Sore Left Hip Flexor: Causes, Treatment, and Prevention
Understanding the Causes, Treatment, and Prevention of a Sore Left Hip Flexor
If you’re experiencing a sore left hip flexor, you’re not alone. This common condition can be caused by a variety of factors, including muscle strains, overuse, and medical conditions. While most cases of a sore left hip flexor can be treated at home with rest, ice, and stretching, it’s important to see a doctor if your pain is severe or doesn’t improve with home treatment.
A sore left hip flexor can make it difficult to walk, run, or even sit comfortably. The pain may be sharp or dull, and it may worsen with activity. In some cases, a sore left hip flexor may also be accompanied by swelling, bruising, or numbness.
The good news is that most cases of a sore left hip flexor can be treated with simple measures. Rest, ice, and stretching can help to reduce pain and inflammation. Strengthening exercises can help to improve flexibility and range of motion. And if your pain is severe, your doctor may prescribe medication or physical therapy.
1. Causes of a Sore Left Hip Flexor
A sore left hip flexor can be caused by a variety of factors, including muscle strains, overuse, and medical conditions.
Muscle strains are the most common cause of a sore left hip flexor. These injuries occur when the muscles in the hip are overstretched or torn. Muscle strains can range from mild to severe, and they may cause pain, swelling, and bruising. The most common muscles to be strained in the hip flexor group are the iliopsoas and the rectus femoris.
Overuse is another common cause of a sore left hip flexor. This can occur when you participate in activities that overuse the hip flexor muscles, such as running, cycling, or dancing. Overuse can lead to inflammation of the tendons and muscles in the hip, which can cause pain and stiffness. In addition to muscle strains and overuse, there are a number of medical conditions that can also cause a sore left hip flexor. These conditions include:
- Arthritis: Arthritis is a condition that causes inflammation of the joints. It can affect the hip joint, which can lead to pain, stiffness, and swelling. If you have arthritis, you are more likely to experience a sore left hip flexor.
- Bursitis: Bursitis is a condition that causes inflammation of the bursae. These are small sacs that are filled with fluid and that help to reduce friction between bones and muscles. Bursitis can occur in the hip, which can lead to pain and stiffness. If you have bursitis, you are more likely to experience a sore left hip flexor.
Muscle Strain
Muscle strains are the most common cause of a sore left hip flexor. These injuries occur when the muscles in the hip are overstretched or torn. Muscle strains can range from mild to severe, and they may cause pain, swelling, and bruising.
There are three main types of muscle strains that can affect the left hip flexor:
- Grade 1 strain: This is the mildest type of muscle strain. It occurs when a few muscle fibers are torn. Grade 1 strains typically cause mild pain and tenderness, and they may not affect mobility.
- Grade 2 strain: This is a moderate type of muscle strain. It occurs when more muscle fibers are torn. Grade 2 strains typically cause moderate pain and swelling, and they may affect mobility.
- Grade 3 strain: This is the most severe type of muscle strain. It occurs when the muscle is completely torn. Grade 3 strains typically cause severe pain and swelling, and they may make it difficult to walk or move the hip.
The most common muscle to be strained in the hip flexor group is the iliopsoas. This muscle is located on the front of the hip and it helps to flex the hip and rotate it outward. Other muscles that can be strained in the hip flexor group include the rectus femoris, the sartorius, and the pectineus.
Muscle strains can occur during a variety of activities, including sports, exercise, and日常生活. They are most likely to occur when the muscle is suddenly stretched or overloaded. Muscle strains can also be caused by overuse, such as when you do too much exercise or physical activity without giving your muscles enough time to rest and recover.
Overuse
Overuse is another common cause of a sore left hip flexor. This can occur when you participate in activities that overuse the hip flexor muscles, such as running, cycling, or dancing. Overuse can lead to inflammation of the tendons and muscles in the hip, which can cause pain and stiffness.
The hip flexor muscles are responsible for flexing the hip and rotating it outward. These muscles are used in a variety of activities, including walking, running, and climbing stairs. If you participate in activities that overuse the hip flexor muscles, you may be at risk of developing a sore left hip flexor.
There are a number of factors that can contribute to overuse of the hip flexor muscles, including:
- Sudden increase in activity: If you suddenly increase the intensity or duration of your activities, you may be at risk of overuse injuries. It is important to gradually increase your activity level to allow your muscles time to adapt.
