Adductor Pain

[ceast]

New to the program and forums, but not so much to lifting. Worked with a few coaches (Westside most recently) over the years but that's no longer possible given with my current schedule. I'll keep this as short as possible.

I'm a cyclist, strength training makes me a better cyclist and more functional human being. Those are pretty much my only two reasons for lifting. I've always had fairly significant groin soreness from squats. About a year ago it became extremely severe and also included the adductor magnus/brevis (from what I can tell). So, not just the inside of my thigh, but the back w/o including the large hamstring muscles. Way more severe in the right leg than the left. DL (sumo and regular) caused no issues, even at high load. For reference sake, I couldn't handle squatting more than 135, but DL was over 300.

A PT thought it was a pinched sciatic nerve (I wasnt' convinced) and had me doing a lot of hip/hamstring mobility work. Another PT (when the first was out sick) thought it was more of an issue of near non existent glute recruitment, causing the adductors to pick up work they weren't remotely ready for. According to him, glutes can get "turned off" in a lot of folks and simply don't contribute the way they should. This seemed more plausible. Their treatment was: stretch the way too tight adductors out so they fire later in hip extension, fix the faulty glute firing timing, strengthen glute max and med.

Any thoughts here? Looking forward to getting back to lifting, but scared I'll have another setback.

I'm sure I left out something important. Thanks in advance.

[Dale Waters]

A video of your squat (with whatever weight you can manage) would be helpful. Glutes do not get turned off unless you have severe nerve damage or severed muscles.

Are you doing ultra-wide stance with toes forward? Also, is the pain soreness, or more acute? Dose cycling hurt? It's helpful info, but el squat vid is necessario.

[ceast]

I used to do quite wide stance, toes out, then went a bit narrower, still toes out. Both seemed to do it, but I think wide was worse. Now I'm following the book so my squat form is vastly different (much more horizontal torso, true low bar). The pain would seem like bad soreness at first (12-24h), but then progress to acute (24-36H) that was most severe at the pelvic attachment. By severe, I mean I couldn't bend my leg at the hip for a few days without the muscle spasming and feeling like it was going to rip off at my taint. Riding definitely hurt, it actually was possible as I couldn't make the hip angle. Anything where I had to bend at the hip.

I forgot to mention, apparently my left SI joint was completely immobile, causing a right shift at the bottom of my squat, but is more free now.

I'll get a video up when I squat again Friday.

[Alex Ptacek]

I've had lots of experience with adductor soreness. I used to squat with toes out a lot, but pointing them more forward has helped alleviate a lot of the issue. I still squat pretty wide, but I point my toes out between 15-20 degrees. My worst pain was when I had them out close to 45, I just didn't have the mobility to squat like that. Try turning them in a little.

[Will Morris]

New to the program and forums, but not so much to lifting. Worked with a few coaches (Westside most recently) over the years but that's no longer possible given with my current schedule. I'll keep this as short as possible.

I'm a cyclist, strength training makes me a better cyclist and more functional human being. Those are pretty much my only two reasons for lifting. I've always had fairly significant groin soreness from squats. About a year ago it became extremely severe and also included the adductor magnus/brevis (from what I can tell). So, not just the inside of my thigh, but the back w/o including the large hamstring muscles. Way more severe in the right leg than the left. DL (sumo and regular) caused no issues, even at high load. For reference sake, I couldn't handle squatting more than 135, but DL was over 300.

A PT thought it was a pinched sciatic nerve (I wasnt' convinced) and had me doing a lot of hip/hamstring mobility work. Another PT (when the first was out sick) thought it was more of an issue of near non existent glute recruitment, causing the adductors to pick up work they weren't remotely ready for. According to him, glutes can get "turned off" in a lot of folks and simply don't contribute the way they should. This seemed more plausible. Their treatment was: stretch the way too tight adductors out so they fire later in hip extension, fix the faulty glute firing timing, strengthen glute max and med.

Any thoughts here? Looking forward to getting back to lifting, but scared I'll have another setback.

I'm sure I left out something important. Thanks in advance.

Do you have a previous history of polio? Sacral plexus injury?

[ceast]

No polio.

Sacral plexus - I don't think so, but I crashed my bike a fair bit during my racing days and had some cortisone shots in the hip to deal with the resulting pain. Googling it would indicate that I do have some chronic pain in that region, but not specifically related to lifting.

[ceast]

Wow, I just noticed I managed to post this in the wrong sub forum. I read repetitive injuries instead of inquiries.

[ceast]

YouTube

Video link. Go easy on me, this is a massive difference in form from how I used to squat. Watching this I see some issues, although I don't think they are related to this injury.

This felt decent actually, but can never tell if anything is messed up until 24h later.

[Will Morris]

No polio.

Sacral plexus - I don't think so, but I crashed my bike a fair bit during my racing days and had some cortisone shots in the hip to deal with the resulting pain. Googling it would indicate that I do have some chronic pain in that region, but not specifically related to lifting.

Sadly, gluteal amnesia is a diagnosis provided by physical therapists that is just generally, utter nonsense...except in the case of post-polio syndrome, stroke, or a sacral plexus injury. The adductors only function as a secondary hip extender when you are in a position of flexion, abduction, and external rotation.....but, they work as a secondary mover. The glutes and hamstrings perform the bulk of the power here.

Most adductor issues are a result of not actively driving the knees out to the side, but rather, allowing your knees to passively flop to the side when you go down into the squat. Letting your knees drift out and actively externally rotating and driving them out are two totally different things. The mostly passive positioning of your knees to the outside, followed by the quick concentric pull of the adductors coming out of the bottom is what does it.

[ceast]

Sadly, gluteal amnesia is a diagnosis provided by physical therapists that is just generally, utter nonsense...except in the case of post-polio syndrome, stroke, or a sacral plexus injury. The adductors only function as a secondary hip extender when you are in a position of flexion, abduction, and external rotation.....but, they work as a secondary mover. The glutes and hamstrings perform the bulk of the power here.

Most adductor issues are a result of not actively driving the knees out to the side, but rather, allowing your knees to passively flop to the side when you go down into the squat. Letting your knees drift out and actively externally rotating and driving them out are two totally different things. The mostly passive positioning of your knees to the outside, followed by the quick concentric pull of the adductors coming out of the bottom is what does it.

Thanks, this makes sense. So the basically they were slack going down, then snapping into tension at the bottom, which is a larger stress than constant tension down and up. I'm sure that prior to reading the books, and still likely bit now, I'm not great at actively driving my knees out. Definitely had more of a "if they're not caving in, I'm okay" thought process.