Hip Flexor Strain - Iliopsoas Strain

Hip Flexor Strain - Iliopsoas Strain
A hip flexor strain involves a tear or partial tearing of one or more of the hip flexor muscles causing pain in the groin, hip or front of the thigh. A hip flexor strain is a common injury and effects people of all ages. It is normally seen in individuals who partake in a lot of athletic sports in particular sprinting, hurdles and kicking sports like football and rugby. Symptoms include a sudden sharp burning pain, along the groin, hip or front of the thigh. In some cases a tearing or snapping noise is heard during the injury. In severe cases a strain will mean that the player or runner is unable to continue. The tear or rupture will be accompanied by severe swelling and bruising that will be incredibly tender to touch. What is a hip flexor strain? A hip flexor strain involves a tear or partial tearing of one or more of the hip flexor muscles causing pain in the groin, hip and front of the thigh. The 2 main hip flexor muscles are the psoas major and the iliacus muscle which start as separate muscles but join to attach through the same tendon, together these muscles are referred to as the iliopsoas muscle. The psoas major muscle originates behind the abdominal wall along the edge of the lumber spine and travels forward under the inguinal ligament of the groin to attach to the inside of edge of the femur (thigh bone). The iliacus muscle originates in the shape of a fan along the inside of the iliac crest of the pelvis and from a portion of the sacrum. The muscle narrows as it travels down and forwards under the inguinal ligament where it conjoins with the psoas major tendon which then attaches it to inside of the femur. The hip flexor muscles are responsible for flexing/bending the hip joint, the action of bringing the hip into the chest. The sartorius and rectus femoris are muscles of the lower limb that also contribute to flexing the hip however hip flexor strains typically only involve tearing of the iliopsoas muscle. The psoas minor is an unsignificant muscle that does not really contribute to any movement and is not always present within the body. A muscle strain commonly known as a pulled muscle is a medical term used when a muscle or tendon has been injured by a sudden powerful contraction or from overuse resulting in small tears within the muscle fibres or tendon itself. Each muscle is made up of thousands of small fibres that have a powerful elastic property that allows it to stretch and be flexible yet strong. The muscle fibres are in what we class the muscle belly and they all converge to one point and are connected to the bone by a very strong tendon which looks similar to a cord or piece of string. General muscle pain is normally pain from the disruption of the small muscle fibres either through mild injury like repetitive movements, tightness or inflammation. A muscle strain results from sudden or excessive tension being placed through the muscle fibres causing small tears. Milder injuries to the muscles tendons are covered under the condition tendonitis. Muscle strains are graded by their severity Grade I- This is where only a small number of muscle fibres are torn resulting in pain and discomfort but not affecting the muscle function or movement. Grade II- This is a partial tear where a substantial number of muscle fibres are torn resulting in slight loss of muscle function and movement. Grade III- This is a complete tear where all the muscle fibres are ruptured resulting in a complete loss of muscle function and movement. Strain injuries are commonly confused with sprains. The injury is very similar but a sprain affects the ligaments not the muscle or tendon. Why and when does a hip flexor strain happen? A hip flexor strain is a common injury and effects people of all ages. It is normally seen in individuals who partake in a lot of athletic sports in particular sprinting, hurdles and kicking sports like football and rugby. A hip flexor strain commonly occurs due to a sudden contraction or overstretching of the iliopsoas muscle. This frequently occurs when an athlete attempts explode out of the starting blocks or lunge over hurdles. It can also occur when a rugby or football player overstretches their leg to kick a ball. Occasionally a strain will occur due to gradual wear and tear of the muscle, this is associated with overuse. Overuse may be due to activities such as repetitive road and distance running or playing sports without adequately stretching the hip flexor muscles. What does a hip flexor strain feel like? A hip flexor strain begins as a sudden sharp burning pain, initially concentrated along the groin, deep into the hip or the front of the thigh. The specific location of the pain will depend on which muscle belly the strain affects. In more severe cases a tearing or snapping noise is heard during the injury. In these instances the hip flexor strain will mean that the player or runner is unable to continue. With milder strains or partial tears the pain will be mild and the player or runner may be able to continue through the activity. The tear or rupture will be accompanied by severe swelling and bruising that will be incredibly tender to touch. In cases of rupture