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Woman doing lunges in a gym, crop

How do you know you have a hip flexor strain?

Physiotherapy

How do you know you have a hip flexor strain?

With summer well underway, levels of sport and recreation over the past couple of months have increased dramatically. While the benefits of being active are endless, the transition from sedentary behaviours during the pandemic to a sudden increase in sport and recreation are resulting in the onset of nagging injuries.

An injury that is commonly seen is hip flexor strains. While the literature supports a relatively high incidence of hip flexor injuries amongst athletic populations, these injuries remain prevalent within the general population as well.

What is a hip flexor?

Before discussing ways of identifying a hip flexor strain and its associated causes, let’s review some anatomy. The hip flexor consists of 6 key muscles that contribute to hip flexion: the iliacus, psoas major, psoas minor, pectineus, rectus femoris, and sartorius (figure 1).

 

Due to the high degree of functional overlap between these muscles, they are often grouped together as they work in conjunction to flex the femur at the hip joint with some of these muscles additionally contributing to extension at the knee. In addition to this, the hip flexor muscles further contribute to lateral flexion of the lower vertebrates and allow for postural stability during various movements. Due to their role in hip flexion and postural stability, the hip flexors are responsible for many of the movements involved in activities of daily living such as walking, running, sitting, carrying a load in the opposite hand, and transitioning from lying down to sitting.

Figure 1. Anatomy of the hip https://spartascience.com/why-hip-flexors-are-tight-and-why-your-hips-pop/
Figure 1. Anatomy of the hip
Why Hip Flexors Are Tight and Why Your Hips Pop

Strain vs sprain

Now that the anatomy of the hip flexor muscles and their actions have been considered, let’s further discuss the term strain. A strain refers to a stretch or a tear of a muscle or tendon (figure 2). 

 

While the terms sprain and strain are often used incorrectly, a sprain refers to a ligamentous injury whereas a strain is an injury to the muscle and/or its tendon. Considering the role that the hip flexors play, hip flexor strains occur from the overuse of these muscles during hip flexion activities or from forceful contraction of these muscles while in a stretched position. Populations that appear to be most vulnerable to hip flexor injuries include cyclists, dancers, football players, runners, soccer players, those who practice martial arts, or individuals who perform any forceful kicking.

Figure 2. Severity of hip flexor strain https://gohockeynews.com/sports-medicine-hip-flexor-strain-a-long-term-problem-for-hockey-players/
Figure 2. Severity of hip flexor strain
SPORTS MEDICINE: Hip flexor strain – a long term problem for hockey players

Signs and symptoms

While the clinical presentation of hip flexor strains largely depends on the degree of the injury as outlined in the figure 2, common signs and symptoms include:

  • Pain and/or pulling to the front of the hip where the thigh meets the pelvis
  • Pain with walking or running
  • Difficulty coming up from a squat position or coming out of a chair
  • Bruising and swelling to the front of the hip
  • A noticeable bulge at the top of the thigh muscle (less common)
  • Pain and potential weakness with resisted hip flexion (figure 3)
  • Pain with passive extension of the injured hip (figure 4)
Figure 3. Resisted hip flexion
Figure 3. Resisted hip flexion
Figure 4. Passive hip extension
Figure 4. Passive hip extension

Recovery and rehabilitation

Depending on the severity of the injury, recovery timelines typically range from 3-8 weeks. Other factors impacting recovery include:

  •  age
  • health
  • a history of previous injuries to the area
  • and the specific hip flexor muscle that is injured. 

While the healing process begins once the hip is no longer being stressed in positions that further aggravate the injury, rehabilitation is essential even when tissue healing timelines are met to further strengthen the area in order to prevent re-injury especially in those involved in high level of sport and recreation.

 

Recovery 

In regards to recovery and specific treatment guidelines for hip flexor injuries, an intricate balance between strength, mobility, and promotion of tissue healing is crucial. 

 

Depending on:

  •  the severity of the injury
  • initial stages of treatment include promotion of tissue healing by decreasing inflammation
  • reducing the stress on the affected areas
  • maintaining or regaining mobility of the affected area
  • maintaining strength of the surrounding musculature

 

As recovery timelines are met, specific stretching and strengthening is progressed in order to further alleviate tension on the affected areas and increase function. When determining return to activity, signs of full recovery are more important than estimated timelines. Return to function is dependent on re-gaining full range of motion and strength, resolution of swelling and bruising, elimination of pain to the affected area with direct palpation and activity, and restoration or proper mechanics of both the affected and surrounding areas. 

 

When should you see a physio?

Due to the intricacy of the hip flexor anatomy, a thorough history and physical examination is crucial when assessing an injury. When identifying a hip flexor injury, important investigation into the nature and location of symptoms, inciting events, aggravating and relieving movements and positions, and any concurrent or past injuries is very important. 

