# Hip Flexor issues in Mountain Bikers



## RooHarris (May 11, 2011)

I have not seen a recent discussion regarding hip flexor issues and mountain biking. What I have read mainly applies to road riders.

Never have I felt so anatomically impaired in my life. Broken bones, torn knee ligaments from ski racing, ankle tears, separated shoulders do not compare to what I am experiencing. This is nothing to take lightly. 

As an individual who needs to be active, a dysfunctional hip/pelvic situation or Hip flexor impingement is a real setback to my active life style. As the hips are the stabilizers for the core of the body it directly impacts the spine as well. Without strong psoas muscles in the hips we would be unable to be vertical as the Lumbar region depends up them. Most folks (a whopping majority) who are experiencing chronic back pain think it is just in the back, but in actuality it is most likely due to poor or traumatized Hip Flexor muscles. A strong core can directly be an influence for a healthy back. The psoas muscles are the only muscles that protect and connect the back and pelvis to each other.

I began doing Pete Egoscue's book "Pain Free" E-cises for Hip Flexors. Without these exercises I'd be doomed! There were times I was in so much discomfort (polite word for PAIN) that I reached for the Oxycontin, but instead took Ibuprofen (up to 1600mg/day). I have been doing these E-cises now for 5+ weeks with slow, but noticeably real improvement in my core. I do them from 6:30AM every morning for 60 minutes with longer supine groin stretches up to 20 minutes/side. It's not so much a torn group of muscles or connective tissue, but more a spasming or intense foreshortening of these hip flexors I am dealing with. And, yes there are times that I yelp! Lots of heavy breathing through the pain and unfortunately, no sex involved. 

An aside: How in hell did someone (a devout masochist?) come up with a pain chart from 0 to 10? Did the Nazi or the Marque De Sade somehow determine this? Isn't it subjective to an individual? HELL YES IT HURTS!, was that a 7 or a 9? 

On top of taking 400mg/time of Advil (actually, an off market NSAID Ibuprofen and no more than 1600mg/day although max dosage is 3200mg/24 hour period), I am also taking a muscle relaxant call Methocarbamol (off market name for Robaxin)two 750mg tablets every 6 hours. Works wonders by mid morning. I drink lots of H2O throughout the day to keep kidneys functioning. Advil can be harsh on these organs. Also, I take Advil with some food too. I found that Ibuprofen works better for me for pain over Aspirin or Tylenol. I am very religious about taking 2 Advil and two Methocarbamol right before bed time. Also, sitting is a pain as the sciatic nerves become involved too. Tough getting up. A really good chair is important if one must be doing what I am at the moment.

Sleeping is still a real issue but since I began using a hammock the pressure off the sciatic nerves and hip area is vastly improved. The lack of sleep was beginning to take it's toll on me. 

Regardless, this will take time ( I've heard up to 6 to 7 weeks!) to resolve and it will, if I have anything to do about it. I WILL not live this way and will do whatever it takes to heal and then revitalize my core with Plank like exercises. The sad irony for me is; I had been doing my leg lifts and crunches since February which I had to stop. Even lost an 1" on my waist. A four pack? But after reading many articles on these old fashion stomach routines, every things I read say NO now!

I'm not sure if I should quit biking for a time. Although, when I do bike I feel no impingement whatso ever. If anything, my hips feel more open and less achy. 

Any information regarding this is most appreciated.


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## Spec44 (Aug 17, 2013)

I've been battling lower back pain for years, steadily getting worse, the longer I sat at a desk all day. Lots of doctor discussions, some x-rays, thousands of dollars spent at the chiropractor. I knew most of the pain was muscular, clearly had super-tight hamstrings, so was stretching my back (too much I have since decided), but the tightness would be back in 10 minutes. 

Started biking again about 5 years ago. Feel fine on the bike, but the longer I rode and the more mashing up hills I did, the worse it would be the next day. Had a pretty bad fall...tore my ac (shoulder) so was sidelined for a couple months. The day after I took my first ride after gettin hurt I went to get out of bed and fell straight to my knees with screaming back pain and no strength to stand up. It took me a couple months of trying different stuff before a google search led me to the hip flexors (because I was looking at the wrong side of my body (back)).

