Hip flexor injuries are a common issue among rowers, due to the repetitive, linear and seated nature of the sport. These injuries can be painful and debilitating, and can significantly impact a rower's performance... and if left neglected require surgery and even become a sport ending event.
The hip flexors are a group of muscles located in the front of the hip, and are responsible for flexing the hip joint. The main muscle in this group is the iliopsoas, which is made up of the psoas major and iliacus muscles. The adductors, or groin muscles, are also involved in hip flexion, as they help to stabilize the hip joint during movement.
Rowing hip flexor injuries typically occur as a result of overuse, poor technique, or a combination of both. Symptoms of a hip flexor injury may include pain in the front of the hip, difficulty walking or standing for long periods of time, and weakness in the hip flexors. Another early warning sign is lower back pain.
When we are seated, our hip flexors are in a shortened state with the muscle origin and insertion relatively close together, which can cause the muscle fibers to tighten. The fall out from this is that when we then stand up, the hip flexor will struggle to go through its full length of motion, so instead it causes flexion. Since our feet are on the floor, it can’t cause hip flexion, so it causes trunk flexion, which in turn causes the pelvis to tilt forward, known as an anterior pelvic tilt (APT).
If this continues over time, the issue can become compounded, the hip flexors will get tighter and tighter, causing a more severe anterior pelvic tilt, which leads to a more severe trunk flexion and lower back pain.
Furthermore, other back injuries are likely to be compounded if the psoas is overactive (as is the case in the rowing stroke), causing lateral flexion.
The other danger of shortened hip flexors is reciprocal inhibition. If your hip flexors are overactive, then your glutes are underactive and being lengthened, which can lead to underactive muscles and back conditions such as sciatica.
There are several treatment options for hip flexor injuries, including:
Stretching: Stretching the hip flexors can help to reduce tension and improve flexibility.
Physiotherapy: A physiotherapist can help to identify the root cause of the injury and develop a treatment plan that may include exercises to strengthen the hip flexors and improve range of motion.
Surgery: In severe cases, surgery may be necessary to repair damaged muscles or tendons.
In addition to hip flexor injuries, rowers may also experience bursitis or labrum tears in the hip. Bursitis is inflammation of the bursae, which are fluid-filled sacs that cushion and protect the joints. Labrum tears are injuries to the cartilage in the hip joint that can cause pain and instability. These injuries may require similar treatment options as hip flexor injuries, such as stretching, physiotherapy, and in some cases, surgery.
It is important for rowers to take proper care of their hip flexors and to make deep stretching a part of their DAILY routine and to seek medical attention if they experience worsening or persistent pain or discomfort in this area. Taking preventative measures, such as warming up before rowing and using proper technique, can further help to reduce the risk of hip flexor injuries.