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The Ready State: Mobility Training with Dr. Kelly Starrett › Forums › General › Need help finding the problem, fixing it, and preventing relapse.
I am having an issue and I am hoping by throwing it out to the community you guys can help me figure it out and then direct me to the resources to resolve it.
Main Issue: Pain toward the top of left hip, an inch or two lateral of the spine.
Background: The pain began at the end of a Muay Thia workout last Saturday and I originally thought it was general lumbar spine pain as I had a strained lumbar from heavy presses (bad form) 6 months ago for which I underwent 8 weeks PT. Prior to that workout I had been in the weightroom and had done squats and presses @95%. After resting, heating and taking anti-inflamitories for a day the pain was concentrated to the hip area leading me to believe it was the QL, but as I started feeling some knee pain as well thought possibly psoase.
A week and a day later: I now only have moderate pain when in the seated position, and minor lateral knee pain (mostly on the left side) Last Monday I got a TP massage and she originally thought QL, but noted my psoase had serious knots, but also noted a tight IT band. For the rest of the week have rolled, sticked, stretched, lacrosse balled, peanuted, and vodoo banded various things trying to find relief. I have limited my activity to walking and doing a various mwods.
Questions?
1-Does it sound like psoase or something else?
2-My best understanding is that to remedy it would be to work up and down the chain from it; any suggested starter wods?
3-Lastly, following one of the vids I tested my posterior chain by doing a lying leg raise. I my leg reached 49 degrees before my knee breaks. I also haven’t been able to touch my toes for years without bending my knees. I train kids and never want to let them get gnarred the way I have over time, I would have assumed that the stretching and foam rolling that I go through twice a day (during classes) four days a week would have been preventative. Does anyone have a daily maintenance routine they would suggest for developing athletes for prevention?
There is most likely more than one area that needs attention.
You are a system of systems.
Yes, your psoas is probably an impacting factor.
Jill Miller Smashes Your Guts! (and psoas, and tacked down viscera, and matted down abdominals…) Part 2
Episode 301: Psoas Flossing and Biker Hips
Episode 290 Haiku Contest And Landing Position Part 1
Episode 290 Haiku Contest And Landing Position Part 2
Episode 129: The Twin Bowstrings, the Psoas and Scalenes
Episode 87: Hip Impingement 2: Band Variation
Episode 75: Your Inside Psoas Bits, World Record?
Episode 40: USAW Oly Prep: Some New Hip Love /Psoas/Calves
Episode 26: Hips and Seppuku: Psoas and Hip Soft Tissue Mob
You have missing range in your posterior chain.
Stretching and foam rolling is a first step. If you are not hitting the areas that are tight or restricted then these areas will not improve. You need to freestyle and hunt to find what needs work.
What you do prior to a workout would change based on what you are doing that day, your tight areas, and places of restriction that you have.
Thanks Kaitlin!
I definitely agree that it is multiple issues since everything is connected and I also know I am missing range of motion since 49 degrees is far from 90. I have been doing the stretch for TJ Murphy episode (altered for my equipment) and am going to recheck my ROM today. I actually have put it on a spreadsheet with other metrics that I track every Monday.
Feel like I am on the right path since I have done several of those episodes (and more) already. Had not though to look at the landing position episodes. The hardest things seems to be singling out what needs the most work because of the total system work I am doing. Obviously the traditional diagnostic approach would be to remove variables to see the results, but I am hesitant to do that since I don’t want to slow recovery.
Good to hear you are seeing improvements with what you are working with.
Working with the area with the most restriction first will open up other areas within the system.
As Kelly has said in some of the videos and on the Joe Rogan podcast, tissue failure is rarely the result of a catastrophic event, but rather the sum total result of billions of repetitions over a period of time. Meaning, that you are not moving correctly, or good enough to avoid that tissue fault. But that is still not the right perspective to have. When I started having back pain in that area I adapted that mindset into everything, meaning everything I do day to day is contributing to the tissue injury, from how I walk, run, work and so on. Am I walking with right form using the right shoes… Am I sitting to much at the office. Is my spine in proper alignment all the time. When you couple this with the tunnel approach(impossible to recover from bad form under load when you start out with bad form) you can start making a bunch of little tweaks here and there and then back problems and other issues go away. The things I have found invaluable in my journey is a foam roller, lacross balls, a car orbital polisher, voodoo wraps, and a good chiropracter willing to actually talk and work with me though my dysfunctions.
