# Training w hip dysfunction and weaker posterior chain one side



## injected59 (Aug 14, 2016)

Greetings everyone, need a little help here. Since I began biking regularly about four years ago I've been slowly trying to strengthen my left posterior chain. I had/have some hip dysfunction on left side due to some inhibited glutes and hip flexors. This caused it band tightness, hip tightness, lateral knee pain, and tight weak hip flexors.

I unclipped one leg at a time this morning on the trainer and while pedaling with the left leg it was definitely lacking compared to pedaling just with the right leg.
I have been doing strength training three days a week throughout the winter in hopes to get this alleviated by spring so I could focus more on the biking aspect. I am stronger I just feel like I've hit a plateau and I need some tips from those who have maybe already gone through this.

My strength sessions have included walking bent over lunges, split squats sumo squats,Deadlifts standing leg raises for psoas And hip flexors, Single leg Romanian deadlifts, lots of single leg balance work, and some core work. Also, when o get overly tight in an area I get dry needled by my PT.

At this point I feel like my strength is mostly there, but the problem now may be more nervous system related, and that I need to perhaps do some more prep work to get the glutes and psoas firing faster before climbing on bike.

Thanks Chris


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## quite.right (Sep 29, 2016)

Hi Chris,
welcome to the club of weak hips  Suffer from this is a real p.i.t.a. (pun intended)

I'm not "already gone through" yet but i would like to share my experiences and the progression. I'm a mountain trail ultra runner, mountain- and road biker, do strenght exercises as well and have intensified my training two years ago. 15 months ago i had pain in my hips while seating mostly in car seats. No doctor and no PT could help me except the advise: no sports. I started searching for the cause.
After months i noticed that a light training is better than stay on the couch.
Than i found an article written by a german M.A.:
Part 1
Part 2.
The author and master of arts wrote about an "activation blockade". So you are right that the nervous system is related.
She wrote about a "synergistic dominance" that a stronger / faster muscle dominates a smaller / weaker muscle which is involved in the same movement. This leads to a "neuronal blockade or delayed activation and leads to a further weakening until a complete neuronal shutdown".
(If you have difficulties in translating please tell me, i will translate all the details for you.)

The small and weak muscles are M. gutaeus medius + minimus, M. piriformis and M. psoas. 
The stronger / bigger muscles are M. glutaeus maximus, M. fem. bizeps + quadrizeps, M. vastus lateralis regarding straighten up the upper body, extend the legs and ensure that the whole body remains in centerline.

So my thesis is, that the mentioned weakness cause amyosthenia in the small and overdominated muscles. Thats why it take so long to recover.
I did the same exercises as you but i stopped that because this strenghten the big muscles too much and the ratio of power between bigger and smaller msucles stays the same and no sustained success is achieved. So i will stick with the recommended exercises from the article for a while.
As a cause of the mentioned blockade i suspect the laterality also.

I supplement B-Vitamine to support the neuronal system and hope it helps.
During the winter the body is not willing to repair unnecessary damages and they will end up in a queue and have to wait until spring. When there is more sunlight the cells generate Vitamin D and this is working as a switch. When enough Vitamin is generated the above mentioned waiting queue will be processed. If you are not based in the sunshine states or Hawaii it is likely that a push will come with the sun... Due to five months of dark and cold winter I supplement Vitamin D + K2 since December and it feels much better. To be patient is hard....

I guess that my Kettlebell training and too much sitting has caused the pain (mainly on the left side). And i noticed bike riding will not help to heal because only the "big" muscles are involved. So i do intervall walking / running on short distances beside of the mentioned exercises of the article.

Please keep me up to date about your progression.
Hope the pain will disappear soon that we can enjoy riding dry trails.

Regards,
Christian


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## injected59 (Aug 14, 2016)

quite.right said:


> Hi Chris,
> welcome to the club of weak hips  Suffer from this is a real p.i.t.a. (pun intended)
> 
> I'm not "already gone through" yet but i would like to share my experiences and the progression. I'm a mountain trail ultra runner, mountain- and road biker, do strenght exercises as well and have intensified my training two years ago. 15 months ago i had pain in my hips while seating mostly in car seats. No doctor and no PT could help me except the advise: no sports. I started searching for the cause.
> ...


Christian, Thanks for the response. I understand most of what you stated aside from the "M." in front of the muscle groups (M. Piriformis), I have never seen this before.