Anyway, several years later, and lots of stretching programs, I'm pretty good...still do lunge type stretches multiple times everyday. I'm stupid by not being more diligent with sitting with proper posture at work, and only doing the core work when I'm having flare-ups. Between the torn ac and a shoulder impingement on the other side, most of the core stuff (and foam roller work) is pretty painful. It took a good year before it wasn't a daily problem.


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## RooHarris (May 11, 2011)

*Hip Issues*

Spec44,

I have been diligent at rehabbing now for 5 weeks. Still have Hip Flexor issues, but not as intense as they were initially. I'm still riding, but not pushing hills only spinning up them easy for the time being.

What I am experiencing is over-use syndrome after the Ibis Migration where I was guiding three days in a row doing 70 miles w/ 9,000+' of elevation gain. It all came home hard the next week. Normally, I am in very fit condition and start my training regimen in April for summer guiding.

Buy yourself a copy of Pete Egoscue's book "Pain Free". It is a classic pain management book with all sorts of exercises to avoid issues as these.

Here are some exercises for rehab of the Hip Flexors:


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## eri (Sep 4, 2012)

I had pt for hip problem, eventually Pt declared me 'myofacial disaster' and 'beyond her skill', she referred me to her teacher.

Teacher homed in on my shins, spent and hour working the facia along my shin bones. Voila: 60 degree more hip motion! Seemed like bs until it wasn't. Usually massage lasts until I get to the car but that treatment worked for years.

Now I have a massager with big ball bearings in it, works the facia like nothing I've seen. Much less painful than stretching and doesn't bruise muscle like a clumsy foam roller.


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## RooHarris (May 11, 2011)

*Hip Flexor issues and PT!*



eri said:


> I had pt for hip problem, eventually Pt declared me 'myofacial disaster' and 'beyond her skill', she referred me to her teacher.
> 
> Teacher homed in on my shins, spent and hour working the facia along my shin bones. Voila: 60 degree more hip motion! Seemed like bs until it wasn't. Usually massage lasts until I get to the car but that treatment worked for years.
> 
> Now I have a massager with big ball bearings in it, works the facia like nothing I've seen. Much less painful than stretching and doesn't bruise muscle like a clumsy foam roller.


Thank you for sharing your hip problem experience and information. The more I counsel with others I find that hip issues (Flexor muscles) are not uncommon and flair up in many different ways. I know there are a number of people in this forum who could add to this issue and it is my hopes to gather more information. What is equally important is finding post issue exercises to build the core better for mountain biking ie: Plank exercises. I think my PT has the experience to treat me well and with positive results. I have three more appointments one beginning tomorrow. He has given me the green light on level easy riding avoiding hills at the moment. I'll ride an easy 20 miles every other day with no issues the next day. If anything, my hips feel more open afterwards.

Each day is getting better. This has gone on now for 7 weeks. I began my Egoscue "Pain Free" rehab then, doing an hour first thing each day and noticing an improvement over this time. Some days are better than others and at least I feel I'm moving forward. Back to mobility!

I've begun reading Andy Weil's "Healthy Aging" where he puts our older years into perspective. I've always felt younger than our friends as most are not as active as I am and if anything too sedentary. Finding folks who enjoy being socially and physically active is a major component in our later years. We age better! At 71, I still feel better than I did at 50, albeit the hip issue. My BP is averaging 115 over 58 w/BPM 57. As an aside: This year's greater than normal incidence of ticks has me concerned and I am bouncing the idea off my Doc regarding being tested for Lyme disease.

thanks again for your input!


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## Oh My Sack! (Aug 21, 2006)

Flexors, Glute medius, all that area has been an absolute disaster for me for years coupled with facet arthropathy, and more recently stenosis. It's truly a pain nightmare. My L4/L5 laminectomy last November helped in a some way but I also had a significant setback in my recovery, as in something shifted a few weeks in and a year later, I still battle pain enough to be seeking ablations and steroid injection.

You may be onto it already but if not, please seek out Abi Carver's yoga videos on Pinkbike. That dear girl has been a Godsend with her hip opening stretches geared to hard core Mountain Bikers that have to spend lots of time sitting on their asses during the week. Perhaps that coupled with your current regimen might be a bit more help.

I don't know if this would help or hinder in your case but my new thing that is helping ME right now is indoor rowing. CORRECT FORM indoor rowing, that is. I don't know how I have missed the benefits of this for all these years. I was just getting ready to start a new thread on that very topic to see if others have been so inclined to do the same routine.


