Rehab of a Chronic groin strain
This is a pertinent topic right now, made popular by the brilliant BBC programme by Dr Chris van Tulleken, who took over part of a GP surgery and attempted to stop patients’ prescriptions
Medication is important, but, not for everything and at the expense of important exercise and rehab support. Have you or anyone you know been to the GPs with an injury, muscle or joint problem and come away with pain killers? Did the problem go away? No, of course it didn’t. Unfortunately only the symptoms of the problem are being addressed here, not the cause.
Case Study: Tony Barber
Let me give you a somewhat extreme example of a chap, a former body builder in fact who came to see me 2 months ago with chronic, debilitating pain in his groin and hip flexor area following an acute injury caused by over-stretching.
By the time I saw him he’d been suffering for 12-months, with pain so bad that he couldn’t pick up his kids, walk comfortably across the road, let alone train in the gym. Even being sedentary and sitting down was problematic.
Even worse, check out his medical journey over the 12-months:
- 4 consultant surgeon appointments with
- 3 different consultant surgeons
- 8 sessions with a chiropractor
- 10 physiotherapy sessions
- 6 sessions of acupuncture
- numerous GP consultations
- 3 MRI scans,
- 4 XRays
- 3 ultrasound scans … And all scans came back clear
What was the result of all of this….? Nothing. He’d been discharged with no advice of what to do, yet he was taking a cocktail of paracetamol and naproxen just to get him through each day - which, incidentally earned him a 2 day stay in hospital due to an allergic reaction.
Just like the woman with the debilitating back problem in the film., he was desperate and he was sure there must be an alternative solution.
To me, it seems crazy how much all of his treatment is likely to have cost the NHS, without resolve. And at no point was he offered exercise support.
What Did I Do Differently?
Well, let me first say that we solved his problem, in 7-weeks! I know, even I was surprised by how quickly we achieved this. But it’s true. And in fact, it was fairly simple. My initial assessment obviously including taking a detailed history of the injury (see here, sign-up for a cheat sheet), which identified that it wasn’t a groin problem, but a hip flexor problem.
Then, through a secondary assessment, conducted in conjunction with one of Get Back To Sport’s finest iPTs, Max, we were quickly able to identify the lack of range of motion in his lower back and hip flexors, and poor postural control and balance.
These issues were likely exacerbated, or even caused by the chronic deconditioning Tony suffered in the 12 months of inactivity and chronic pain.
Our success was made easier by a model client; he performed his exercises daily!
We’re now working in ‘prehabilitation’ mode to future proof him from further injury. He’s built the solid foundations needed to layer on the more challenging muscle strengthening and soft tissue work. Exercise IS medication!
Tune in next week where I’ll tell you about the key exercises and progressions.
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