A comparative analysis of stretching and strengthening exercises for alleviating iliopsoas tightness misdiagnosed as low back pain in athletes

After evaluating the subjects based on the inclusion and exclusion criteria ,those who qualify will be enrolled in the study. Participants will then fill out a consent form and be provided with a detailed explanation of the procedure .Participants will be assigned to one of two groups: either the stretching exercises Group  (Group A) or the strengthening exercises for hip flexors Group (Group B) . Each group will receive instructions on how to perform the exercises and how the testing will be conducted. Prior to the commencement of the protocol, the subjects will be assessed using various outcome measures, including the Oswestry  Disability Index (ODI) ,Modifies Thomas test and Goniometer measurements for range of motion.

Group A Experimental group-

Subjects in Group A will receive a protocol of stretching exercise subjects will undergo stretching exercise the patient position is close to the edge of the treatment table so the hip being stretched can be beyond the neutral position. The opposite hip and knee are flexed towards the patients chest to stabilize the pelvis during the stretching. Stabilize the opposite leg against the patients chest with one hand or if possible assist patient by grasping around the thigh and hold it to prevent tilt of the pelvis during the stretch. Move the hip to be stretched into extension or hyper extension by placing downward pressure on the anterior aspect of distal thigh with your other hand. Allow the knee into extension so the two joint rectus Femoris does not restrict the range. The stretch was maintained by 30 seconds and perform one time. Perform this method for 6 days in a week and once in a day.

Group B - Experimental Group-

Subjects in Group B will receive strengthening exercises for hip flexors  the individual will be performing 3 strengthening exercises. The three strengthening exercises are Seated leg raise where the Subject place a kettlebell on the ground and sit behind it while bracing core , legs extended places  hands on the floor just behind the hips then patient Lift the foot closest to the kettlebell up and over it, keeping the leg extended with no knee bend, and place it on the floor on the other side of the kettlebell and Repeat for 6 reps, then switch legs by moving the other leg closest to the kettlebell and repeating the same movement. The second exercises Psoas March (Banded ) Subject in supine position places a light-resistance band around both feet with legs up at a 90-degree angle while bracing  core subject slowly extend one leg out, leading with your heel and keeping the other leg fixed in position. Once the leg is fully extended, bring it back to the starting position. Extend the opposite leg out, then back to the starting position. Repeat ‘march’ for 20 reps, keeping the movement slow and controlled. The third exercise is Weighted Standing Psoas March While standing on the step with one foot, placing it near the edge of the step on the same side as the kettlebell. With the foot that isn’t placed on the step, bring it down and hook the kettlebell handle over it. Subject Keeping the standing leg straight, bend the knee of the leg with the kettlebell upwards towards your torso, bracing the core to keep the body stable. Then subject Lift the knee until it is in line with the hip, bent at a 90-degree angle, then lower it back down. Repeat for 10 reps, then switch to perform the psoas march on the other leg. All the three exercises are performed for 2- 5 times a week.