Groin pain Part 5b: Treatment of Enrique L., sessions 3-6

Groin pain, Neuromuscular therapy / Monday, August 3rd, 2009

This is a series on groin pain. If you missed the beginning, go back to Part 1. Neuromuscular Therapy treatments take place in my Boston area clinic.

At the 3rd session, Enrique said that he had been sore after the treatment, but then the muscles had “freed up.” At that moment he said he felt pretty good. We talked about the mind-body connection, about stress reduction, breathing and imaging. I stretched him out and treated all of his adductor muscles, iliopsoas, abdominal oblique attachments to the iliac crest and the quadriceps. He was sore when he left but felt more relaxed.

In his 4th session he was treated by one of our other therapists. She said he reported that he had felt a big change since the last treatment. He was walking much better, but he felt that his abdominals were very tight and contracted. She treated the abdominals, iliopsoas (tight and tender), TFL (still very sensitive), adductors, quads and IT band. She also did some work on the QL, lumbar erectors and gluteus minimus and medius.

In the 5th session he reported that the pain had leveled off and he was beginning to exercise, trying to do some light swimming. His stomach muscles felt weak, but he felt a tremendous difference since the treatment. The hardest movement to do was stooping down and bending over. I taught him some stretches to do at home and treated all of the muscles in the thigh, hip and groin plus the glutes and lateral rotators in the hip.

In the 6th session he said he felt good. An Epsom salts bath helped with the soreness, he had tried the stretching, but felt that it seemed to aggravate the groin. That day he felt only groin pain, but that pain had gone into the testicles and was acute. I treated him as before and found that in stretching, he couldn’t contract the muscles in the groin without pain, meaning that they were still very tight and unhealthy. That limited his home stretch program but he was doing whatever he could.