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Coach's Column - Getting Back to Form After Hip Injury

Posted by: Shannon Boffeli |January 21, 2014 2:42 AM

Coach's Column with Ben Ollett - Getting Back to Form After a Hip Injury


Question: "I'm recovering from a hip injury that kept me off the bike for over a month and am working through compensation patterns now that I'm getting back on the bike having lost some significant fitness.  How do I work back into a training program staying balanced and healthy to be strong for racing next year?"

 

Answer: The hips are tough!  I know all too well, having spent the last two years trying to figure out my own hip, low back, and sacroiliac (SI) problems.  After exhausting just about every option, I ended up having arthroscopic hip surgery for a femoral acetabular impingement (FAI) and through the recovery process learned that I also have a 14mm leg length discrepancy.

If youíve determined a diagnosis of your hip injury, youíre well ahead of the game. If you havenít, you should definitely seek the advice of a medical professional as issues with the hip, pelvic, and lumbar regions can be quite complicated and are not always a straightforward diagnosis.  Determining what is a soft tissue versus a hard tissue injury, what is structural versus functional, and the underlying causes of each can be a long and frustrating process.

Based on your question, Iíll assume you have diagnosed your hip injury and that it is a functional problem as opposed to a structural one.  Part of recovering from or preventing injury in this region involves maintaining a strong pelvic-stabilizing musculature. These stabilizing muscles include the gluteus medius, gluteus maximus, adductors, and abductors.  What do these muscles have in common with cycling?  Not much.  The human body is not designed to ride a bike.  Cycling forces your body to operate in a fixed, linear, and very limited range of motion, which means that certain muscles get very strong while others get very weak.  Over time, the body adapts to this position and becomes increasingly unbalanced, which can lead to overuse injury. 

At a basic level, the exercises that all cyclists need to do to achieve balance involve moving in ways that we donít move on the bike.  Specifically, lateral movement, hip extension, and lumbar extension are important.  These movements can be achieved in a variety of ways.  Lateral jumps, side squats, and side shuffles are all examples of lateral movement.  Single leg variations are a great way to ensure that the stabilizing muscles are engaged more intensely.  Glute strength exercises can be addressed through squats, lunges, side squats, Romanian Deadlifts, yoga, and pilates, among many other ways.  Lumbar strength and stability often falls into the "core strengthĒ category, but is also a significant piece in achieving proper technique for the above-mentioned exercises. 

To answer your question in short, if you have compensation patterns that remain post-injury, go to a physical therapist to determine what is not working properly. If youíre not convinced of your diagnosis, it never hurts to get a few opinions.  Once you have addressed the specific problems, you can move onto a strength maintenance program that specifically targets the muscles involved in your compensation patterns.  This program needs to become part of your new routine, two to three days per week, year-round.  There is no one-size-fits-all regimen, the key is finding the option that works best and is most enjoyable for you so you stick with the program.  


Ben is a cycling coach and bike fitter with Plan7 Endurance Coaching.  He has coached athletes to a total of 15 US National Championships at the Pro/U23 level in mountain biking and cyclocross as well as a Bronze Medal in Mountain Biking at the London Olympics.  He holds degrees in Exercise Physiology and Sport Pedagogy and is a USA Cycling Level 1 Coach. Visit plan7coaching.com for more information.

 

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