Armstrong Podiatry & Sports Health's Blog

Information that promotes wellness

Interesting Look at “Groin” strains

It definitely hurts!

It definitely hurts!


I had an opportunity to contribute to a friend’s webmagazine ( the other day in regards to “groin” strains.  There are many ways that people look at it, but it is a reminder of how each body part works in unison with each other.



Muscles of the "groin"

Muscles of the “groin”

The “groin” is a catch-all term, referring to five muscles in the inside of the thigh.  Their major function is to bring the leg towards the midline of the body (adduction).  Injuries to these muscles are usually due to these muscles doing more than they can handle, as a large component of their activity is postural in nature (keep the body upright).  This excessive activity is due to muscular imbalances and faulty body positioning elsewhere in the body.


Don't you know this can kill you?

Don’t you know this can kill you?

Tight hip flexor musculature (lifting the leg and thigh up at the hip)  is something I find all too common with patients, specifically the iliopsoas muscle group).  This can be created by prolonged sitting, bad postural (forward lean) when walking and of course, the dreaded high heel shoegear. These can all make for an overworked iliopsoas group, which causes it to become tight.

Two muscles that make up the “groin” have a lesser function in hip flexion also.  If the iliopsoas is not able to perform its usual function, these muscles become the primary hip flexors. This increases its muscular activity, making it more prone to strain/injury.



Muscles rotating on the pelvis

Muscles rotating on the pelvis

Another result of an overworked/tight iliopsoas muscle group would be its effect on the pelvic bone.  Because of their attachment to the pelvis, its tightness causes the pelvis to tilt, lengthening some other muscles attached to the bone, i.e., the hamstrings (muscles at the back of your thigh).  The hamstrings changes from a primarily postural muscle to a hip extender (bringing your hip and thigh down), as the gluteal muscles (“butt” muscles) loses this role and its resultant strength via pelvic positioning.  In addition to the hamstrings, three other muscles of the “groin” become hip extenders.  These muscles are prone to become overworked, due to their increased activity.


Lifting for health!

Lifting for health!

Treatment of “groin” injuries involve the usual rest, compression and elevation.  But the emphasis should be on not forcing these muscles to be overworked.  Hip flexor stretching, along with soft tissue release can help with the tight iliopsoas muscles, in addition to flatter shoes, more erect posture when walking and lesser sitting. Abdominal exercises will help tilt the pelvis properly; variety is the key (the regular crunches do not work the right muscles and are not recommended).  Lastly, exercises that focus on the gluteal muscles will help it regain some of its strength, i.e., Deadlifts, Romanian Deadlifts, Hip thrusts.

Please feel free to contact me if any questions at

Health and happiness!

April 23, 2014 Posted by | Overuse injuries, Resistance training, Sportsmedicine, Stretching | , , , , , , | Leave a comment

NFL and Achilles tendon injuries

As an outsider looking in, I have noticed an inordinate number of Achilles tendon injuries at NFL camps (nine the last time I looked) this year.  As many try to explain them away as not related to the lockout, I would contend it is precisely due to the lockout that these injuries are occurring.

The Achilles tendon is the longest and thickest tendon in your body.  It is made up of two muscles, the gastrocnemius (which is more easily seen and referred to some as the “calf muscle” with its two heads) and the soleus muscle (which is deeper in the body and makes up most of the tendon).  They join together to form the Achilles tendon and occupies the bottom quarter of the leg. It inserts at the back of the heel bone (calcaneus).  This anatomy makes the tendon a powerful force during accelerations, sudden stops and sprinting activity.

Jumping to Achilles tendon readiness

Massaging the tendon after intense activity


Even though the Achilles tendon is not a muscle, studies have shown that it has contractile properties, so it should be treated as such.  Sensible, progressive training principles should be done to help strengthen the Achilles tendon and give it adequate viscoelasticity.  Typical training methods, such as resistance exercises, plyometric training and sprint training all provide strength to the tendon, and recovery activities, such as stretching and massage therapy, provide pliability to the tendon (so it will be useful for the next training session).  These methods such be put into place for months before full game day activity is attempted.

Struggling to get into game shape with limited training time is certainly a dilemma.  If someone asked me (and no one will!) how I would solve this, I would tell them to do less volume daily, but increase the restorative activities.  This will do two things, allow the athletes to do more intense work on a more regular basis, because they are recovered fully and also give the athletes a fitness base with the restorative activities such as circuit training or stationary biking.  Then, like any fitness program, slowly increase the volume of intense work as the weeks progress.  As a podiatrist, I would add two measures in regards to the Achilles tendon:  add in some eccentric heel drops, made famous by Alfredson;  and of course, to wear some shoes with no heel lift, i.e., Altra,  during the day (not during exercise) to provide increased Achilles tendon activity.

Always back to shoegear!

Hopefully all the players get into game shape and are able to play the beloved sport of football! Please contact me if you have any questions.

Health and happiness!

August 10, 2011 Posted by | Foot and ankle injuries, Resistance training | , , , , , | Leave a comment


As I look for ways to help reduce health care costs, I have looked at things such as nutrition and exercise.  It is all fine and good to say, “Eat better”, and “Exercise more”, but the questions really should be, “What types of food?” and “What type of exercise?”  Since I am not a nutritionist, I will not delve into that subject of food, but I have a more in-depth perspective of exercise.  The more I think about how I train athletes, the more I realize that the entire population can benefit from the same exercise too!

The athletes I currently train are trying to achieve a goal, i.e., to run a certain distance as far as possible.  How is that achieved?  By working on their speed, strength, power ( a combination of speed and strength) and coordination/balance.  I could argue that anyone can be defined as an athlete, because they too  are trying to achieve a goal, i.e., walk downstairs, open a can, climb a ladder.  All tasks require a degree of speed, strength, power and coordination. So it behooves everyone to try to maximize these skills for daily lives. 

The question still remains, “What type of exercise?” My answer would be one that promotes speed, strength, power and coordination, that is resistance training.  Resistance training does not necessarily mean only lifting heavy barbells, but includes dumbbells, elastic bands, such as Rubberbanditz, and medicine balls, anything that provides resistance to normal motion.  Of course, this is not the only exercise, but things like core exercises and jogging/walking should be seen as RECOVERY from resistance training.  Resistance training should always be primary in anyone’s bid to maximize their natural abilities (especially with our muscle-weakening desk jobs and shoegear wear) and prevent injuries.


Athletes have been training this way for decades; it only makes sense for everyone to share in this knowledge to become fitter and healthier human beings.  


Please feel free to contact me with any questions as I continue to expand this concept in upcoming blogs.

Health and happiness!

December 6, 2010 Posted by | Physical Activity, Resistance training | , , , , , | 1 Comment