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## RooHarris (May 11, 2011)

*Yoga*



Oh My Sack! said:


> Flexors, Glute medius, all that area has been an absolute disaster for me for years coupled with facet arthropathy, and more recently stenosis. It's truly a pain nightmare. My L4/L5 laminectomy last November helped in a some way but I also had a significant setback in my recovery, as in something shifted a few weeks in and a year later, I still battle pain enough to be seeking ablations and steroid injection.
> 
> You may be onto it already but if not, please seek out Abi Carver's yoga videos on Pinkbike. That dear girl has been a Godsend with her hip opening stretches geared to hard core Mountain Bikers that have to spend lots of time sitting on their asses during the week. Perhaps that coupled with your current regimen might be a bit more help.
> 
> I don't know if this would help or hinder in your case but my new thing that is helping ME right now is indoor rowing. CORRECT FORM indoor rowing, that is. I don't know how I have missed the benefits of this for all these years. I was just getting ready to start a new thread on that very topic to see if others have been so inclined to do the same routine.


Thank you for this. I've gotten serious about yoga. What some are saying is Restorative yoga seems a bit aggressive at the moment for me. Stretching is having a great effect on my issue. My inflexibility finally caught up with me in August. The last 8 weeks has been a real eye opener for someone who values an active life. Physical therapy has been wonderful with all the range of motion therapy and homework. I will look into Abi Carver's tape. I need structure and that will just add more information through this phuckin nightmare and very gradual recovery. My guiding days may be over, but I will still be riding one way or another.

Send info on your rowing machine.

Thanks again,


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## anarchist87 (Nov 24, 2018)

Uyhf Gives You A Practical, Easy-to-follow Program You Can Use To Instantly Release Your Hip Flexors For More Strength, Better Health And All Day. Energy.https://life70411755.wordpress.com18c6al7fwbr3b-0ao2udlq4x5z.hop.clickbank.net/


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## OwenM (Oct 17, 2012)

https://gmb.io/hip-mobility/
I tried these(literally the first thing that pops up on google for "hip mobility drills"). I don't know that they're better or worse than anything else, just that doing them made a big difference for me. Went from very painful, and having me shaking to hold a stretch for 10 seconds, to being able to stretch much further and hold them for minutes within 2-3 weeks. I started getting sore, and my chiropractor told me I might be overdoing it, like I do everything else, and to back off. I just stopped doing them, but I haven't had problems with my hips since, either.


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## cyclelicious (Oct 7, 2008)

8 weeks go I had an issue with right sided hip pain which came on suddenly. It went on for a couple weeks and I would just work through the pain which started in the buttocks and travelled down my leg. I mentioned my symptoms to my crossfit coach and she said it sounded like Piriformis syndrome. She sent me a link.



> Piriformis syndrome is a condition which is believed to result from compression of the sciatic nerve around the piriformis muscle.[2][5] Symptoms may include pain and numbness in the buttocks and down the leg.[2][3] Often symptoms are worsened with sitting or running


More about it
https://en.m.wikipedia.org/wiki/Pir...mlSg-MZy3v-TktY_kZRVASj3pwJmBIfKl9hvhSCFwvCdo

I started doing the isolated stretches and it subsided. Maybe it was Piriformis syndrome ... I'm not sure but the stretches helped and it hasn't returned.


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## panchosdad (Sep 21, 2008)

Trainer I've been working with has me doing CARS (Controlled Articular Rotations) and PAILS and RAILS. Below is a link that explains them some.

https://kinstretch.com/pails-rails-good/


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## Streetdoctor (Oct 14, 2011)

I'm probably having a microdiscectomy at L5/S1 at 34 years old in the next month or so mostly because of ignoring how tight my legs are/how weak my core is and dealing with sciatica that will not improve after 4 months. Religious weekly PT/injections/multiple doctors, etc. no relief. You need to get in front of it before symptoms arise. I have about a month to see improvement or it's surgery. Doc says I have a 80-90% chance of full recovery if I go through with surgery.

Get on it now before it gets worse. I'm about as active as it gets- 200 days of cycling a year, 70 days on the ski mountain, a dozen competitive level enduro/DH races... potentially sidelined for most of 2019 because of this and it's devastating. Not to mention the possibility of losing my job and everything that comes with that. Not trying to preach here but I guess I am.


