Ask a PT

156 Posts
 
Posted - 02/14/2008 :  16:44:38  Show Profile  Reply with Quote
Our user asked: "Hi there! I received a groin pull three years ago as a result of falling off a horse. After a year of being in pain while I rode, I went to PT. My dx was a groin strain and the massage, strengthening and stretching tx the PT prescribed helped quite a bit. However, it's been a year since then, and the stretches have helped very little w/ flexibility and pain control. My main problem area seems to be the hip adducters - I cannot lift my legs up off the saddle (aka - widening my legs). Now I know I can go back to my PT for further discussion, but here is my main question (which may not translate well over the internet, but I'll try): I noticed that while sitting in the saddle and swinging my effected leg back and forth (swinging from the hip joint, not the knee joint), if I relax or plantarflex my foot while swinging, I feel intense pain through my medial thigh. However, if I really dorsiflex my foot throughout the whole swing, I don't feel any pain. I'm assuming the pain I feel is the hip adductor/groin strain pain (as it's the same intensity and location as the original pain), but I don't know how this relates to foot flexion. Perhaps this discovery will shed more light on my dx and change tx. Do you have any insight? Thank you very much!"

Ask a PT Response: "What you describe is very interesting and I will try my best to give you my theory behind what you describe. You mention that when you swing your affected leg back and forth (hip abduction/adduction) on the horse with your leg relaxed or foot plantarflexed you experience intense pain in the region of your inner thigh. However, when your foot is dorsiflexed and you perform this motion pain is not elicited. My theory would be that when you dorsiflex your foot you are recruiting other muscles (ie. hip flexors, hip rotators, sartorius, hamstring etc..) concurrently besides the main muscles which are responsible for generating the motion of hip abduction and adduction. These secondary muscles are recruited and are in synergy with the main muscles when you perform hip abduction/adduction with your foot dorsiflexed. This would allow for more stability and less strain on your adductors when you perform the movement. This is just my theory but it makes sense to me and another PT I discussed this with. One thing that I would suggest for you, if you have not already done so, is to have your PT examine your pelvis. A dysfunction or misalignment in this area, including your pubic symphysis, can affect you groin region. Therefore, you can stretch as much as you want and you will not achieve lasting gains or relief from pain if the problem in this region is not corrected. I hope this helps and I wish you the best of luck."