- Poor training techniques: If you do not use proper form when you exercise, you may be putting excessive stress on your hip flexor muscles. It is important to learn and practice proper exercise techniques to avoid injury.
- Muscle imbalances: If the muscles around your hip are not balanced, you may be more likely to overuse your hip flexor muscles. It is important to strengthen all of the muscles around your hip to help prevent overuse injuries.
Medical Conditions
In addition to muscle strains and overuse, there are a number of medical conditions that can also cause a sore left hip flexor. These conditions include:
-
Arthritis: Arthritis is a condition that causes inflammation of the joints. It can affect the hip joint, which can lead to pain, stiffness, and swelling. If you have arthritis, you are more likely to experience a sore left hip flexor.
-
Bursitis: Bursitis is a condition that causes inflammation of the bursae. These are small sacs that are filled with fluid and that help to reduce friction between bones and muscles. Bursitis can occur in the hip, which can lead to pain and stiffness. If you have bursitis, you are more likely to experience a sore left hip flexor.
-
Other medical conditions: Other medical conditions that can cause a sore left hip flexor include:
-Hip labral tear -Hip impingement -Osteoarthritis -Rheumatoid arthritis -Ankylosing spondylitis -Sacroiliitis
If you have a sore left hip flexor and you are concerned about an underlying medical condition, it is important to see a doctor for evaluation.
2. Treatment Options for a Sore Left Hip Flexor
There are a variety of treatment options available for a sore left hip flexor. The best treatment approach will depend on the underlying cause of your pain. In many cases, home treatment measures can be effective in relieving pain and restoring mobility. However, if your pain is severe or does not improve with home treatment, you may need to see a doctor for further evaluation and treatment.
Home treatment measures
There are a number of things you can do at home to treat a sore left hip flexor, including:
- Rest: Rest is essential for allowing your hip flexor to heal. Avoid activities that aggravate your pain.
- Ice: Ice can help to reduce pain and inflammation. Apply an ice pack to your hip flexor for 15-20 minutes at a time, several times a day.
- Heat: Heat can help to relax muscles and relieve pain. Apply a heat pack to your hip flexor for 15-20 minutes at a time, several times a day.
- Stretching: Stretching can help to improve flexibility and range of motion in your hip flexor. Gently stretch your hip flexor several times a day.
- Strengthening exercises: Strengthening exercises can help to improve strength and stability in your hip flexor. Perform strengthening exercises for your hip flexor several times a week.
Medical treatment
If your pain is severe or does not improve with home treatment, you may need to see a doctor for further evaluation and treatment. Your doctor may recommend:
- Physical therapy: Physical therapy can help to improve flexibility, range of motion, and strength in your hip flexor.
- Medication: Your doctor may prescribe medication to relieve pain and inflammation.
- Injections: In some cases, your doctor may inject medication into your hip flexor to relieve pain.
- Surgery: Surgery is rarely necessary to treat a sore left hip flexor.
Rest and Ice
Rest and ice are two of the most important things you can do to treat a sore left hip flexor. Rest allows your muscles to heal, while ice helps to reduce pain and inflammation.
Rest
When you have a sore left hip flexor, it is important to rest the muscle. This means avoiding activities that aggravate your pain. You may need to modify your activities or take a break from them altogether. For example, if you are a runner, you may need to switch to walking or swimming. If you work a physical job, you may need to ask for modified duties.
Ice
Ice can help to reduce pain and inflammation in your sore left hip flexor. Apply an ice pack to your hip flexor for 15-20 minutes at a time, several times a day. You can also use a cold compress or take a cold bath.
Rest and ice are simple and effective ways to treat a sore left hip flexor. By following these tips, you can help to reduce your pain and inflammation and speed up your recovery.
Stretching and Exercises
Stretching and strengthening exercises can help to improve flexibility and range of motion in the left hip flexor. This can help to reduce pain and improve mobility. Here are a few effective stretching and strengthening exercises for the left hip flexor:
Stretching exercises
- Quad stretch: Stand with your feet shoulder-width apart. Bend your right knee and grab your right foot with your right hand. Pull your right heel towards your buttocks. Hold the stretch for 30 seconds. Repeat with your left leg.