 

These questions in part allow for partial differentiation between hip flexor strains and other conditions that may be present such as bursitis, tendinopathy, osteitis pubis, stress fracture, labral tear, etc. thereby ensuring an appropriate and effective treatment and rehabilitation plan. 

 

 Due to the high functional and postural contributions from the hip flexor muscles, it is important to consider both dynamic and static movements as well as risk factors that increase the likelihood of developing a hip flexor injury or re-injuring the area.

 

 Some of these factors include surrounding muscle tightness and weakness, excessive or inappropriate training or activity with inadequate warm-up or recovery, joint stiffness, poor biomechanics and fitness, fatigue, muscle imbalances, etc. As with the treatment of any injury, a carefully taken history and physical examination are of paramount importance.

 

 At Advantage Sport Medicine, our team of health care professionals are trained in assessment and are highly knowledgeable in injury identification and rehabilitation to get you back to doing what you love.  Book your appointment today!

 

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Mar 21

Open
EXERCISE OF THE WEEK:
Slider Wall Push Up

Emilie’s pick for this week’s exercise is a slider wall push up. This exercise targets core stability as well as shoulder/scapular stability!
Wanting a harder variation? Try the above from the floor!

Start your day off on an active note and give it a try! Remember to listen to your body when performing the above.

#yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy #hypopressives

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Mar 14

Open
✨ ASM Athlete Highlight ✨

This week marks 1 year post Achilles Tendon Repair for ASM athlete Alex!
Alex has been diligent with his rehabilitation program and has worked hard with the team at ASM. 
Alex is now mastering high level rehabilitation exercises and is returning to sport.
Great work Alex!!! 👏 #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy

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Mar 8

Open
🚺 INTERNATIONAL WOMEN’S DAY 🚺

Today we recognize all the amazing women that make-up our staff at ASM North and South! You all rock! #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy #hypopressives #internationalwomensday

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Mar 6

Open
Strengthening Up The Chain

While the initial treatment plan following an injury might include basic strengthening exercises, it is important to eventually address the areas that are “ further up the chain”.

In other words, once progressed past the initial phases of injury, looking beyond the injury and targeting muscles groups that may be influencing and contributing to the injured area is crucial to maximize healing and return to performance.

Have you experienced an injury? Our team of physiotherapists, athletic therapists, occupational therapists, and kinesiologists are experts in helping you identify all the things contributing to your injury. Call us today for an assessment.
☎️ 780-229-0174  #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy #hypopressives

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Feb 28

Open
EXERCISE OF THE WEEK:
Overhead Pallof Press 
(darn autocorrect in the video; our apologies!)

Koji’s pick for this week’s exercise is a pall-off press with an overhead variation. This exercise targets core stability as well as shoulder/scapular stability.

Start your day off on an active note and give it a try! Remember to listen to your body when performing the above.
#yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy #hypopressives

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Feb 22

Open
EXERCISE OF THE WEEK:
Front foot elevated split squat 

Austin’s pick for this week’s exercise is the front foot elevated split squat. This excise targets single leg strength and stability, core strength, and balance.

Start your day off on an active note and give it a try! Remember to listen to your body when performing the above. #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy #hypopressives

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Feb 17

Open
Taping “How To”: Buddy Taping 👯‍♀️ 

Buddy taping refers to tapping an injured finger or toe to an uninjured/healthy one. The healthy digit thus acts as a digit act as a splint to support the injured digit and promote healing.

Stay tuned for more taping tutorials coming your way!  #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy #hypopressives

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Feb 15

Open
EXERCISE OF THE WEEK

Tannis’ pick of the week is: heel elevated back squats 🏋️‍♀️ 

This exercise is an excellent way to increase the depth of your squat and target your quadriceps muscles. In addition to this, it also allows activation of various hip stabilizers allowing for greater muscle group utilization. 

I don’t have a squat rack or not quite ready to use one? Try the above without any weight or hold a dumbbell as a goblet weight!
Don’t forgot to listen to your body when attempting the above! #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy #hypopressives

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Feb 9

Open
EXERCISE OF THE WEEK - “Therapist pick edition”

Danielle’s pick for exercise of the week is:
Single Leg Lateral Ball Squat

This exercise is an excellent way of strengthening the hip stabilizer muscles in a dynamic way. The exercise works a combination of single leg strength, core stability, and balance to provide an excellent dynamic strengthening exercise! 
Remember to listen to your body when attempting the above!  #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy #hypopressives

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Feb 7

Open
Introducing: 
H Y P O P R E S S I V E S

Hypopressives utilize deep breathing and core activation to increase the strength of postural muscles, and help regulate the nervous system.

