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  • Lionel Pannunzio PT / SCS

Introduction


Playing soccer puts a high demand on Groin muscle in general and hip flexors in particular.

If you been around soccer for a while I'm pretty sure that You may heard about " I pull my hip flexor " or " hip flexor injuries".

In today's post I will discuss with you, the different type of injuries Soccer Players may have surrounding the front of the hip and more specifically problems associated with the Hip Flexors.



What are the Hip Flexors ?





The Hip flexors are a group of muscles located in the front of the hip joint.

There are two main muscles in this group : The IlioPsoas and the Rectus Femoris. These muscles, when working together, create powerful hip flexion contractions necessary for kicking (shoelaces kick , long balls), sprinting and change of directions .



Hip Flexor Injuries



Location of Hip Flexor injury ( light blue area)
Location of Hip Flexor injury ( light blue area)



The most common cause of anterior hip pain is IlioPsoas-Related Pain.

The IlioPsoas is a two-part muscle ( Illio and Psoas ) located deep in the anterior hip joint area

The injury of the hip flexors occurs due to excessive strain on these muscles creating a muscle injury than can go from a small microtrauma of the fibers to a complete rupture of the IlioPoas.


What can cause a Hip Flexor Injury?


The most common mechanism of injury are Kicking, sprinting and change of directions.

In my years working with soccer players, these are very common activities or situations that increase the risk for a hip flexor injury:

  • Shooting practices where the player takes multiple kicks or goalie practices where the goalkeeper rehearse goal kicks or punts over an over are very common scenarios for Hip flexor Strains.

  • Overuse or overload from back to back games without proper resting or hip mobility drills to restore proper length of the hip musculature is another cause that predisposes soccer players to this injury. (see my post on hip mobility on how to restore hip mobility after games or practices)



Severity of the Injury and Time for Healing




Hip Flexor Exercises


Restoring the strength of the hip flexor and mobility of the hip is a challenge and you should not return to play without proper treatment because this problem has a high rate of re-injury. Follow the exercises below to start working of these two pillars of a good recovery: movement and strength.

Hip flexor Mobility in Half-Kneeling







Knee to Chest Mobility Work



Setup

Begin lying on your back with your legs straight.

Movement

Using your hands, slowly pull one knee toward your chest until you feel a gentle stretch in your lower back.

Tip

Make sure to keep your back relaxed and flat on the ground during the stretch.




Hip flexor Isometric



Setup

Begin lying on your back with your knees bent and feet resting on the floor.

Movement

Bend one leg up to a 90 degree angle and place your hand on your knee. Try to bend your leg toward your chest, but resist the movement with your hand.

Tip

Make sure to keep your trunk stiff and do not arch your low back during the exercise.




Hip Flexor Strengthening at 90/90 with Abdominal Bracing



Rationale:

Create a contraction of the Abdominals and Hip Flexors synchronically which will make you more tolerable to Hip Flexor activation to promote healing with less pain.

Setup

Begin lying on your back with your knees bent and feet resting flat on the floor or on the Swiss Ball.

Tighten your abdominals and lift one leg up to a 90 degree angle, then lift your other leg to the same position and hold, keeping your abdominals tight. Then lower each foot in the same order to the Ball or the floor if you don’t have a Ball.





Hip Flexor Strengthening with band



Setup

Begin by lying on your back with your hips and knees bent, and feet resting flat on the floor. Your arms should be flat at your sides, palms facing the ground.

Movement

Lift your legs off the ground to 90 degrees , then slowly straighten the opposite leg holding the involved leg at 90 degrees in an isometric contraction resisting the pull from the band.

Tip

Choose a light band first and Do not allow your back to arch during the exercise.



Conclusion


  • Hip Flexor Injuries are very common in soccer players

  • Follow the progression of exercises listed above in the order presented: first mobility, then isometric contractions , then band workout

  • Soccer players need strong but at the same time mobile Hips.

  • You will feel stronger and quicker once you do these Drills



#Groinpain #HipPain #AdductorPain #AdductorStrain #PulledMuscle #Soccerinjuries #publagia #sportshernia #Soccergroinpain #soccerpubalgia #westonsoccer #westonhippain #hippainsucks #westonflorida #westonfloridaphysicaltherapy #daviefl #coopercityflorida #pembrokepinesfl #miramarflorida #weston #physicaltherapy #southwestranches #westonfitness #livinginweston #hipflexor #hipflexorinjury #hipflexorpain


Are you having Hip or Groin pain while playing soccer ?

Do you want to find out what tissues or muscles can be causing your hip Pain ?




