In part 1, we reviewed why a swimmer might get anterior hip pain when swimming, what muscles are to blame, and which ones tend to become inhibited. This blog will put together a plan with specific exercises to decrease your anterior hip pain and get you back in the water and back to crushing your workouts. If you want a quick review of anterior hip pain when swimming, go read part 1.
Quick overview:
- Decrease hip pain by using a foam roller to relax the muscles around the area
- Specific exercise targeting glutes
- Integrate into full body exercises to improve strength and prevent future hip pain
Step One: Decrease the pain
In order to get the the right muscles working, you need to relax the muscles around the hip that are tight or holding extra tension. This step is critical for stopping anterior hip pain when swimming. To do this, you want to use a foam roller and work on your hip flexors and adductor muscle groups. In order to see if this is effective for you, I suggest doing a squat before you foam roll and after you foam roll to see if you feel a difference. You may find that squatting feels easier and that the pinching in the front of your hip is gone.
Foam Rolling to the Front of the Thigh 1:00 Minute
Foam Rolling to the Inside of the Thigh 1:00 Minute
Step Two: Muscle Activation
After the hip flexors and adductors are relaxed, the next to step to eliminate anterior hip pain is to get the muscles that have been inhibited, uninhibited. You may find that the glute med, or the muscle on the side of your hip, has suddenly become weaker. This is not a true weakness, instead the anterior hip pain causes the muscles around the hip to become inhibited. Inhibition presents as muscle weakness, but can be reversed quickly. This is your bodies attempt to try to protect the area. It is your job to break this pattern and get the glute med back to back to full function again.
Without the glute med at full function, the hip flexors and adductor may keep tightening up. This will keep you stuck at step one of the rehab plan. Below are three exercises I like to use for glute med strengthening for swimmers with anterior hip pain. The key it to make sure a small muscle on the side of your hip is working, not the hip flexors or adductors.
Sidelying hip abduction
Side Plank
Advanced Side plank
Step Three: Integration
Lastly, you need to integrate all of this is into full body, functional movements. This will incorporate everything you have worked on to this point, but also will make you stronger overall. Many swimmers note that after this rehab progression, their legs actually feel stronger than before and notice an improvement in their kick. Here are some of my favorite exercises in this stage of the rehab. These exercises also make for great dryland ones too.
RFESS
Skater Squat
Step down
What Should You Do in the Pool?
At first you should decrease the amount of kicking done in the pool. This does not mean eliminate all kicking! You can keep kicking as long as your pain pain remains under a 3/10. Once it starts to creep above a 3/10, it is best to pull or switch to another kick that is not painful. A low level of pain will not set you back, but it will actually push the muscles just enough to adapt to the training load, so that they come back stronger next time. Following these parameters, the amount of kicking volume should progressively increase until a swimmer reaches the point where most the their kick is done with minimal discomfort and eventually no pain.