Hip Flexor Overuse Injuries in Gymnasts
As we get into this new season and routines become, well routine, coaches, parents, and providers, must be ready to identify overuse injuries in our athletes.
My number one overuse injury I see is hip flexor strain with associated low back pain.
So why is hip flexor/back pain the number one overuse injury I see? To find out, I think we should see the actions of this muscle and my Gray’s Anatomy (yes there was a TV show named after this book!) is a great place to start.
Actions. – The Psoas and Iliacus muscles[the hip flexors], acting from above, flex the thigh upon the pelvis. Acting from below, the femur being fixed, the muscles of both sides bend the lumbar portion of the spine and pelvis forward. They also serve to maintain the erect position, by supporting the spine and pelvis upon the femur, and assist in raising the trunk when the body is in the recumbent position.
Athletes utilize hip flexor muscles in almost every aspect of their daily work in the gym. And some work legitimately utilizes hip flexors.
But the issue is athletes over use the hip flexor for jumping, landing and bar work instead of the muscles designed to optimally and efficiently complete these tasks.
So what muslces should young gymnasts be using instead of the hip flexors?
Gluteus Maximus (GM) and abdominal muscles, and they should be using these without pelvic tilt!
So with the bolded information above in mind, let’s talk about the opposite of the hip flexor, or it’s antagonist, Gluteus Maximus Muscle (GM).
GM is the largest muscle in the body and does an amazing action for athletes, it extends the femur and brings it in line with the body and provides stability of the sacrum/lumbar spine junction. This action, along with maintaining a tight core creates a strong lumbar spine by reducing pelvic tilt and decreasing excessive lordosis or curve in the back…big deal right?
Why Is The Gluteus Maximus Such An Important Muscle?
Well, according to this study (Click here to see) completed in October of 2011, the greater the pelvic tilt, the more likely the chance young gymnast will suffer a back fracture and in particular, a pars interarticularis fracture in the lumbar spine. The easy definition of what I said is, “THIS IS BAD!” and most likely represents a career ending injury for a gymnast.
You can return, but no physician will allow you to participate in gymnastics with an acute back fracture, nor should they. Most orthopedic surgeons generally require a back brace and 6 months no physical activity. THIS IS DEVASTATING FOR GYMNASTS.
Prevention? Too Easy!
But there is some amazing news. It’s extremely easy to learn to use your core and create habits to offer your back protection. This is why we have to make these processes habits: when you’re on the beam and the whole world is staring at you, you will not remember to tighten your core and squeeze your GM. It has to be a habit.
How do we create these habits? A small amount of work (less than 5 minutes) every day, progressively increasing difficulty, and applying sport specific positioning until the athlete does it without thinking when at the gym.
Remember, true core strength, and true use of GM allows the athlete to achieve all anatomically correct positioning needed for gymnastics.
You just can’t cheat the process and use pelvic tilt to create positioning.
Landing with increased anterior pelvic tilt (pooched tummy) or posterior pelvic tilt (hips tucked under) can create severe pain, fractures and problems in the lower back.
Use the right musculature to achieve positioning. It’s vital to your health.
We’d love to hear what you think about core strength and utilizing proper muscles in the gym. Leave us a comment below to let us know how you protect your gymnasts!
Thanks again for your support and we’ll see you soon…Make sure you start putting this information into practice!