Flexibility and Psoas Muscle - Jeremy?

Hi Jeremy, I'm hoping you'll have some advice for me. :)  I've returned to karate after about 13 yrs away from it.  When I did karate in my 20s, after about 3 yrs, I started having left hip pain.  The pain was specific to rotation.  I could do any type of "forward" kicks (stretching, front kicks, etc), but any kick that involved rotation (side kick, round kick) would eventually cause pain in the hip and then almost a numbness if I continued.  The pain wasn't as bad if I kept my kicks below waist level, but eventually, just the base leg rotation caused problems. Eventually, I quit karate.  I became more sedentary (had children, gained more weight, etc).  After getting banded, I was hoping that I could return to karate since it'd been so long and I now weigh less than I did in my 20s. Unfortunately, barely a month into karate, the hip pain is back. :( :(  I've been to an orthopedist, but honestly, I get the feeling that he's doing "hit and miss" diagnosis.  I've had X-Rays and an MRI...both are normal.  Earlier this week, I had a cortison injection into the psoas tendon because the orthopedist is "thinking" psoas tendonitis.  Not sure yet it helped since I haven't "tested" it yet. So finally to my question. :)  Do you know of any specific exercises that can strengthen the iliopsoas muscle?  If it is tendonitis, and IF the cortisone is going to help with the inflammation, I'd prefer to do exercises to prevent the inflammation from returning.  I'm not willing to do more than the one cortisone shot, so, IMO, I need to fix the source of the problem. Any thoughts/ideas would be very appreciated! Cindy

Hello Cindy, If it is illiopsoas tendonitis there are a couple of things you can do but first let me make a couple of suggestions. Progression is a big thing. It sounds like maybe you have progressed a little too fast and irritated the illiopsoas that is involved in hip flexion. It is possible that you will simply need to stop performing the kicks that cause pain. I know this may be difficult to do but that is most likely what needs to be done (in conjunction with other things).  I don't know your level of flexibility or your level of fitness but if you lack hip flexor flexibility and do not have very strong abs or hip flexors, and then you try to perform the type of kicks you are having issues with, you are certainly setting yourself up for injury. Even if you are well trainined and perform the same movement over and over again, tendonitis commonly occurs. Those types of kicks produce a lot of power and are very dynamic movements. You need to have a good level of flexibility and strength in the working muscles prior to performing these kicks. A couple of things you should focus on is increasing the flexibility of the illiopsoas (hip flexor) and increasing the strength of the abdominals which assist in hip flexion.  Flexibility: Perform one of the follwing quadricep/hip flexor strethces 2-3 sets once or twice a day and hold for at least 30 seconds. Be sure to stay in a zone you are comfortable with. http://exrx.net/Stretches/HipFlexors/KneelingHipFlexor.html http://exrx.net/Stretches/Quadriceps/Standing.html Abdominal Strengthening: Three days a week with one day of rest between each exercising day, perform 2-3 sets of 15-20 repetitions of the follwing exercise. Again, only work in your comfort zone. If the first exercise is too difficult try the second. http://exrx.net/WeightExercises/RectusAbdominis/CBLyingLegHi pRaise.html This exercise can be done without weight: http://exrx.net/WeightExercises/RectusAbdominis/CBLyingCrunc hStabilityBall.html I hope this helps but it is going to be very important for you to stop performing the kicks that cause pain until you have the tendonitis under contol.  Let me know if you need anything else

Thank you, Jeremy.  :)  The good news so far is that the cortisone shot has helped with the pain.  Instead of being the "gnome killer," I can comfortably kick at least my waist level, and with care, my shoulder level.  I am trying to progress back slowly...I think that I've had to keep my kicks so low for so long that those muscles aren't used to kicking higher. :\  But it's wonderful to kick without pain. As for my general level of fitness...I've been working out with a trainer for almost a year, so I'm in very good shape.  I'm only about 15 lbs above my ideal weight, so even weight really isn't an issue any more.  The flexibility could also be improved, but since stretching hurt, I was obviously avoiding it.

I'll begin incorporating the first stretch that you linked...the other we already do on a regular basis during workouts.  I also regularly do the ab exercises.

Again, thanks for your input! Cindy

Cindy, It is good to hear to are so close to your ideal weight.....CONGRATS!!! Unfortunnately, as I mentioned briefly in my previous response, even if you are in good shape, tendonitis often results from overuse. Rest and a combination of medication and a bit of rehab is often the only way to get it under control. I understand this can be frustrating; I get tendonitis in my wrist and it is just ridiculous becuase it hurts to do pretty much anything.   I am happy to hear the cortisone has helped. Keep it up and get some rest. Happy Holidays!!!