On my left leg, whenever I flex my hip, the rectus femoris muscle does maybe 80 % or more of the work, while the psoas just… flickers on and off or does nothing. The rectus muscle is easily overloaded if I do hip flexor exercises, so how can I wake the psoas up and put it into my muscle memory proper?

This is an interesting question. A full assessment including manual muscle testing, an assessment of your lower back, looking at your postural alignment and examining muscle length would help to determine the best course of action to help you make sure your muscles are working as efficiently as possible for you. A muscular imbalance of this kind could be neurological in origin or could be due to posture/biomechanics. If it is a neurological issue you may have other signs and symptoms including: pins and needles or areas of numbness – but this are not necessarily the case.

If it is due to biomechanics the position of your pelvis and lower back during hip flexion could be part of the issue. Given the origin and insertion of the psoas major, keeping your spine neutral and making sure you don’t tuck your pelvis under during hip flexion are both important factors in keeping this muscle healthy and firing well for you. In addition to assessing and adjusting posture, other factors that could contribute to trouble in hip flexion include: the length of the muscles in question, any history of back pain, what you do for work/recreation, your current level of fitness, and if you have any history of injury.

Call North Shore Sports Medicine to book an appointment with a physiotherapist today and we can work together to help address this issue (604) 973-0242.

I have running for almost 2 weeks with no serious pain in lower leg bone ,then after that two week i do sprinting which i think cause left lower leg bone serious pain, now when i run i felt serious pain in it ,then i don’t even walk correctly

There are a number of questions that could help to better understand your injury: How long has it been since you felt the pain after sprinting? Do you have any redness, swelling or a very tender spot in your lower leg? Where is the pain in your lower leg (the front or back?). For the time being, I recommend taking a break from running to allow your leg to heal. You can try another activity for the time being such as swimming or cycling. If it is even hurting to walk you should consider going to see a doctor or physiotherapist to get assessed.

Depending on the type of injury you have sustained they can offer you different types of support and help you towards recovery. Also, if you are just starting to run, you should follow a plan to get you able to run injury-free. That would start very slowly, perhaps 10 minutes per run, progressing very slowly, like 10% increase in time each run, each week.

If you would like to work with a physiotherapist, give us a call at North Shore Sports Medicine (604) 973-0242.

I have a question that a 16 old male has fractured right femur. What is the best physiotherapy treatment for him?

Treatment for a fractured femur in an adolescent will depend on the extent of the fracture, the medical intervention required (surgery? non weight bearing cast?) and the amount of time that has passed since the injury.

A physiotherapist can help from the time of injury all the way through to getting this individual back to their previous level of activity (or to being more active!). Depending on the cast/brace the individual is in a physiotherapist will work to help keep the joints and muscles above and below the injury active and strong while healing occurs.

Once the individual is permitted to move their knee a physiotherapist will work with them to ensure they regain their full range of motion and slowly gain the strength back in the thigh and hip.

I have severe pain in right thigh, knee and hip. It happens all the day daily. Medicines are not able to cure it. What should I do?

If you have constant pain every day I would recommend you come in for an assessment. A physiotherapist can help determine what is causing your pain and start the recovery process!

I had the maisonneuve break and had orif 8 weeks ago. Now removed cast and starting physio soon. Is it normal to feel quad pain? Feels like the bone in quad is tense, very hard and flexed. Is that possibly atrophy?

There are a number of factors that could be leading to pain in your quad. Since you had an accident with enough force to cause fractures, it is quite likely that other structures were injured at the same time. Some questions that might help determine the cause of your pain include: How did you sustain your break? Was there any injury to your quadriceps at that time (bruising/pain)?

Where in your quadriceps are you experiencing pain – closer to your knee or to your hip? When did the pain in your quad begin? Is this pain associated with movement or is it constant? Is it painful to push on? Is there any redness/swelling in the area now? The muscles throughout your injured leg will have atrophied to some extent from lack of use as you rested to help heal from your break and surgery. Usually atrophy is associated with muscle bulk decrease (the thigh of your injured leg will be smaller than your other thigh) and weakness. Pain in your quadriceps could be due to the fact you are using your muscle more now that the cast is off.

A physiotherapist is able to do a complete assessment to diagnose and treat the discomfort in your quad, as well as provide treatment to continue your leg and ankle rehabilitation.

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