- Hamstring stretch: Stand with your feet shoulder-width apart. Bend over and reach for your toes. Hold the stretch for 30 seconds. Repeat 2-3 times.
- Hip flexor stretch: Kneel on your right knee and place your left foot flat on the floor in front of you. Lean forward and place your hands on your left thigh. Gently push your hips forward until you feel a stretch in your left hip flexor. Hold the stretch for 30 seconds. Repeat with your right leg.
Strengthening exercises
- Hip flexor raises: Lie on your back with your knees bent and your feet flat on the floor. Lift your hips up towards the ceiling, squeezing your glutes at the top of the movement. Lower your hips back down to the starting position. Repeat 10-12 times.
- Leg lifts: Lie on your side with your legs straight. Lift your top leg up towards the ceiling, keeping your knee straight. Lower your leg back down to the starting position. Repeat 10-12 times on each side.
- Squats: Stand with your feet shoulder-width apart. Bend your knees and lower your body down into a squat position. Make sure to keep your back straight and your knees aligned with your toes. Press through your heels to return to the starting position. Repeat 10-12 times.
Medication
Medication can be an effective way to manage pain from a sore left hip flexor. There are two main types of medication that can be used for this purpose: over-the-counter pain relievers and prescription medications.
Over-the-counter pain relievers
Over-the-counter pain relievers, such as ibuprofen and naproxen, can be effective in reducing pain from a sore left hip flexor. These medications work by blocking the body’s production of prostaglandins, which are chemicals that cause pain and inflammation. Over-the-counter pain relievers are available in both pill and topical form. Topical pain relievers, such as creams and gels, can be applied directly to the affected area.
Prescription medications
Prescription medications, such as opioids and muscle relaxants, may be necessary to manage severe pain from a sore left hip flexor. Opioids are powerful pain relievers that are typically used for short-term pain relief. Muscle relaxants can help to relieve muscle spasms, which can contribute to pain. Prescription medications should only be used under the supervision of a doctor.
Considerations
When considering medication for a sore left hip flexor, it is important to weigh the benefits and risks. Over-the-counter pain relievers are generally safe for most people to use, but they can cause side effects such as stomach upset, nausea, and dizziness. Prescription medications can have more serious side effects, such as addiction, respiratory depression, and constipation. It is important to talk to your doctor about the risks and benefits of medication before taking it.
Physical Therapy
Physical therapy can play an important role in the treatment of a sore left hip flexor. A physical therapist can help to develop a personalized treatment plan that promotes healing and prevents recurrence. Physical therapy may include:
- Stretching: Stretching can help to improve flexibility and range of motion in the left hip flexor. A physical therapist can teach you how to stretch your hip flexor properly.
- Strengthening exercises: Strengthening exercises can help to improve strength and stability in the left hip flexor. A physical therapist can teach you how to perform strengthening exercises for your hip flexor.
- Manual therapy: Manual therapy is a type of hands-on treatment that can help to improve range of motion, reduce pain, and promote healing. A physical therapist may use manual therapy to treat your sore left hip flexor.
- Modalities: Modalities are treatments that use heat, cold, or electricity to relieve pain and promote healing. A physical therapist may use modalities to treat your sore left hip flexor.
Physical therapy can be an effective way to treat a sore left hip flexor. By following your physical therapist’s instructions, you can help to improve your flexibility, strength, and range of motion. This can help to reduce your pain and prevent recurrence.
3. Preventing a Sore Left Hip Flexor
There are a number of things you can do to prevent a sore left hip flexor, including:
- Warm up before exercising: Warming up before exercising helps to prepare your muscles for activity. This can help to prevent injuries, including a sore left hip flexor.
- Cool down after exercising: Cooling down after exercising helps to reduce muscle soreness. This can help to prevent a sore left hip flexor.
- Stretch your hip flexors regularly: Stretching your hip flexors regularly can help to improve flexibility and range of motion. This can help to prevent a sore left hip flexor.
- Strengthen your hip flexors: Strengthening your hip flexors can help to improve strength and stability. This can help to prevent a sore left hip flexor.
- Maintain a healthy weight: Being overweight or obese can put extra stress on your hip flexors. This can increase your risk of developing a sore left hip flexor.