there will possibly be a reduced ability to bend the hip. Pain levels will be aggravated by most hip movements making weight bearing and walking excruciating and impossible in a rupture case with specific weakness when trying to lift the leg and bend the knee into the chest. In partial tear cases, patients can still fully use their leg with stiffness and a feeling of discomfort on weight bearing, resulting in a mild limp. Once healing has started the severe pain will be replaced with dull aches and discomfort felt when the hip flexor muscles are stressed. Stiffness and dull aches are normally experienced during the night and most intense early in the mornings. How long does a hip flexor strain or tear take to heal? A mild hip flexor strain can recover relatively fast, normally between 1-3 weeks. The healing time varies dramatically depending on the severity of the strain, with most hip flexor muscle tears the healing time ranges from 1-2 months and in some cases as long as 3 months. However complete muscle tears take much longer to heal and almost always need surgical intervention. Post-surgery a cast may be applied and the patient may be immobilised for up to two months followed by up to 6 months’ worth of physical rehabilitation, a recovery to the original muscles strength can take up to a year. How is a hip flexor strain diagnosed? Your GP or therapist will be able to diagnose you by both listening to your history and examining you. No X-rays or further investigation should be needed to confirm the diagnosis however occasionally an ultrasound or MRI will be used to evaluate the extent of the tear or rupture. What treatment options are available for a hip flexor strain? Your GP will most likely prescribe anti-inflammatory medication and painkillers for pain relief and to reduce any swelling. Initially you will be advised to follow the R.I.C.E protocol. The R.I.C.E protocol involves Resting your leg, try not to walk about on it too much and most importantly to avoid all aggravating movements. Ice the area by applying a covered ice pack, this may significantly hasten the healing process by reducing the pain and swelling. Make sure the ice pack is covered to prevent any ice burn and for best results use the icepack regularly for 10-15 minutes with intervals of 30 minutes. Compression, try and keep the elastic bandage on during the day to limit the swelling and make sure to take it off at night. Elevation, keep your foot raised on cushions or a stool to help limit the swelling. Your doctor or therapist will evaluate the extent of the tear or rupture. If the strain is mild then you may just be instructed to rest and avoid any aggravating movements for a couple of weeks. In cases where weight bearing is painful crutches may be provided. Once it is no longer painful, you should try to gradually return to full weight bearing using hip flexor muscle stretches to help. Stretches should be avoided if they aggravate pain levels. Once you are weight bearing pain free then you should focus on strengthening the hip flexor muscles which will have atrophied and weakened after the injury and rest period. Your therapist or rehabilitation trainer will be able to provide you with the correct exercises, which will be mild and may involve resistance bands. Once the affected hip flexor muscle is as strong as the other side then you can reintroduce any activities or sports that were previously painful. Using sports or athletic tape whilst training can also help to prevent further strains and help relieve any discomfort and pain once a strain has occurred. The hip flexor muscles and groin can be taped as a unit connecting the trunk of the body to the upper thigh. Many sports therapists, physiotherapists, chiropractors and osteopaths can apply sports tape but you can also buy pre-cut strips and use the many online videos to help you apply them correctly (see our products section below). If the hip flexor muscle is partially torn then a cast or splint may be applied and you will be ordered to rest for as long as the healing process takes. In cases of a complete muscle rupture, surgery is almost always necessary and is the best form of treatment to return the muscle back to original function and strength. The surgery will stitch the muscle back together, after this a cast will be applied and you will be instructed to rest for 2 months at which point you will be referred through to a physiotherapist who will provide you with strengthening exercises for the leg muscles. Full strength recovery is not guaranteed and can occasionally take well over 6 months to achieve. A good rehabilitation program can aid the healing process and prevent reoccurring injury. Once into the later phase of recovery many people find massage therapy helpful to loosen the affected muscles, manipulative therapies such as physiotherapy, chiropractic and osteopathy are thought to help through mobilisation treatment of the hip and knee working to reduce any stiffness levels and return the joint back to its normal movement. Tweet Keywords Hip flexor strain Muscle strain Hip pain Groin pain Groin strain Thigh pain Original article and pictures take http://www.clinic-hq.co.uk/article_78_Hip+Flexor+Strain+-+Iliopsoas+Strain site