Thigh injury again

[Seventies Man]

Hi,
My son who is 16 has a grade 1 outer thigh strain. He's had some phsyio but despite this after a few weeks he still feels a pull when he chips a football. The pull is not where the original strain was but has moved to the inner thigh. The phsyio says that this is due to more pressure being taken by the inner thigh to compensate for the injury. Is this normal and is it okay to play with this dis-comfort or should he stop playing until all traces of the injury have gone?Just looking for more opinions based on experience.

Thanks

[Seventies Man]

Me again!

I gave the thigh a massage tonight and felt near the top of the thigh a small lump or nodule under the skin. My son say that this is the source point of the discomfort. Is this a piece of torn tissue/muscle or what could it be?

[Heidi]

Hi
A small, tender nodule in the muscle is often a trigger point. This may be the cause of his pain and can easily be released with some massage, trigger point therapy and stretching.
As for playing, he is definitely better off to not play until he can run and kick the ball pain free.
Get him some professional sports massage. That should really help.
http://www.sportsinjuryclinic.net/sports_massage/index.php

[Seventies Man]

Heidi, Thank you for the reply. Just to add that he has been training and only really feels the pull/pain when he chips the ball or hits it a long distance. He can pass, run, and shoot reasonably well. Do you think playing (Sunday) is out of the question? He has had a few phsyio sessions. I know that without dealing with the case directly it's hard to tell but do you think it will take many sessions?

[Seventies Man]

After going for more phsyio injury has now got worse! He now can't run without pain! There seems to be an area of about 2 inches square that is swollen. No bruising showing but just swollen. Physio could only say that it's probably torn tissue but can't understand why it is worse! Maybe he went back training too soon!
Any advise appreciated

[Heidi]

Hi

Just read your 1st post again to check if I missed anything. How did the injury happen in the 1st place? Was he running/kicking or an impact?
What initial treatment was he given and how soon after injury?
I do think it is best if he rests completely from any training until the problem is resolved.

[Seventies Man]

Heidi, Thanks for the replies.
The injury occured while practising corners in football. We iced the injury on return and visited a phsyio within a day or so. After a another two phsyio visits and about a week later he felt on the mend except for a slight pull when kicking a long distance. At this stage he returned to training. He attended two training sessions without complications and planned to play a match the following weekend. As a precaution I brought him back for one more physio visit. After this visit he complained of the injury being sore and he was not able to run without pain. I brought him back to the physio who said it was strange that he was feling pain again. He strapped up the injury and said he could try to play. However on match day he was not up to it. This was about 3 weeks after the initial injury.
In any event, he has now got the flu and can't train so maybe it's a blessing! The pain has subsided and he's resting but now stating to do a few stretches. My plan is to keep resting and stretching, make a physio appointment for next week and take it from there. My hope is that towards the end of next week he might be able to return to light training.
Does this sound over-ambitious?

[Seventies Man]

Still no football after over six weeks!
Decided to switch physios. Had a session a week ago after resting the injury for 10 days. He said that he needed to build up strength in his thigh and would have to wait for 10 days before playing. One week later, went for another session and told it would be at least another two weeks. Why has the time extended by so much? My son now feels fine but he's afraid to go back playing as the physio has given him the impression that he's far from ready.
Is this just a case of the physio stringing us along to earn more fees?? That my feeling!
Maybe it would be better to use own judgement!
Are there any tests he could do at home to check if he's okay? Heidi??

[Heidi]

Hi

At the end of the day it is down to your son and how he feels about it. The physio can only give you a guideline from their knowledge and experience. If he really is ready to return to training, then it may be a case of an over cautious physio, or like you say, wanting more fees.

When you went to this physio the second time and he/she said 2 weeks, had there been any change in symptoms?

What I would do is to try to gently progress his activity to 'test' it, but this does have to be very gentle and gradual. Start with jogging in straight lines one day. Rest the next. Then try jogging with changing directions and round corners, then rest a day. Then try running and passing the ball the next.
Carry on like this provided there is no set back or increase in pain, until he can sprint and kick a ball at full pelt with no problems.
Also carry on with any strengthening/stretching exercises the physio gave you.

Good luck!

[Seventies Man]

Thanks for the reply Heidi.
The Physio initially gave him a number of strengthening exercises to do. This was on a Wednesday. At that stage he said that there was a possibility of playing Sunday week. After a week and after working really hard on the exercises, he returned for another appointment. He did a good work out. At the end of the workout, the physio said that there was a slight improvement but he would need another few sessions and he would probably be out for at least another two weeks. There were no further symptoms to worry about.
At this stage he is well able to run, sprint, pass etc. but he is afraid to kick the ball hard as the physio said this could cause re-injury. This seems like a step back rather than forward.
He also did light training tonight with no problems whatsoever.
My son feels that with a little more exercise and training he would be okay to play but is afraid to go against the physio's advise as he is supposedly "the expert"

[Seventies Man]

Okay, after another couple of weeks and two more physio sessions and lots of quad strengthening exercises I brought him to a sports doctor and also decided to get him an MRI scan.
The results showed that the quad muscle has healed well but that as a result of the excess pressure being taken up by other muscles, they are now a little inflamed and he also has a slight groin strain!
The sports doctor said that he needs to get rid of the inflammation and build up his core strength and this should take about another 3 weeks before he should go back. He can do some straight line training but no zig-zagging! Last week the Phsyio gave him exercises to do involving zig-zagging around cones??
He feels fine except a little stiff after chipping/kicking, probably due to the inflammation and feels he could play again next weekend.
It's so confusing... 9 weeks ago he was told he could play at the weekend, now he should wait another 3 weeks before going back!
Is there any quick method of reducing inflammation (not an injection) and how risky would it be to play a bit of a game at the weekend?
Heidi, can you help?

[Heidi]

Hi
I think that given the new information, which is more accurate given the MRI, he should follow the advice given by the doc.
Groin injuries can be pesky little so and so's and definately need respect!
To reduce inflammation, ice and anti-inflammatories such as ibuprofen - provided he is not asthmatic or has any of the other conditions on the label that prohibit its use ;-)