- Wear supportive shoes: Wearing supportive shoes can help to distribute your weight evenly and reduce stress on your hip flexors. This can help to prevent a sore left hip flexor.
- Use proper technique when lifting: Using proper technique when lifting can help to prevent injuries, including a sore left hip flexor.
- Avoid overuse: Overuse can put stress on your hip flexors and increase your risk of developing a sore left hip flexor.
Warm-up and Cool-down
Warming up before exercising and cooling down afterwards are both important for preventing injuries and improving performance. A proper warm-up helps to prepare your muscles for activity by increasing blood flow and temperature. This can help to reduce muscle soreness and stiffness, and it can also improve your range of motion. A proper cool-down helps to reduce muscle soreness and stiffness by flushing out waste products and allowing your muscles to relax.
Warm-up
A warm-up should be gradual and include exercises that target the muscles that you will be using during your workout. For example, if you are going for a run, your warm-up should include light cardio, such as walking or jogging, and dynamic stretches, such as leg swings and arm circles. The warm-up should last for 5-10 minutes.
Cool-down
A cool-down should also be gradual and include exercises that target the muscles that you used during your workout. For example, if you went for a run, your cool-down should include light cardio, such as walking or jogging, and static stretches, such as holding each stretch for 30 seconds. The cool-down should last for 5-10 minutes.
Warming up and cooling down are both important parts of any exercise routine. By following these tips, you can help to prevent injuries and improve your performance.
Strengthening Exercises
Strengthening the hip flexors and surrounding muscles is important for preventing and treating a sore left hip flexor. Strong hip flexors help to stabilize the hip joint and pelvis, and they also help to generate power for activities such as walking, running, and jumping. Strengthening the surrounding muscles, such as the quadriceps, hamstrings, and glutes, can also help to improve hip stability and function.
There are a variety of strengthening exercises that you can do to target the hip flexors and surrounding muscles. Some of the most effective exercises include:
- Hip flexor raises: Lie on your back with your knees bent and your feet flat on the floor. Lift your hips up towards the ceiling, squeezing your glutes at the top of the movement. Lower your hips back down to the starting position. Repeat 10-12 times.
- Leg lifts: Lie on your side with your legs straight. Lift your top leg up towards the ceiling, keeping your knee straight. Lower your leg back down to the starting position. Repeat 10-12 times on each side.
- Squats: Stand with your feet shoulder-width apart. Bend your knees and lower your body down into a squat position. Make sure to keep your back straight and your knees aligned with your toes. Press through your heels to return to the starting position. Repeat 10-12 times.
- Lunges: Step forward with one leg and bend your knee so that your thigh is parallel to the floor. Keep your other leg straight. Push off with your front leg to return to the starting position. Repeat 10-12 times on each side.
Strengthening exercises should be done 2-3 times per week. It is important to start slowly and gradually increase the weight or resistance as you get stronger.
Proper Technique
Maintaining proper form and technique during exercises and everyday activities is important for preventing injuries and improving performance. Proper form helps to ensure that you are using the correct muscles and that you are not putting unnecessary stress on your joints. Good technique can also help you to get the most out of your workouts and improve your overall fitness.
Here are some tips for maintaining proper form and technique:
- Pay attention to your posture. Stand up straight with your shoulders back and your head held high. Avoid slouching or hunching over.
- Use the correct muscles for each exercise. For example, when you are doing a bicep curl, focus on using your biceps to lift the weight. Don’t swing your arms or use your back to help you lift the weight.
- Keep your core engaged. Your core muscles help to stabilize your body and protect your back. Engage your core by drawing your belly button towards your spine.
- Move smoothly and controlled. Don’t jerk or swing your body when you are exercising. Move smoothly and in control throughout the entire range of motion.
- Listen to your body. If you feel pain, stop the exercise and consult with a doctor or physical therapist.
Maintaining proper form and technique is important for both preventing injuries and improving performance. By following these tips, you can help to ensure that you are getting the most out of your workouts and that you are staying healthy and injury-free.
Lifestyle Modifications
Lifestyle modifications, such as weight management and quitting smoking, can contribute to overall hip health. Maintaining a healthy weight can help to reduce stress on the hip joint, and quitting smoking can help to improve blood flow to the hip joint. Here are some lifestyle modifications that you can make to improve your hip health:
- Maintain a healthy weight. Being overweight or obese can put extra stress on your hip joints. Losing weight can help to reduce this stress and improve your hip health.