The links are interesting. However, the excercise techniques are bit difficult to nail down. Looking at the crossover reach the author says to lead with left leg across the right front with the arms also reaching up and to the right front. The pics show the athlete leading with the right leg across to the left and her arms reaching in the opposite direction. Can you clarify some instrction on this and where I should be feeling it.

Per my progress- I saw my PT yesterday. I told him I was a little depressed and upset of the fact that I am now into spring and still getting pains in the left glute, knee and IT band. He had me do a standing bent leg raise test to check hip flexor test to check hip flexor strength and I could only raise leg to about 90 degrees (femur parallel to floor). He did prescribe this as an excercise a couple months ago but I have been doing it mostly as a warmup and obviously not executing it properly. He reiterated that this is a major part of my issues, especially on the bike where we sit and flex the hip for extended periods. He told me to focus on getting my psoas stronger for now.

Per my restrictions- He dry needled the heck out of my left deep hip rotators along with my adductors. That in combination with a one hr massage today on my left hip and leg has really opened up my entire left hip. I don't know your opinions on dry needling but it really works well on knotted up muscles with trigger points. When I say well, I mean immediately. Now that everything is loose it definitely feels more unstable so I will probably start back up fresh tomorow with some of those simple excercises in your links along with some basic step ups onto an 8 or 10 inch step to work on proper hip hinging. I also like an excercise by Gray Cook where you walk on a 2x4 and place on foot in front of the other then bend over and set something down on board, then stand, then bend back down and pick it up , then repeat with other foot forward. This forces the body to hip hinge and shift weight properly.
My wife is waiting for me so this is all I got for now.


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## ladljon (Nov 30, 2011)

15-30mm shorter cranks arms would most likely help...I went from 170's to 135mm just to make movements easier.


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## injected59 (Aug 14, 2016)

ladljon said:


> 15-30mm shorter cranks arms would most likely help...I went from 170's to 135mm just to make movements easier.


Hmm interesting I've never thought of this. I will def do some reading

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## CHIEF500 (Aug 30, 2012)

Christian thank you for the information. I've been having some issues also. I will be doing some reading of the articles you supplied.
If anyone needs them in english I translated the articles and will be reading and supplying them to my PT for some input.


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## injected59 (Aug 14, 2016)

CHIEF500 said:


> Christian thank you for the information. I've been having some issues also. I will be doing some reading of the articles you supplied.
> If anyone needs them in english I translated the articles and will be reading and supplying them to my PT for some input.


Chief please share your issues and progress if you'd like.

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## CHIEF500 (Aug 30, 2012)

I will do.
I had right knee replaced last April. Doing well with it but my right hip has been very tight ever since and I have trouble getting it loosened up. Biking gets me very tight in the hips. Being tight loads up on my SI joint and I have issues there. 
That happened Monday trying to put socks on. I walked a good bit Monday with a backpack loaded with goodies in NYC.
Tuesday the SI joint let go.
I've been working to get that taken care of. Finally my Chiro got me straightened out on Friday. I've been doing stretching and core work. The right hip is tight but getting better. I will discuss the article with my PT and see what he has to say.


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## ladljon (Nov 30, 2011)

Also may I suggest a Kinesiologist...U may have an imbalanced meridian, which blocks different muscle groups....When there is a muscle imbalance, it causes havoc on the skeletal system.


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## quite.right (Sep 29, 2016)

Hi Chris,
Maria Härter, the author of the article, decribes always weaknesses on both sides of the hips and therefore she suggests doing the recommended exercises on both sides. So it doesn't matter which side is pictured in the image.
I have pain on both sides - the right side is nearly gone - but i do each exercise on both sides to avoid imbalances.
When you do the crossover reaches you should push your butt backwards and feel a little tension on the iscium on those side where the hip is overcrossed by the leg in front = i.e. right leg in front, tension in the left iscium. Than keep the tension for some seconds and go back.

Needling, Akkupressure or a Massage with the Massage wood (in my case) is always painful but it helps to loosen the trigger point and release tension of the tortured muscles. All the tension of the muscles will disappear for a short time and its a temporary "break through" from the circle of pain and inhibited muscles. And so you can feel the "normality"...

Your problems with the M. psoas are a sign of a crumpy and weak frontside - like the most cyclists have, me also. Do the exercises suggested by your PT. A good exercise is also the mountain climber I do this sometimes with a rubber band.
It will help your problem with your hips but it is only a part of the whole story. The main part of the pain are caused by inhibited M. gluteus medius+minimus and M. piriformis that compress the Nervus gluteus superior. Thats why all the muscles, tendons and fascies around hurt so much. Even until down to the feet.

