Member
Update on hip/groin problem
History:
Squatting and power cleaning back in August started noticing my left groin was really sore. Pain originates up at insertion point of adductor tendon. Tried to train through it, got worse to the point where rolling over in bed would wake me up at night.
Went to a PT that is himself a powerlifter. Tried some stretching/dry needling/etc and none of that shit worked and actually made it worse.
Tried sort of a modified Starr protocol with squatting, didn't work - as soon as the weight got heavy enough the groin would get pissed off again.
Tried taking time off. After 3 months the pain had basically subsided but as soon as I started squatting again it would come back.
Since then I have just been deadlifting and pushing a sled, since that doesn't bother it.
Went to an ortho who ordered an MRI with contrast in January. Results showed some slightly worn cartilage and a subsurface labrum tear. Forwards me to a sub-specialist that does hip arthroscopy and other procedures. Top surgeon in the area (Charlotte).
I just met with him this morning, and after looking at MRI and an exam, he said the following:
1. Injury is presenting very much like a sports hernia, but MRI doesn't show one
2. Labrum tear is the result of some hip impingement, but not directly related to the groin pain
3. Doesn't recommend getting the hip scoped unless absolutely necessary since the impingement wasn't affecting my squatting.
4. Recommends first trying cortisone shot to the adductor insertion and getting me back to squatting again after a week and see if pain returns.
5. If pain returns, recommends doing a cortisone shot to the hip/labrum side to see if groin pain is some sort of referral pain.
Any other thoughts/recommendations here?
✓ Member
I would be careful with the cortisone shots. They can have negative effects on the joint, although they can relieve symptoms. High hamstring/adductor tendinopathy is a serious bitch. I don't know that I have any great words of wisdom here besides what you have already done. We'll see if anyone else has input.
Member
A cortisone shot to the adductor insertion could cause damage to the joint?
The MRI shows a healthy adductor insertion area - so is it the shot it self that would cause the damage in that case, or were you referring to a shot to the labrum area?
✓ Member
I should have been more specific. It can be deleterious for the connective tissues, such as tendons and ligaments, that hold the joint together. For example, you can only inject an area with cortisone so many times before doctors throw their hands up and say, "no mas!" This might be a miracle cure, or it might buy you a year or two of being pain free before it comes back. I cannot tell you. I can tell you that you should do some reading and ask a lot of questions of your doctor.
Beware of what the NYT has to say on things health-related, but this is actually reasonable:
https://well.blogs.nytimes.com/2010/...-things-worse/
It also links to the Lancet study that forms the basis of the article. If you were really interested, you could track it down, too.
✓ Member
To bring this around full circle, we don't know what causes tendinopathy. It is a description of symptoms, not a diagnosis. The causes are likely multi-factorial and differ between patients. We don't know what it is and we don't know how to make it go away. Cortisone shots are not fully understood, either. I wish I had something more for you.
✓ Member
I have exactly the same symptoms, but only for about 6 weeks now.Originally Posted by tweakxc03
I have no other recommendations for you, but I'll hang around in this thread - to see if you have input for me or to relate my experiences to you.
What I noticed is that the pain seems to fluctuate, sometimes after squats it's a little better or not worse, sometimes it gets aggravated again. The next thing i'm gonna try is reduce squatting frequency (currently 3x/week HLM). Yesterday I did some squatting up to moderate weights (around 50-60% for 5s) and the sets were okayish after the first rep, but after the workout it really hurt again. I'm not sure yet if deadlifting and power cleans bother it, because i definitely feel it, but less than in squats, yet after the workouts with DL or PC in it, the pain seems to increase more than after just squats.
After 1-2x 800mg Ibuprofen it got better so far and stayed better, until squatting heavyish again. Weird is that sometimes the squatting hurts to the Point i can't do it, and sometimes it's possible but afterwards the hip flares up again.
I don't want to aggravate the situation, but I'm not sure if working through the pain or taking time off from squats would be worse. The normal rehab protocol doesn't work/apply here. I'm not sure pausing squats altogether for a longer period would be a good idea and do anything but make me weaker.
I tore some fibres in the left adductor in december, did the Rehab Protocol, and soon after getting back to working weights the adductor/hip/groin area acted up. I'm not sure it's related, but i suspect it. I have a pelvic tilt and maybe i favoured the injured side, leading up to the new injury by uneven loading. Just a theory. I have an appointment with a chiro in a month.
Hope you get well, tweak (isn't that some character from South Park..?).
Member
Are you treating an adductor tendon or the hip joint? Your 2nd point inclines towards adductor tendon. If so, you'd be smart to question the proposed justification for cortisone injection.
Simply, are you only sore in one point (the tendon) when you either i) squat or ii) prod it?
Start adductor isometrics. 3 lots of 20 seconds, twice a day. Squeeze the hell out of a foam-roller placed between your legs. Each hold should be fatiguing, but not pain-producing. You should be shaking. Isometrics function not only as a bridge to isotonic work, they also augment descending neural inhibition. That is, they are your non-pharmalogical analgesic.
Don't go straight into LBBS. Spend a week or two front squatting. Leave at least 48 hours minimum between squats. Tendon's swell transiently for 48 hours in response to load- give it the full time to adapt. On the recovery day, hit the isometrics again.
I had this injury last year. It has not disrupted training since. Successful management requires attention to loading. You can PM me if you'd like some help with this. I understand it's a frustrating injury.
Member
I have the same problem...its basically arthritis
Arthritis affects the surrounding tissues....its sucks and you basically have to learn to live with it...just focus on what you can do as opposed to what you cant do
✓ Member
When did we start talking about arthritis?
Member
Justification for the cortisone shot is to stop the pain in the adductor. The labrum tear isn't the source of the pain, and in general he doesn't think surgery is necessary to repair the labrum.
As I said before, MRI shows that the adductor insertion is healthy, so who knows why there is pain there to begin with. Squeezing a foam roller or whatever it is you are talking about is exactly the kind of thing that would inflame the adductor to the max, so I'm not sure why that would be a good idea.
I've been able to get back to doing some very light squatting without much soreness in the adductor in the last couple of weeks. I haven't really been pushing it either.
Unless somebody can explain to me how ONE cortisone shot as a test to see if it works is going to destroy my hip joint, I'm going to go ahead with it this week. If the pain comes back I don't intend on getting a second one.
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