- Quit smoking. Smoking can damage the blood vessels and reduce blood flow to the hip joint. Quitting smoking can help to improve blood flow to the hip joint and promote healing.
- Get regular exercise. Exercise can help to strengthen the muscles around the hip joint and improve range of motion. Choose exercises that are low-impact and do not put excessive stress on the hip joint, such as walking, swimming, or biking.
- Eat a healthy diet. Eating a healthy diet can help to maintain a healthy weight and provide the nutrients that your body needs to stay healthy. Include plenty of fruits, vegetables, and whole grains in your diet.
- Get enough sleep. Getting enough sleep can help to reduce inflammation and promote healing. Aim for 7-8 hours of sleep per night.
Making these lifestyle modifications can help to improve your overall hip health and reduce your risk of developing hip problems.
4. When to Seek Medical Attention
It is important to seek medical attention if your sore left hip flexor persists or worsens. This is especially true if you experience any of the following symptoms:
- Severe pain that does not improve with home treatment
- Swelling or bruising around the hip joint
- Inability to bear weight on the affected leg
- Numbness or tingling in the leg or foot
- Fever
These symptoms may indicate a more serious underlying condition, such as a hip fracture, dislocation, or infection. Seeking medical attention promptly can help to ensure that you receive the proper diagnosis and treatment.
Your doctor will likely perform a physical examination and ask you about your symptoms. They may also order imaging tests, such as an X-ray or MRI, to help diagnose the cause of your pain. Treatment for a sore left hip flexor will depend on the underlying cause. In some cases, home treatment measures, such as rest, ice, and stretching, may be sufficient. In other cases, more aggressive treatment, such as physical therapy or surgery, may be necessary.
Persistent Pain
If you have tried home remedies for your sore left hip flexor and the pain persists, it is important to consult a healthcare professional. Persistent pain may indicate a more serious underlying condition that requires medical treatment. Your doctor will be able to evaluate your symptoms and determine the best course of treatment.
There are a number of potential causes of persistent pain in the left hip flexor, including:
- Muscle strain or tear
- Arthritis
- Bursitis
- Hip impingement
- Labral tear
- Stress fracture
Your doctor will likely perform a physical examination and ask you about your symptoms. They may also order imaging tests, such as an X-ray or MRI, to help diagnose the cause of your pain. Treatment for persistent pain in the left hip flexor will depend on the underlying cause.
In some cases, home remedies may be sufficient to relieve pain. However, if your pain is severe or does not improve with home treatment, your doctor may recommend more aggressive treatment, such as physical therapy, injections, or surgery.
Limited Mobility
If your sore left hip flexor is accompanied by reduced range of motion or difficulty walking, it is important to seek medical attention. These symptoms may indicate a more serious underlying condition, such as a hip fracture, dislocation, or infection. Seeking medical attention promptly can help to ensure that you receive the proper diagnosis and treatment.
Your doctor will likely perform a physical examination and ask you about your symptoms. They may also order imaging tests, such as an X-ray or MRI, to help diagnose the cause of your pain and mobility problems. Treatment for a sore left hip flexor with reduced range of motion or difficulty walking will depend on the underlying cause.
In some cases, home treatment measures, such as rest, ice, and stretching, may be sufficient to improve range of motion and reduce pain. In other cases, more aggressive treatment, such as physical therapy or surgery, may be necessary. Your doctor will be able to recommend the best course of treatment for your specific condition.
Other Symptoms
In addition to pain, swelling, redness, and fever may also be present if your sore left hip flexor is caused by an underlying medical condition. These symptoms may indicate a more serious condition, such as an infection or a blood clot. It is important to seek medical attention promptly if you experience any of these symptoms.
Swelling
Swelling around the left hip joint may be a sign of inflammation or fluid buildup. This can be caused by a variety of conditions, including arthritis, bursitis, and infection.
Redness
Redness around the left hip joint may be a sign of inflammation or infection. This can be caused by a variety of conditions, including arthritis, bursitis, and cellulitis.
Fever
A fever is a body temperature that is higher than normal. This can be a sign of infection. If you have a fever along with other symptoms, such as pain and swelling in your left hip flexor, it is important to seek medical attention promptly.