Hypopressves train and restore the deep core and pelvic floor function from the deepest layer inside out under low pressure.

Here’s how the Hypopressives technique has helped our clients over the years: 

💬 “Helped with postpartum recovery”
💬 “Find it helpful for back pain & chronic pain
Improved posture” 
💬 “Calming when feeling stressed”
💬 “Stopped peeing with coughs & sneezes”
💬 “Not afraid to jump on the trampoline with kids”
💬 “Run without fear of peeing”
💬 “Stopped living in fear of prolapse symptoms” 
💬 “Helped with period pain during menstruation”

Want to learn more?
Call us today!
780-229-0174  #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy #hypopressives

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Feb 6

Open
We love hearing about our client and patient’s success! Hearing things like “I have progressed so much further than I ever thought it possible” is music to our ears! 👂 

At ASM, we pride ourselves on being an integral part of your rehabilitation journey! 

Call us today to book your assessment!
📞 780-229-0174

 #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy

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Feb 3

Open
‼️ N E W • B L O G • A L E R T ‼️ 

We are now 1 month into New Year’s Resolutions. 
Are you looks for tips for long term success? 💁 ✅

Making a resolution or setting a goal is the first step in making a change to your lifestyle or behaviour. Goals can be big or small, short or long term and they can be geared towards creating a new habit or reducing one we already have. Whether you want to get more sleep, eat better, or be more physically active, your goals will be the stepping stones to get you on the right track!

Check out of website to read the full blog post on how you can remain successful with your New Year’s resolutions! #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy

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Feb 2

Open
🌟 ASM SPOTLIGHT: INTRODUCING SYLYANNE 🌟 

Sylyanne Foo graduated from the University of Alberta with a Master of Science in Physical Therapy. Previously, Sylyanne completed a Bachelor of Science in Environmental Sciences with Distinction.
 
Sylyanne is passionate about working with clients of all ages and activity levels – she will take the time to understand how your injury is impacting your life and work with you to meet your own unique goals. Taking the time to set specific goals will allow her to appreciate what is important to you and to integrate rehab into your daily routine. Sylyanne’s goal is to empower each individual by helping you understand and manage your injury/condition and by providing tools and the latest evidenced-based treatment to aid in your own recovery. Her treatment style emphasizes education, manual therapy, exercise prescription, and self-management techniques, to optimize recovery. She is also determined in staying up to date with the latest evidence-based treatment through research and continuing education courses. Sylyanne has been fortunate enough to have experiences in acute care/ICU, community neurorehabilitation, geriatrics and orthopaedic settings throughout her education.
 
Outside of work, Sylyanne loves to spend time with her two senior dogs (Milo and Bella). Sylyanne enjoys different ways to stay active, such as running, hiking, biking, skiing and snowboarding, ice skating, and volleyball. Sylyanne also loves having a good brunch, spending time outdoors, and exploring different travel destinations. Her goals for 2023 is to complete a marathon and continue to be involved in the community through skating lessons and volunteering. 

☎️ Call today to book with Sylyanne!
(780) 229-0174

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Jan 30

Open
MOBILITY • MONDAY

“Mobility Monday” is making a comeback this week to feature “Around the World”
Thoracic Rotation 🌎 

Get your week started with the exercise above to help improve the mobility of your mid back.

Remember to listen to your body when attempting the above. 👂  #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy

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Jan 26

Open
We pride ourselves on providing the best possible care for our patients and clients 👥

Returning people to full function in their every day lives and increasing people’s quality of life is what we strive for 

We are so glad that we can help get people back to what they do!  #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy

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Jan 24

Open
E X E R C I S E • O F • T H E • W E E K

This week we are featuring a thoracic rotation exercise that combines lower body and upper body mobility.
Get moving this week and give it a try!
Remember to listen to your body when attempting the above.  #yeg #yegphysio #yegphysicaltherapy #yeglift #yeghealthandwellness #yeghealth #yegathlete #edmontonlife #edmontonathlete #stalbert #stalbertphysio #stalbertfitness #physicaltherapy #physio #edmonton #yegsportmedicine #education #advantagesportmedyeg #athletictherapy #yegathletictherapy
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Edmonton, T6X 0S8

Phone: (780) 229 0174

Fax: (780) 498 6024

Clinic Hours:

Mon-Thursday 7am-7pm

Friday: 7am–4pm

Saturday: 8am-3pm

Sunday: Closed

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St. Albert, AB T8N 6W2

Phone: (780) 460 9977

Fax: (780) 460 9978

Clinic Hours:

Monday-Thursday: 7am-7pm

Friday: 7am-4pm

Saturday: 8am-3pm

Sunday: Closed

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