I have a 25 year old male, h/o LBP for which he recieved injections recently with good results, went back to gym., might have overdone it, now has diagnosis of groin pull. Does not have reproduction of symptoms with any back movement, plapation etc, only with palpation of hip flexors. Deep tissue work on iliacus, psoas and pectinuis , ice and stetching give some releif, but would like to progress him further. Start exercise or continue to address pain issue? I guess the real question is, do I wait until most of the pain is gone to start exercise or start now? he is back in gym doing upper body and really wants to return to lower extremity work outs, slowly of course. He stands all day, can do stratches frequntly, but can't sit down often to unload structures. Advice please. Many thanks.
Does he have pain even with walking/standing? try seeing if repetitive press ups (10-15) going all the way until he feels a strain in his back change his hip flexor pain level with whatever elicits his pain (even though palp/single ROM doesnt affect repeated motions if you havent already tried might)... also can try if unilateral a lateral glide MWM of the hip with belt during painful motion (ie squat...ect)- the try to do exercise in high reps if you can get him pain-free with the sustained mob...know that doesnt really answer your question regarding exercise... Maybe have him avoid repetitive open chain hip flexion exercise and start CKC
also check out femoral nerve tension- in prone knee bend position see if it is affected by cervical flexion/extension and how soon he feels the stretch- if you suspect nerve tension adding some nerve sliders or tensioners could help too
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