Written by Anthony LoGuarro – Maidstone Franchise Partner
I recently had a client we will call him Bobby, he come through into my Maidstone clinic the week of his local Footy Grand Final. He was increasingly worried about an issue he had been feeling in his upper left groin for three weeks. He initially noticed an achy pain the day after the last round game which he chalked down to the usual post-match soreness, but by Thursday night’s training session it was still noticeably there. He got through training and managed to play through the minor discomfort in the first final leading to his team qualifying for the grand final and earning him a week off and 10 days rest.
However; after training on Tuesday it was clear that the pain hadn’t gone away, in fact it was worse. The ache was beginning to move more noticeably to testicular pain. He got in touch and came down to our new Maidstone clinic on Thursday before training, by this stage more in hope than confidence as the grand final was two days away.
“Mate, you need to help me. I think I’ve done my groin and I can’t miss the Grand Final!”
After going through the history of the issue, we began assessing the strength of all his muscles around his hip, glutes, hamstrings and quads were fine. A were his adductors, where he was experiencing the pain! So far there was no pain but I had left one muscle group to check last as it was my suspected cause of his pain: the hip flexors. Low and behold, their strength was down and it brought on the exact same pain he had been feeling. I smiled and pulled a weird face. ‘Is it bad? Can I play?”
I was confident that by releasing his hip flexors, specifically the psoas and iliacus muscles, we would see a significant improvement in a short period of time – enough for him to play with minor discomfort. We would then get the wheels in motion for a full recovery in follow up treatments after the game. I also know from previous experience that treating this area isn’t the most comfortable thing in the world.
We did some active myofascial release, a technique where I would apply pressure on specific points of a muscle while getting Bobby to bend and straighten his hip. I started off gently, only pressing hard enough to reproduce his pain symptoms at a 6 out of 10. Any higher and he won’t be able to keep his muscles relaxed. As the muscle released and pain reduced, I increased my pressure but still not going higher than a 7 out of 10. After treating all of the hip flexor muscles, we retested his strength and it had improved greatly and most importantly, the pain was gone.
Curious, Bobby asked why pressing around his abdominal region alleviated the problem in his groin. I pointed out the hip flexor muscles on a poster on my wall, showing that the belly of those muscles sit on the inside of the hip bone. In front of the spine, behind the intestines, and they attach into the top of the leg in the groin region. Pressing on the trigger points in the muscle bellies referred the pain downwards.
He also questioned how the testicular pain occurred when it was a muscular issue. I explained that is was not uncommon for trigger points in the psoas muscle to radiate into that area. But also that the genitofemoral nerve runs through the muscle on its way down to the testicles and a tight psoas can cause pain there. More importantly, I encouraged him to see his GP regardless as men’s health is nothing to avoid even as a young male in his 20s!
If you are experiencing this pain or a similar type please contact your Myotherapists to assist you!