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## hikerdave (Mar 8, 2006)

I have an SI joint problem and find that doing hip flexor stretches before, during and after my ride helps a lot with pain prevention. My weight lifting routine, which is basically a continuation of physical therapy, includes a lot of work on the hip machine including front leg lifts of around 100 pounds to keep the hip flexors strong.


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## Forest Rider (Oct 29, 2018)

I'll get back to this one later.
This post is my reminder to come back (subscription added)


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## smoothmoose (Jun 8, 2008)

DISCLAIMER - NOT a doc or PT. But do consider myself a bike and gym rat and with my fair share of injuries and rehab.

FLAT PEDALS - PLEASE try them (if you are on clip-ins). Unbeknownst to many - the "upward" pull while clipped in is primarily activates your HIP FLEXORS rather than hamstrings. Hip flexor overuse is common while clipped in.


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## Forest Rider (Oct 29, 2018)

A couple years ago I had an injury that prevented me from riding very much, and no running. Basically no impact due to a tibia and fibula edema. 

After things were back on track and I slowly increased my activity level (been through other injuries in the past to know how to rebuild) the muscles had been gaining strength.

At some point I developed Hip Flexor soreness. At the time I wasn't aware my severe back pain was a result of the Hip Flexor. My back hurt so badly I was unable to walk a few steps without a spasm.
I went to a physical therapist just to find out if they could poke or touch to see if there was any apparent back injury. During the consultation, the therapist was trying to get me to relax my leg/quad. I explained that I needed a second because my leg was constantly fatigued and tight. He pushed down on the Hip Flexor and I about leapt off the table.
After a short conversation it was determined I needed to stretch. He guided me through a few stretching exercises that were very difficult and painful.\
I was barely able to walk IN to the facility because of the pain, however, I did walk OUT in much better condition, just from 3 stretching exercises for the Hip Flexor.

I am an ACL patient, that after surgery became a runner and cyclist. I have developed really good MTB skills as well as I had become a fast runner and have run marathons and short races. Something like 80 races, short and long, in about 7 years. After surgery and months of physical therapy, I had to learn how to balance my leg use due to 15 years of a severed ACL and babying that leg. It took time, but I was able to overcome the mental obstacle of no longer needing to protect that knee.
After the 2nd injury (knee injury but unrelated to the other injury), I never rebounded quite the same. I was reluctant to fully extend my lower leg during a run. I never quite had the same power in that leg for riding and as the miles built up the 'good' leg was tighter and tighter until the Hip Flexor finally begged for a break.

That's been I think 3 years and I'm still not quite right. I have to occasionally fall back to the stretching exercises. Now is a good time as a matter of fact. I've been getting tight and my back is paying the price on longer climbs. Normal daily activity is fine, but I do get tense on the bike. Running is fine and I feel strong enough to cover the 4-6 miles I am able to complete without exaggerating any knee soreness.

Even just doing the mild stretching exercises a few times a day for a couple days I feel better. I just need to do this more often and I wouldn't be in this repetitive situation.

For the record I'm quite athletic. Have an athletic build. Decent leg strength. A solid runner, despite slowing down due to not running as many miles. My bike climbing is nearly as good as ever. Only slowing down right now due to less riding and not as good of a diet. I ride flat pedals on the mountain bike. Clips on the road bike but haven't ridding the roadie in a few months, so that isn't a contributor to the tense muscle right now. In the several years of using clips on the road bike have I ever contribute the clips to a sore Hip Flexor because when used properly, you aren't "pulling" as many would think is the rule. Remembering that I am riding flats and still have Hip Flexor stiffness/pain.

So yeah, a Hip Flexor can easily contribute to back pain. Each case should be identified from a professional but I think Hip Flexor exercises are critical for athletes who run (especially faster runners) combined with bicycle riders of any type. It took a few years of serious activity before my Hip Flexor issues became a thing. And I believe it is, in my case, because my brain doesn't allow me to abuse my 'bad' leg the same as the good. But I work on it consciously when I recognize I'm not feeling balanced between the two legs.


