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Movement-based intervention to resolve severe pelvic and hip pain in a female Iron-distance triathlete


A 40-year-old professional female Iron-distance triathlete presented with an 11-month history of left hip, iliotibial band and pelvic pain. She had fallen from her bicycle onto a railway track, and injured the soft tissue of her left buttock. The patient reported persistent hip pain. Furthermore, her attempts to return to training had led to pelvic pain symptoms that were made acute by walking, rolling over in bed and activities of daily living. Her continuing pain resulted in a fear of movement. A lack of progress with a sports medicine physiotherapist and five pelvic health physiotherapists led the patient to seek a more comprehensive approach to care. She was provided with a biopsychosocial programme that drew from the fields of pelvic, musculoskeletal and sports performance physiotherapy. The intervention strategy reduced her fears about movement, and altered her gluteal–pelvic floor muscle synergy by linking the dynamic interrelationship of the diaphragm, abdomen and pelvic floor to sport-specific movements that were meaningful to the
patient. This increased her tolerance for challenges over time. Collaboration with the patient’s strength, running and swimming coaches led to her return to training and short-distance racing within 2 and 6 months, respectively. Integrated pelvic health, musculoskeletal and sports performance concepts led to the resolution of the patient’s symptoms, and her subsequent return to competition.

Keywords: athletics, hip pain, injury, pelvic floor dysfunction, pelvic pain.

Journal Details

Journal Title: POGP Journal Issue 128 - Spring 2021

Issue Date: 01 March 2021

Issue: 128

Pages: 108