This has been an interesting journey. I have been following these mobility wods for a longs time, but mostly when directed to do one by CFE or a few standard ones we repeat with my athletes.
With a week and a half of going through the videos above and more in order to learn more about what could be causing has lead to some good and bad things. The good thing is I have become more observant about my own issues; I have noticed when doing low load squats I clearly that my right foot turns out, I seem to running with a duck foot on the right, and when I bike my left knee points out if I don’t concentrate on keeping it forward. The bad news is that I am now doubting everything I do and stumped have lost some confidence.
As far as the original pain, it now only hurts when I am sitting. Sadly, I start back to school tomorrow so I will be doing a lot of sitting. I am still trying to figure out how reduce the pain, rolling my QL area with a oversized tennis ball (from petstore) is painful so I think it is in fact the area causing my issue.
I was already rolling, flossing, and using lacrosse balls as needed, but now the number of movements I tackle during my post workout routine has probably tripled. Hopefully I will see serious improvements with all of this extra work.
Identifying what needs work isn’t a bad thing.
Getting some of these things in order can help your bigger issues come around as well.
Have you watched the videos that address sitting to improve your position when sitting and different things you can do when you must sit for extended amounts of time?
You don’t need to hit all of your areas that need work everyday.
Instead pick the first 2-3 areas will lead to the most improvement and attack those first.
You want to spend quality time vs quantity of time.
No worries here Kaitlin, I don’t think that identifying problem issues is bad. Actually I am very happy about my ability to be more observant. But, it does make my to go take a step back aggravated wondering how long I have been doing some things that way, or debate internally about whether or not to try a movement if I have an issue. Its not a bad thing at all, just internally frustrating. I’m simply a perfectionist and hold myself to high standards. I don’t think I am alone in the athlete world with that issue.
No I have not looked at any videos on sitting, but I will be searching them momentarily.
Up until today I had been working many areas as part of my post workout biz, but up until today I had plenty of time do do it. Going forward I be doing only 2-3 a day.
Kaitlin, maybe you or other members could help me in prioritizing my 2-3 areas by helping answer a question. asside from the current issue- my goat seems to be posterior chain tightness, but I am trying to decipher the worst area. I described above that I assessed ROM using one of the videos. I know it is significantly dysnormal. At the same time, in one of the videos KStarr describes how many athletes end up with ROM of the hip that stops at 90 degrees. I did the same assessment and I can get each leg to my chest without issue.However, when doing the straight leg lift test, doing hamstring mob work, or even a simple hamstring stretch I actually feel the most discomfort in my calf… not in the hammy. Is this indicative of hamstring pulling on calf OR calf pulling on hamstring… since we know its all interconnected??
Your original question about pain from the crest of the hip is a tell-tale for having a locked up sacroiliac joint, in conjunction with a l3-l5 issue in conjunction with the hips locked in extension. This can lead to very serious problems. I know because I suffered the exact same thing. The pain while sitting is basically an elevation of the same condition, meaning its getting worse. High level athletes are able to perform with similiar or worse conditions because they do so many things. You are in good shape, and doing a lot of right things, so you are able to be functional in this condition, but as you grow older it will catch up with you. You have to find a good chiropractor that will work with you to unlock the sacroiliac joint and l3-5 out, you cannot do that on your own. A very good massage therapist may be able to unlock them but that is rare. When you have that level of fault the muscles will not relax via stretching, its part of the protection mechanism. They have to be massaged lose. Once your back is straightened, and your hips and sacroiliac is unlocked you can begin to work on a few areas. The first is the hip flexors. they need to be stretched and lacrossed, to do that get 4 balls and tape them in a pyramid structure. the second area is the psoas. the third is with hip mobility, put a foot up on a counter and try to get that foots knee outside the shoulder. As to your calfs being sore, I suggest listening to the joe rogan experience episode with Kelly, the walking/running part will give you insight as to the problems cause.
Debating on whether or not to do something isn’t a good place to be. You need to have confidence and commit to it or not commit to it.
High standards are definitely a good thing. Have it work for you.
If one area doesn’t stick out just pick one of them.
Sounds like your calf is also tight. Go to work on them.