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## RooHarris (May 11, 2011)

Forest Rider said:


> So yeah, a Hip Flexor can easily contribute to back pain. Each case should be identified from a professional but I think Hip Flexor exercises are critical for athletes who run (especially faster runners) combined with bicycle riders of any type. It took a few years of serious activity before my Hip Flexor issues became a thing. And I believe it is, in my case, because my brain doesn't allow me to abuse my 'bad' leg the same as the good. But I work on it consciously when I recognize I'm not feeling balanced between the two legs.


Thank you for your post. This issue has not gotten enough discussion as it is more common than I ever thought. First off, how old are you? You abilities sounds similar to mine with my strength being in skiing. I was always very strong but my Achille's heel was in my lack of flexibility. I finally paid the ultimate price of having my body shut down due to my laziness. Now, I stretch before and after rides.

The psoas muscle deep in the hips can really get out of whack (along with the other hip flexors) and because it also attaches to the 5 lumbar vertebrae can seem like it is a back problem when actually, it's really all in the hips.

I've had to learn a great deal to resolve my current hip flexor problems. I am now in my 15th week of rehab/stretching since the old hips went totally south on me (right after 3 days guiding the Ibis Migration). The spasming and constant migrating pain was unbearable the first 4 weeks. Sleeping totally sucked! I spent the next four weeks slowly (measured in Millimeters) climbing out of the disability.

After 8 weeks, I stopped the NSAIDs and muscle relaxant (Methocarbamol). Today, I am still recovering and each day feels a little bit better. My PT told me it could take another 10 weeks to see a full recovery. In the meantime, I continue to use Pete Egoscue's "Pain Free" techniques for resolving the hip flexor issue, plus a number of yoga postures as well. I'm seeing good results, but I do know at my age I will be practicing yoga everyday for the rest of my life. If I don't, I know what would be instore for me and that was one pain in the ass I never want to revisit...


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## Forest Rider (Oct 29, 2018)

Glad to hear you are on the mend, albeit a slow mend.
I've heard from several folks that have taken up yoga saying how much better they feel now. It's been an interesting evolution of how Yoga is now more understood and had a greater following with great benefits.

I'm mid 40's. Had ACL reconstruction just before 40 I believe and had a good bunch of years before I had any of this imbalance. It wasn't until the 2nd injury where I wasn't able to treat my leg use equally.
The negative for me is mostly that I end up fatiguing more quickly because the quads are somewhat activated (tight). So once I begin activity my one leg is already tired. Sort of.


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## RooHarris (May 11, 2011)

*Persistance*



Forest Rider said:


> Glad to hear you are on the mend, albeit a slow mend.
> I've heard from several folks that have taken up yoga saying how much better they feel now. It's been an interesting evolution of how Yoga is now more understood and had a greater following with great benefits.
> 
> I'm mid 40's. Had ACL reconstruction just before 40 I believe and had a good bunch of years before I had any of this imbalance. It wasn't until the 2nd injury where I wasn't able to treat my leg use equally.
> The negative for me is mostly that I end up fatiguing more quickly because the quads are somewhat activated (tight). So once I begin activity my one leg is already tired. Sort of.


Once in my life many years ago when I was professionally ski racing and coaching, I did yoga. The increased agility was night and day. Then, I crashed! Leg cast for 8 weeks and yoga went out the window.

Now, it is a necessity for me if I am to regain the quality conditioning I can usually maintain throughout the year. Riding three days a week, each ride is calculated towards conditioning. I will also have rest days between guiding. No more three day back to back all day rides ever again. Over use indeed...


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## Romaxy (Jul 5, 2016)

Hey, thanks for the post and tips! As a busted up Motocross & Hare scrambles racer I need this. Due to a lifetime of injuries there are days I can't even throw a leg over the bike. I'll definitely order the book!


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## NYrr496 (Sep 10, 2008)

The only issue I have with my hips is when I sleep on my left side. After a time, maybe 45 minutes to an hour, my left hip starts to hurt deep in the joint. The instant I roll on my back, the pain subsides. Hate that.


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## RooHarris (May 11, 2011)

*clipless vs flats*



smoothmoose said:


> DISCLAIMER - NOT a doc or PT. But do consider myself a bike and gym rat and with my fair share of injuries and rehab.
> 
> FLAT PEDALS - PLEASE try them (if you are on clip-ins). Unbeknownst to many - the "upward" pull while clipped in is primarily activates your HIP FLEXORS rather than hamstrings. Hip flexor overuse is common while clipped in.