Your doctor will likely perform a physical examination and ask you about your symptoms. They may also order imaging tests, such as an X-ray or MRI, to help diagnose the cause of your symptoms. Treatment for a sore left hip flexor with additional symptoms, such as swelling, redness, or fever, will depend on the underlying cause.
5. Additional Resources
In addition to the information provided in this article, there are a number of other resources available online that can provide you with more information on sore left hip flexors. Some of these resources include:
- American Academy of Orthopaedic Surgeons: https://www.aaos.org/ – The American Academy of Orthopaedic Surgeons is a professional organization that provides information on a variety of musculoskeletal conditions, including sore left hip flexors.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: https://www.niams.nih.gov/ – The National Institute of Arthritis and Musculoskeletal and Skin Diseases is a part of the National Institutes of Health that provides information on a variety of musculoskeletal conditions, including sore left hip flexors.
- Hip Flexor Stretches: https://www.webmd.com/fitness-exercise/hip-flexor-stretches – This website provides a number of different stretches that can help to relieve pain and improve range of motion in the left hip flexor.
These are just a few of the many resources that are available online. If you are experiencing pain in your left hip flexor, it is important to consult with a healthcare professional to determine the cause of your pain and get the appropriate treatment.
American Academy of Orthopaedic Surgeons
The American Academy of Orthopaedic Surgeons (AAOS) is a professional organization that provides information on a variety of musculoskeletal conditions, including hip flexor injuries. The AAOS website has a wealth of information on hip flexor injuries, including causes, symptoms, diagnosis, and treatment. The website also has a number of patient education resources, such as videos and infographics, that can help you to learn more about hip flexor injuries and how to prevent them.
Here is a link to the AAOS website: https://www.aaos.org/
The AAOS website is a valuable resource for anyone who is interested in learning more about hip flexor injuries. The website provides up-to-date information on the latest treatment options and research findings. The AAOS website also has a number of tools and resources that can help you to find a qualified orthopaedic surgeon in your area.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is a part of the National Institutes of Health that provides information on a variety of musculoskeletal conditions, including hip flexor injuries. The NIAMS website has a wealth of information on musculoskeletal conditions, including causes, symptoms, diagnosis, and treatment. The website also has a number of patient education resources, such as videos and infographics, that can help you to learn more about musculoskeletal conditions and how to prevent them.
Here is a link to the NIAMS website: https://www.niams.nih.gov/
The NIAMS website is a valuable resource for anyone who is interested in learning more about musculoskeletal conditions. The website provides up-to-date information on the latest treatment options and research findings. The NIAMS website also has a number of tools and resources that can help you to find a qualified healthcare provider in your area.
Hip Flexor Stretches
Hip flexor stretches can help to relieve pain and improve range of motion in the left hip flexor. There are a number of different hip flexor stretches that you can do, but some of the most effective stretches include:
- Standing quad stretch: Stand with your feet shoulder-width apart. Bend your right knee and grab your right foot with your right hand. Pull your right heel towards your buttocks. Hold the stretch for 30 seconds. Repeat with your left leg.
- Kneeling hip flexor stretch: Kneel on your right knee and place your left foot flat on the floor in front of you. Lean forward and place your hands on your left thigh. Gently push your hips forward until you feel a stretch in your left hip flexor. Hold the stretch for 30 seconds. Repeat with your right leg.
- Seated hip flexor stretch: Sit on the floor with your legs extended straight out in front of you. Bend your right knee and bring your right foot towards your chest. Hold the stretch for 30 seconds. Repeat with your left leg.
These are just a few of the many different hip flexor stretches that you can do. It is important to stretch your hip flexors regularly to help prevent pain and improve range of motion.
Quiz
- What is the most common cause of a sore left hip flexor?
(a) Muscle strain (b) Arthritis (c) Bursitis (d) Hip impingement
- What is the best way to treat a sore left hip flexor?
(a) Rest and ice (b) Stretching and exercises (c) Medication (d) All of the above
- When should you seek medical attention for a sore left hip flexor?
(a) If the pain is severe or does not improve with home treatment (b) If you have swelling or bruising around the hip joint (c) If you have difficulty walking or bearing weight on the affected leg (d) All of the above
Answer Key
- (a) Muscle strain
- (d) All of the above
- (d) All of the above