So I'm finding difficult to bridge the gap because if I push the hip flexor exercises then it will complain.

Is this something I should worry about, have others a similar experience at this stage?

[Tim Bratten]

Hi whyme
Don't know how to answer your question, but wanted to chip in because we had the same surgeon with the same implant, not so long ago. Sorry to hear you still have some irritation with activity. I'm pretty happy with how mine is evolving: at this point (5 and a half months) it is considerably more advanced than the revision was at the same time. Comparing the two as they are in the moment: the revised side still wins in almost every category except for certain forms of balancing on one leg, but it's worth mentioning that I still see improvement on the revised side even after two and-a-half years, so I expect alot of improvement from the HR over time. In some ways I'm still taking it easy: I would like to start jogging occasionaly but the resurfaced side is not ready yet. I've tried some fast, fairly long distance (about 10k) hikes without my trekking poles: first at about four months (this made the HR side sore towards the end and it stayed sore for a day after) then again last week (the HR side got tired and a bit sore at the end but was fine the next day). I honestly think with a little more time I will be ready for some jogging!. I don't do much cycling, but both hips are working quite well for the climbing and hiking I do without hardly any irritation.

Probably there is nothing at all to worry about and things will improve over time, but you might need to modify your activity/training/stretching procedures (beats me how) to maximize your recovery.

Cheers
Tim 
 

[HowieF-16]

I am at seven months and still have sensitivity and pain in the groin, psoas area. When I first discussed it with Dr Raterman at my 3-month check, he recommended I switch from biking to elliptical. That reduced my problem significantly. When I brought it up again at my six-month check, last week, he recommended to really stretch the heck out of it and to try Yoga. So, I will be working with a Yoga instructor starting next week.  I don't think it will be a quick fix, but we all need to keep moving forward. Good luck sorting it out and keep us posted.

[whyme]

Thanks guys for the replies... Just to be clear, I chose the word 'sensitive' as I don't normally experience pain there.
Since surgery, the feeling ranges between 'aware of it (at times)' and 'discomfort'.
At 7 months the physio told me the new hip was already as strong (if not stronger) as the other one, except the psoas that was noticeable weaker.

So I'd like to know if, based on experience from others, it's going to be kind of a small price to pay for an otherwise fantastic hip.

Just for reference I'm very active at the moment, a typical week would include: swimming twice (3-4km per session, as hard as before surgery), cycling 1-2 times (30-50km per session, easy to moderate pace, not much hill climbing yet) and 2-3 hip exercise sessions (1h each).
The progress has been steady without the 'sensitivity' getting worse, but every time I increased significantly duration/intensity/incline/new routine/new exercise ... it gives me a warning and I go back to baby steps.

There was only one instance where 'pain' would be the adequate word, it happened last Sunday after (not during) an open water swim race, 3.6km long (I had already trained longer than this in the pool, at similar pace), where incidentally finished 7th overall (quite surprisingly)... The last few hundred meters I got into a sprint with a fellow swimmer and I gave it all (just inching ahead in the end) :-)
As soon as I came out of the water I felt the groin, then it was bothering me for the rest of the day, that night and the next morning, which got me concerned. However, it lasted just around 24h.  Three days later I swam again with some caution, no problems.

I don't do any particular stretching exercise for the hip flexor/psoas. Mobility wise, I can bring the knee to the chest just a few degrees less than with the other hip, but it would be normal range of movement for most people.

[Tim Bratten]

Wow: I have a ways to go before I can bring my knee to my chest! (it's been years since I could lay flat on my back and simply grab around my knee with both hands together ... at least I can do this now).

Once again I can only refer to some experiences that I've had which are different but perhaps parallel. At around 10-11 months after the revision I siginificantly stepped up my activity (it was summer vacation and I could go hiking/climbing everyday). After about 5 or 6 days in a row of being more active and also doing more stretching I wound up being pretty sore for a few days and had to take it easy for a couple of days to recover ... but later I was fine again. However by the second year's summer vacation I was able to perform at a much higher level for basically as long as I wanted (I was a couple of weeks climbing extensively every day, many pitches daily, hiking with a pack full of gear, etc.) until the rest of my body gave finally into exhaustion, without any problems from the hip. The point is: if you're like me, time and activity with moderation should cure all ills. But it takes time.

PS: the pain you described after the swimming race sounds similiar to the pain I felt after walking hard at four months. I felt it in the groin, but in the butt as well. With the revision, when I got some pain I felt it down the side of my leg to the foot.

[whyme]

Hey Tim, you must be enjoying a lot with your climbing achievements of lately... Those moments when you are in control and with confidence, the feeling is something else. I climbed for a few years so I follow your posts with interest. And we are joined by the hip (same surgeon! :-) ).

Went to the physio today, she thinks the psoas is probably overworking to compensate the gluteus, that doesn't seem to engage in functional positions. So I've normal strength there (doing bridges etc etc) but it kind of switches off a bit when I'm standing or in movement. Also, the psoas was tight, so she worked on the lower back at the point of insertion, and could loosen it up a bit.
Apparently, I should be doing some kind of warm up routine to "wake up" the gluteus prior to exercise, so when the real activity starts it's fully engaged. If that makes sense...

We'll see how it goes.

[hernanu]

Hey Tim, you must be enjoying a lot with your climbing achievements of lately... Those moments when you are in control and with confidence, the feeling is something else. I climbed for a few years so I follow your posts with interest. And we are joined by the hip (same surgeon! :-) ).

Went to the physio today, she thinks the psoas is probably overworking to compensate the gluteus, that doesn't seem to engage in functional positions. So I've normal strength there (doing bridges etc etc) but it kind of switches off a bit when I'm standing or in movement. Also, the psoas was tight, so she worked on the lower back at the point of insertion, and could loosen it up a bit.
Apparently, I should be doing some kind of warm up routine to "wake up" the gluteus prior to exercise, so when the real activity starts it's fully engaged. If that makes sense...

We'll see how it goes.

I've hit a couple of snags lately, at four years. My lower back has gone into muscle spasms and took a bit to return from. I think being diligent about some sort of warm up is important.

I got cocky and jumped right into heavy bag workouts and basketball without a light warm up. I checked out the hip and it's fine, my doctor looked at my lower back and pronounced it muscle spasms.

Oh well. I'll add a good warm up before any heavy workout.  You might try the roller as well...