By definition, one of the main motions involved in core exercises is flexion of the trunk. This not only involves bending forward at the waist, but also involves flexion of the hip joints, as well. The problem is, sometimes a lancing pain in the groin can inhibit your performance of the crunches, knee-ups, v-ups, and other core conditioning exercises that you're trying to do. So you not only hurt, but your workout is ruined, too.

Sometimes the pain is from arthritic change in the hip joint, which is right in the middle of the groin crease, in front, not on the outside of the "hip bone," which is what many people think. This is especially true if the flexion at the hips is combined with a little rotation, as when you twist from side to side, during crunches. With arthritis, rotation is usually the first motion to be affected.

More often, however, a sharp stabbing pain is due to tendinitis of the upper end of the rectus femoris muscle. This long, straight muscle is part of the quadriceps in front of the thigh and lies right on top. The defining characteristic of this muscle, though, is that it's one of the few muscles that crosses two joints, in this case, the hip and the knee. The rectus (as we call it, for short) helps to straighten the knee joint, by pulling on the front of the tibia at its lower end. The upper end crosses the hip in front and attaches above the joint, on the anterior inferior iliac spine. This is often the site of the pain when the tendon of the muscle is inflamed.

Because this pain is so close to the hip, it is often mistaken for true hip pain. Tendinitis of yet another muscle attachment, the iliopsoas, which comes from a muscle that lies inside the pelvic bone (iliacus) and from along side the lower spine (psoas), a muscle which, in a cow, we know as filet mignon. This joint tendon attaches to the lesser trochanter of the femur. Its action is to flex the hip, pulling the knee up toward the chest. The pain from this tendon is slightly lower than the hip joint, since it's below the femoral head and neck, and it's perceived as being "deeper," that is more internal, as well.

Although it is sometimes difficult to diagnose exactly which structure is causing the pain in the hip region, the good news is, you treat them all the same. Here are a few tips to help you overcome this type of pain:

1 Rest-If you have a tendinitis, it won't heal if you keep aggravating it with motion. Avoid any motion that elicits the pain. Work AROUND the painful area.

2. Sleep with a pillow or two beneath your knees. This will passively flex the hips, thereby relaxing the upper end of the tendons (and relaxing the capsule of the hip joint, in the event of arthritis) and allow them to heal, if inflamed.

3. Local heat, preferably moist, for 20 minutes, 4-6X/day is soothing and brings blood to the area.

4. Anti-inflammatory medication can be very helpful. Take Aleve: 2 tabs, TWICE a day, WITH FOOD (to protect your stomach from irritation, bleeding or ulcers). An alternative is Advil 2-3 tabs, up to 4X/day. DO NOT TAKE these medications if you are allergic to them or aspirin, or if you have ulcer disease, GERD, bleeding disorders, etc. Do NOT exceed these dosages, without a doctor's supervision.

5. Avoid red meat and take oral fish oil (2000-4000mg/day) to soothe inflammation.

6. Use a CANE in the hand opposite the affected hip. Use two canes if they're both involved.

7. Sit on a higher toilet seat, to prevent "pinching" the tendons with deeper hip flexion.

8. Be patient-weeks, sometimes months, are necessary to achieve healing. Then, you can begin gentle stretching and strengthening exercises, after heat applications.

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