I do the "step ups" with a strong rubber band around my waistline mounted on the wall behind me which brings resistance while moving forward onto the step. This forces the Glut. med+min more to work.
Another favorite exercises are single leg hip thrusts w/ or w/o additional weight.

Two days ago i did some running interval sprints and my hips hurts a lot. Yesterday i did some roadcycling to recover and after 20min my my right knee starts to ache and felt overloaded. I focused on my left leg to pedal harder and after some minutes the pain has gone. That means the laterality has a stronger influence that i thought. I have to care about it. It's known that the brain can be trained just as well as a muscle... juggling, playing piano, singing to chorus a.s.o.



ladljon said:


> 15-30mm shorter cranks arms would most likely help...I went from 170's to 135mm just to make movements easier.


This will cover the cause and aggravate the symptoms. 


ladljon said:


> Also may I suggest a Kinesiologist...U may have an imbalanced meridian, which blocks different muscle groups....When there is a muscle imbalance, it causes havoc on the skeletal system.


Yes there is a blocked meridian but caused by blocked muscles, nerves and blood supply. A meridian is a logical line to describe where the energy (Qi) is flowing or should flow. If e.g. a muscle is blocked the meridian is blocked also but not vice versa. It's a kind of philosophy...

Welcome to the club, @Chief500.
Thank you for translation 
I guess the above mentioned exercises will help you also. Additionally I can recommend the "The Jane Fonda" w/ or w/o a rubber band and for sure all the other excercises.


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## CHIEF500 (Aug 30, 2012)

Thanks for the welcome. I will post the translation tomorrow at work. I added the pictures to the document since they didn't come over in the translation.


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## quite.right (Sep 29, 2016)

quite.right said:


> The main part of the pain are caused by inhibited M. gluteus medius+minimus and M. piriformis that compress the Nervus gluteus superior.


 I put some wrong information in here.
The compressed nerv is the Nervus ischiadicus known as Sciatica which leads the pain through the leg til the foot. Sorry guys.
(Fortunately i haven't been cutting off something. Doctor's joke  )


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## quite.right (Sep 29, 2016)

Hi guys,
Any progress here?

I habe been doing different exercises twice a week and i notice a progress in general. Happy about...


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## injected59 (Aug 14, 2016)

quite.right said:


> Hi guys,
> Any progress here?
> 
> I habe been doing different exercises twice a week and i notice a progress in general. Happy about...


I thought I was until few days ago, went for a short ride and my TFL has been sore. I found this video yesterday that I think may help


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## quite.right (Sep 29, 2016)

I had to feed my search engine for 'TFL' and now I know whats missed in my collection of small muscles described above.
Thank you for the vid. I will test it and report.
Please keep us up to date.


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## quite.right (Sep 29, 2016)

Hi,
Any news? 
After all the exercises without any improvement i was really frustrated. I got fat 
I changed (again) my nutrition: a lot more proteine, no carbs in the evening. Since that i have a much better recovery every day and... more power and the pain in the hip is nearly gone. Hope that will last...


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## injected59 (Aug 14, 2016)

quite.right said:


> Hi,
> Any news?
> After all the exercises without any improvement i was really frustrated. I got fat
> I changed (again) my nutrition: a lot more proteine, no carbs in the evening. Since that i have a much better recovery every day and... more power and the pain in the hip is nearly gone. Hope that will last...


Yes I've been meaning to post but haven't had the opp. Anyways, I've been seeing a lady that teaches Pilates and I have learned and gained more from her in one month then I have the last eight years of doctors and physical therapists. If you don't know what /Pilates is Google it or read up on it. Pilates instructors study movement in the human body. The equipment and tools they use allows them to watch the body under stress. Within the first two sessions she indicated I had weak right obliques and inhibited left serratus. I could go on anon about the things she has pointed out that is wrong with my body but I have to get back to work. Oh also I Purchased flossing bands from rogue fitness and holy crap every cyclist in the world should on some of these. I've had knots in my left quad's for years that massage therapists and dry needling couldn't eliminate after three or four times of these floss bands there pretty much back to normal got to go please respond With any questions and I will try and get to them

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## injected59 (Aug 14, 2016)

… I forgot to add my progress. I’ve been putting in 10 to 15 mile rides consecutively every other day for the last week and a half which I know is not a lot of mileage compared to a lot of you , but I have had almost no hip, low back pain or tightness the following day, so as far as I’m concerned good news on the horizon… Finally.