IF YOU ARE



OR READY TO START



GETTING BETTER



CLICK HERE









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Introduction


Our 5th and last blog post on Hip Strengthening will be dedicated to the one the most powerful muscles groups in the lower limb: the Hip Adductors.



What is Hip Adduction?


Adduction is the movement of a limb toward the mid-line of the body. If we think of the hip then we’re looking at the pelvis and the femur moving toward each other.





In soccer think about a pass or kick with inside of your foot, Hip adduction happens when the kicking leg is off the ground and moving toward the pelvis. It can also happen with the foot on the ground and the pelvis moving toward the leg. ( think about the plant leg in the same kick).



Anatomy of Hip Adduction



The adductors is a group of 5 muscles:

  • the adductor longus,

  • adductor magnus,

  • adductor brevis,

  • Pectinus

  • Gracilis


Why having weak or tight Adductors can lead to serious problems for Soccer Players?


Lack of movement in adduction and / or weakness in these powerful muscle group have been associated with Low Back Pain, Groin Pain, Pulled Hamstrings to name a few.


There are many reason why Hip Adductors can be stiff , weak and tight. Sports that require repetitive sprinting, kicking or constant change of direction ( football, soccer , rugby , hockey ) load the adductors and can increase your risk of having a Adductor injury or Groin Pain.


When these muscles are weak or tight ( tightness is another sign for weakness), they will not have the proper length to allow the limb to properly access to the extremes of the movement causing tearing or pulling of this muscles.


Furthermore, the body will sense this inability of the adductors to function adequately and will compensate with another muscle group to allow us to keep doing those important movements we need to play soccer, overloading other joints or muscles like the hamstrings, gluteal muscles, hip flexors or lower abdominal muscles.



Adductors and Groin Pain


Tight hip adductors will overload the Groin area and may damage the surrounding soft tissues like the Inguinal canal, the abdominal wall and even the bone when they pull “too hard “ from its attachment and causing pain in the pubic area


Adductors are one of the main causes of Pain in people with Chronic Groin Pain. Groin Pain always goes with weakness in adduction and this is one of the movements , we as therapist, need to restore first in these cases. Research (Kristian Thorborg 2018) shows that from all the Groin injuries, the Adductor Group ( inner thigh muscles) accounts for 40 % of them.


The most common Injury to the Adductor Group is a muscle Strain of the Adductor Longus (aka Pulled Muscle)



The adductors is a group of 5 muscles: the adductor longus, adductor magnus, adductor brevis, Pectinus and Gracilis. 62 % of Adductor Tears occurs in the Adductor Longus, that thick vertical muscle in your inner thigh. If you want to Lean more about Adductor Strain, check out our Blog Post on this topic




How to improve Hip Adduction


By now you can see that having proper Hip Adduction ( mobility and strength) are super important components, so now I will share with you different exercises you can do to improve them.


Hip Adductor Mobility Work


In this first two Videos, I demonstrate how to increase hip range of motion


Knee to Chest mobility work



To improve hip flexion and gentle mobilize your groin area to reduce symptoms of pain and stiffness.


Setup

  • Begin lying on your back with your legs straight.

Movement

  • Using your hands, slowly pull one knee toward your chest until you feel a gentle stretch in your lower back.

Tip

  • Make sure to keep your back relaxed and flat on the ground during the stretch. Use this as part of your warm up or after games to maintain a healthy balance at the hip and play pain-free


Adductor Mobility Work


Hip Strengthening


Supine Hip Adduction - “Ball Squeeze “




Setup

  • Begin lying on your back with your legs bent, feet resting on the floor, and a soft ball positioned between your knees.

Movement

  • Engage your core musculature by Bracing with your abdominal muscles

  • Squeeze your knees together into the ball, then release and repeat.

Tip

  • Make sure to keep your back flat against the floor during the exercise.


Conclusion


  • Soccer players need strong but at the same time mobile Hips.

  • Today I showed you the importance of hip adduction for this sport.

  • You have now two mobility drills and 1 exercises to improve Hip Adduction.

  • You will feel stronger and quicker once you do these Drills



#Groinpain #HipPain #AdductorPain #AdductorStrain #PulledMuscle #Soccerinjuries #publagia #sportshernia #Soccergroinpain #soccerpubalgia #westonsoccer #westonhippain #hippainsucks #westonflorida #westonfloridaphysicaltherapy #daviefl #coopercityflorida #pembrokepinesfl #miramarflorida #weston #physicaltherapy #southwestranches #westonfitness #livinginweston


Are you having Hip or Groin pain while playing soccer ?

Do you want to find out what tissues or muscles can be causing your hip Pain ?