I posed this question to my Sports Medicine PT - Dave Townsend of Santa Rosa Physical Therapy. Dave said w/ proper technique, the pulling stroke is executed to the back and not up, helping to complete the circle. He said, to think of a comma. You should be pulling back from around 4 o'clock near the bottom and to about 7 where one releases. At which point, the opposite leg is actively pushing down the pedal. He said one needs to avoid actually pulling up which indeed fires the hip flexors. Proper stoke depend upon the hamstrings and glutes at the bottom of the stroke only. One technique to alleviate stressing hip flexors is stand periodically during climbing. Although, one is most efficient staying seated, but some times is necessary to give the hip flexors a rest into the climbs.

I'm 16 weeks into the hip flexor issue and look forward to regaining my strength, flexibility and consistency in my longer rides, generally 4 to 5 hours. Recently, I have been doing hills to the point I notice the lack of my conditioning. There was a time I could ride all day and not feel a thing. Now, I'm feeling my age but, working steadily back up through this quagmire.


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## Oh My Sack! (Aug 21, 2006)

RooHarris said:


> I You should be pulling back from around 4 o'clock near the bottom and to about 7 where one releases. At which point, the opposite leg is actively pushing down the pedal. He said one needs to avoid actually pulling up which indeed fires the hip flexors.


This was best demonstrated to me as the physical motion of getting dog **** off your shoe.


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## smoothmoose (Jun 8, 2008)

RooHarris said:


> I posed this question to my Sports Medicine PT - Dave Townsend of Santa Rosa Physical Therapy. Dave said w/ proper technique, the pulling stroke is executed to the back and not up, helping to complete the circle. He said, to think of a comma. You should be pulling back from around 4 o'clock near the bottom and to about 7 where one releases. At which point, the opposite leg is actively pushing down the pedal. He said one needs to avoid actually pulling up which indeed fires the hip flexors. Proper stoke depend upon the hamstrings and glutes at the bottom of the stroke only. One technique to alleviate stressing hip flexors is stand periodically during climbing. Although, one is most efficient staying seated, but some times is necessary to give the hip flexors a rest into the climbs.


Technically PT is correct. But how sure are you that you executing the proper technique, all the time? There are other biomechanical downsides with riding clipped, but I digress.

My point, why not try riding flats? Especially if you are in pain. It's $100-$200 investment which is very cheap compared PT, surgery, and worst case chronic pain. Give it try for a couple months and I almost certain you'll see improvement with your pain.


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## Forest Rider (Oct 29, 2018)

It is possible to reduce the symptoms -he has a bad case.

I just get occasional flareups of soreness/tiredness. I don't ride clipped.


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## formica (Jul 4, 2004)

eri said:


> I had pt for hip problem, eventually Pt declared me 'myofacial disaster' and 'beyond her skill', she referred me to her teacher.
> 
> Teacher homed in on my shins, spent and hour working the facia along my shin bones. Voila: 60 degree more hip motion! Seemed like bs until it wasn't. Usually massage lasts until I get to the car but that treatment worked for years.
> 
> Now I have a massager with big ball bearings in it, works the facia like nothing I've seen. Much less painful than stretching and doesn't bruise muscle like a clumsy foam roller.


Link to this device?


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## RooHarris (May 11, 2011)

*New PT exercises*



smoothmoose said:


> Technically PT is correct. But how sure are you that you executing the proper technique, all the time? There are other biomechanical downsides with riding clipped, but I digress.
> 
> My point, why not try riding flats? Especially if you are in pain. It's $100-$200 investment which is very cheap compared PT, surgery, and worst case chronic pain. Give it try for a couple months and I almost certain you'll see improvement with your pain.


I'm no longer in pain in the hips (walking or riding), but the lack of flexibility is my biggest complaint. Retraining the hip flexors with new PT exercises has been very helpful. I'm confident that I will regain what I had in mid-August with Dave's guidance.

I will seriously consider flats in the near future. So far, I'm stressing proper pedaling action each time I spin with clipless on the flats or short hill climbs. Unfortunately at the moment, raining way too hard to get out since Friday's ride. The only surgery I possibly see in the future will be a hip replacement, but meanwhile, the "moderate" damage to the hip joint is manageable, pain and flexibility wise. Here are some of the newer hip exercises I am doing twice a day:


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