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## matt.s67 (Nov 4, 2016)

I've been dealing with this on and off for years. I've been cycling since ~2010 and have been weight training since ~2006. Heavy squats and deadlifts with my hip imbalance finally caught up to me in mid 2012 and I've been dealing with chronic SI joint dysfunction as a result of it. Luckily, cycling helps keeps things loose. 

The best explanation / understanding of the condition that I've found is from Postural Restoration Institute. Google "PRI left AIC" or "zac cupples left AIC" (he has some good notes from their courses. 

I probably wouldn't be walking today if I didn't find a local PT with a good grasp on the concept. Whenever my left side of my lower back goes into spasm, he knows exactly what to do to keep me functioning. In addition to this, a lot of glute activation exercises seem to be key for me, along with unilateral training to keep leg strength the same between both sides.

Oh, and you guys might laugh, but I thought I'd finish this post by letting you know that I'm 30 years old. :madman:


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## injected59 (Aug 14, 2016)

>Matt.s67- I won't pretend to fully understand your ailments nor claim that what helped me will help you, but I would like to say that you shouldn't settle for "whenever my lower back goes into spasm, he knows what to do". This is how I have lived for the last 8 years or so. You need to keep hunting for a cure so your back doesn't even go into spasm. Study anatomy and movement, and fire your physical therapist if you see no improvements after 4 months.

As I stated in my prior post I didn't find help until a month ago when I started pilates. I'm not trying to sell everyone on pilates, it's just what is helping me. Thanks to the instructor identifying my weaknesses and faulty movement patterns I now have some cues on the bike- e.g., activate transverse abs (keeps me from collapsing into left dominant obliques essentially shortening that entire side and overworking the hip flexors and psoas), keep right hip pulled back(a mental cue that fires my right obliques and actually makes my hips even), don't push with outside of right foot (don't know why I do this yet), keep even weight on hands (My inhibited left serratus fatigues and does not support my weight on the bars, so I end up hiking my left shoulder to recruit another muscle group, this results in shoulder and neck problems. Now when my right hand starts feeling fatigued I know I need to lock in my core.) These are things that are coming more naturally as I continue to work with her and she continues to strengthen my weaknesses.

I am sounding like a complete pussbag so to offer some perspective I am a midpack finisher when I do triathlons, and do multi-day bike rides in CO at elevation with these issues, I simply pay the price more so than others and take longer to heal which in turn delays further training.

I speculate these issues begin small in most of us- a pulled hip flexor, torn rotator cuff.. mine perhaps a cracked rib from car accident. The human nervous system does a good job of protecting the body from further pain and inflammation after an injury and will shut down muscle groups that potentially further aggravate the situation (my rib most likely shut down the serratus). Once healed, sometimes these muscle groups don't fully come back online and a faulty movement pattern is born.

better explained here- https://www.prehabexercises.com/compensation-patterns/

Compensation
A pattern of compensation is the body's attempt to make up for the lack of movement in one area by adding a new movement. More specifically, a compensation pattern is a neuromuscular strategy of including a 'new' firing sequence (Motor Units and Muscles) and/or utilizing structural reliance (bones, ligaments, tendons, fascia and joint structures) to supplement or avoid another firing sequence and/or structural reliance.

Essentially, a compensation pattern is an alternate neuromuscular strategy that the body employs when the naturally prescribed neuromuscular strategy is no longer a viable option to use in the creation of a given movement.

Walking on a limb after an ankle sprain is an example of a compensation pattern. The body simply replaces its normal gait (walking) mechanics with an alternate version or strategy that limits the amount of weight placed on the injured ankle.


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## quite.right (Sep 29, 2016)

@matt.s67 - welcome to the club. Even if you are younger 

Thanks Chris for the detailled explanation and the link to Prehabexercises. Its really interesting but scary that there are well known preformed pattern. After reading the website carefully and multiple times i guess all the pattern are active in my body 
So i have to think about a complete redesigned (Rehab) training for me.
My problem with uncontrolled switching from catabolic to anabolic state of metabolism and back is nearly solved so I'm very hopeful to achieve notable improvements in my exercises.

Nice that you discovered your problem zones and hope the Pilatus sessions will help you to get stronger soon. Stay tuned!

Let's stay in touch and do our exercises!
Christian


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