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Many of you looking at this page, may be doing so, as you are looking for the most useful stretches for keeping your back muscles supple and maintaining flexibility in your back and hips. And you may also have found this page because you have front (anterior) groin pain. Occasionally, groin pain can result from a worn (osteoarthritic) hip joint, and if there is significant hip osteoarthritis then eventually a joint prosthesis may be required. However, this is the 'end stage', and even if this were the case, then effective osteopathic treatment (probably with some hip traction / distraction and range of motion optimisation) may prove beneficial. And there is a lot that you can also do for yourself, with appropriate and accurate stretches. These video clips are an adjunct to Osteopathic treatment (or physiotherapy) and are not intended to be a substitute for it. So caution and guidance is recommended.
Groin or hip pain may result from over-tight hip-flexors (psoas muscle) and it may be on one or both sides. If the pain is worse on one side, it suggests a much tighter hip flexor on that side – and possibly some pelvic torsion or more global muscle imbalance. For this, it's probably a good idea to visit an Osteopath (at least once, for an assessment) as there may also be spinal restrictions. Osteopathy can be an effective treatment – yet there is also scope for your own self-management – and certain stretches can be helpful.
Of course, there are reasons why your groin pain is on one side, and not the other. Leaping out of a right hand drive vehicle, always onto the right leg, may be enough to generate right groin pain – or at least exacerbate any pre-existing injury. There may be a muscle tear on one side from sport's injury, and many things can aggravate this. Typically the body needs rest (and appropriate rehabilitation and treatment) to fully heal. You may need to suspend or reduce your training – otherwise it will get steadily worse.
Seeing your osteopath or physiotherapist would be an excellent idea, if this is your predicament. Particularly if you want to excel in your chosen sport – or even if you just want to live pain-free! For severe cases, sadly surgery may be required. But to begin with – seeing a sports physiotherapist or osteopath would be the first port of call. An osteopath (or a good physiotherapist or musculoskeletal specialist) will be able to evaluate and detect any muscle imbalance and altered biomechanics, that may be predisposing you to pain on one side.
And of course there are many other causes of hip and groin pain, including low back sprain and injury, sacro-illiac joint dysfunction etc. For more on this, please see: Hip pain
There may also be medical causes: possibly a psoas abscess, or peritonitis (usually, but not always, with other symptoms such as abdominal pain, fever, night pain, etc) and it is sensible (essential) to have this checked out from a healthcare professional (GP, osteopath, etc).
Sadly, as previously mentioned, hip osteoarthritis – where there is erosion of the cartilage and loss of joint space can also be a major cause of groin pain on the side of the worn hip joint. Physical therapy (osteopathy, physiotherapy, etc) may be of some help, and at least achieve palliative treatment. Your osteopath (or physiotherapist) is a good person to assess the joint range of motion, and any loss of normal range (particularly in internal rotation). Ultimately, for a severely arthritic degenerative hip – where the ball and socket joint has become worn, a joint replacement hip prosthesis is required. See: hip replacement
If this is your predicament then effective physical therapy (e.g. osteopathy / physiotherapy) may be very helpful. An x-ray and other medical imaging can show any loss of joint space or degenerative changes. (And yes, here in NZ, an Osteopath or physiotherapist can also send you for an x-ray. You don't necessarily have to go to your GP for this).
However, there are many other reasons for hip or groin pain, as mentioned, and frequently it can be a combination of over-tight hip flexors and weak core (abdominal) muscles. Another component can be very tight gluteal or piriformis muscles (again this pattern often tends to also be compensatory to poor core strength or under-used abdominal muscles). Please see my other video-clips of pilates exercises to help strengthen core muscles: Pilates and Core-stability
And, of course, it's not always weak muscles that cause the problem (true – most physiotherapists seem to think this way).
Yes, often (in most cases) the core-abdominal muscles could be stronger – but if there is weakness or under-use in one place, there will invariably be over-use or tightness somewhere else. As an Osteopath, I find it helpful to emphasise muscle length (for tight muscle) rather than muscle strength for weak muscle. And this is where stretching comes in. Particularly for the ageing athlete.
In youth, muscles are elastic and there is often good natural flexibility – but the ageing process slowly results in a loss of this, and we tend to become more brittle and inelastic, and there is some natural demineralisation and loss of strength, and certainly loss of flexibility. (and sadly our recovery time from injury seems to get longer and longer. We no longer bounce back as we once did).
What I'm trying to say here – is that we (hopefully) get away with it in youth – but in middle and old age – we have to exercise and train far more 'intelligently'. And this is where at least some gentle stretching can be so helpful.
For hip pain, and lower back pain, and sacro-illiac joint pain – have a look at these simple stretches. Please go gently, never push through the pain, but stretch regularly. Please have a look at this sequence – for hip, low back and groin pain:
Show video: Hip/piriformis/gluts stretches + twists
And here are a few other hip-opener type stretches that you might also want to check out:
Supta Baddha Konasana – Yoga Hip Openers
Show video: Reclined Hero Pose Full Length | Andrew McGonigle | Online Yoga | Movement for Modern Life
Supta Virasana – Restorative Yoga Pose inspired by BKS Iyengar
Show video: Supta Virasana, Restorative Yoga
The caveat again here, again, is that one should never attempt to perform these yoga postures without the guidance and supervision of a qualified teacher. Your osteopath or physiotherapist should be able to advice you on any planned exercise, and when to return to exercise, and what kind of exercise would be appropriate and safe.
Of course, there is usually a way of training with injury, under the supervision of an experienced personal trainer – but ideally, if available, it's good to be assessed by, and be guided by an experienced osteopath, physiotherapist, or exercise-physiologist also.
MRIs and other medical imaging can be helpful – but it is usually best that your osteopath (or physiotherapist, or musculoskeletal specialist) helps plan your recovery and rehabilitation, particularly after serious injury.
CAUTION is always advised. If something doesn't feel right – don't do it! When in doubt stop. Never attempt to push though the pain.
Disclaimer: whilst every effort has been made to demonstrate these movements (as shown in the video clips) in as safe a way as possible, no responsibility can be taken for any injury caused, or aggravated, by doing, or attempting to do, any of these movements or exercises. A major reason for presenting the video clips in this Chapter is to present as safe a series of exercises as possible. However, please use your own judgement, and only do, or attempt to do something that you feel OK with, without any pain or stiffness.
No responsibility can be taken for any injury you may sustain from attempting to perform any of these exercises. Some links are from other sites, and caution and self-responsibility at all times, is also advised. Ideally, always try to find a local class, with a competent and qualified teacher. This also ensures ‘safety’ as someone can keep an eye on you, to ensure you are doing everything properly, safely, and getting the best from your practice.
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