IF YOU ARE



OR READY TO START



GETTING BETTER



CLICK HERE









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Introduction


We continue with our series on Hip Strengthening Exercises for Soccer Players and today we will focus on the hip internal rotators



What is Hip Internal Rotation?





Hip internal rotation is the twisting movement of your thigh inward from your hip joint.

In soccer, Hip internal roration is very important to

  • change of direction or when making a cut Hip Internal Rotation helps decelerate the body while also loading the hip allowing for a powerful re-acceleration.

  • When sprinting Hip Internal Rotation allows a soccer player to maximally extend their hip. You know from our previous blogs on this topic, how important Hip Extension is for playing soccer.

  • For rotational movements, Internal Rotation is crucial for optimizing force transfer from the upper body to the lower extremity.

  • In strength training, having and optimal Hip Internal Rotation allows the femoral head to remain centrated within the acetabulum allowing for a pure Squat pattern without compensations at the lumbar spine/knees/ankles.


Anatomy of hip Internal Rotation






As estrange as it could sound, we don't have any primary Hip Internal Rotation Muscles, yes, none. Other muscles from the hip which their primary functions is not Internal rotation will secondarily rotate the hip internally.


These muscles are:

  • the adductor longus, brevis, and magnus (your usual inner thigh muscles )

  • Pectineus muscle: The pectineus muscle is a flat, quadrangular muscle that lies at the top of your inner thigh, often referred to as your groin muscle. It's primarily responsible for hip flexion, but it also rotates your thigh and adducts, which means it pulls your legs together when the muscles contracts.


One of the main problems in soccer players, is lack of Hip Internal Rotation


For a healthy Hip, we need full Range Of Motion (ROM) in all the directions. We discuss in other blogs the problems associated with the lack of Hip Extension and for Hip Internal Rotation the situation is very similar


Lack of Hip Internal Rotation may lead to:

  • increased risk for adductor strain in professional soccer players

  • increased lower back pain in professional soccer players.

  • back and abdominal muscle injuries in soccer players.

  • increased risk of Hamstrings injuries.

  • increased risk of Groin Injuries

  • Labrum tear (inside the hip joint ) and Femoro-Acetabular Impingement.



We have the solution for those deficits of Internal Rotation...


Mobility drills and strengthening are a must for every joint but especially important for the hip. Restoring full ROM in between practices and games is mandatory is you want to stay pain-free.


Hip Internal Mobility in Supine


Setup

  • Begin lying on your back with your knees bent, feet flat on the floor, and legs wider than hip width apart.

Movement

  • Let your knees fall toward the same side, then repeat on the other side.

Tips

  • Make sure to keep both of your shoulders on the ground during the exercise and do not arch your back.

  • Keep your core active and the lower back in contact with the floor Push to the end actively. You can also help a little bit with your hands to reach a tiny bit further

  • As you repeat this you should feel that you can go further and further in both directions






Hip Internal Rotation Strengthening




Setup

  • Begin sitting upright with your feet flat on the floor , a soccer ball in between your thighs by the knee and a resistance loop wrapped around your ankles.

Movement

  • Brace your core muscles, Keeping your other foot anchored to the floor and rotate your lower leg outward, pulling against the resistance. Hold briefly, then return to the starting position and repeat.

Tip

  • Make sure to keep your knee bent at a 90 degree angle and do not lift your thigh from the chair during the exercise.



Conclusion


  • Hip Internal rotation exercises can offer many benefits from Hip and Pelvic stabilization necessary for sports to help prevent Groin and Hip Pain.

  • Exercises you can do to improve hip flexion strength include: mobility drills to increase range of motion in internal rotation and strengthening exercises of this movement

  • Soccer players need strong but at the same time very mobile Hips.

  • Today I showed you the importance of hip Internal Rotation for this sport.

  • You have now a couple of very good exercises to increase or maintain the strength of your rotator hip muscles.

  • You will feel stronger and quicker once you do these Drills



#Groinpain #HipPain #AdductorPain #AdductorStrain #PulledMuscle #Soccerinjuries #publagia #sportshernia #Soccergroinpain #soccerpubalgia #westonsoccer #westonhippain #hippainsucks #westonflorida #westonfloridaphysicaltherapy #daviefl #coopercityflorida #pembrokepinesfl #miramarflorida #weston #physicaltherapy #southwestranches #westonfitness #livinginweston


Are you having Hip or Groin pain while playing soccer ?

Do you want to find out what tissues or muscles can be causing your hip Pain ?




IF YOU ARE



OR READY TO START



GETTING BETTER



CLICK HERE









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