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Hip Issues
A friend of mine became a client about 6 months ago and originally said that she had a really hard time getting her hamstrings to loosen up. She does yoga regularly and also works out with weights and cardio. After just a couple of visits, she said her hamstrings were significantly looser and that she could do yoga poses more effectively than she had ever been able to do so before. She still comes in for regular appointments, and although her hamstrings are no longer our "focus", we know she holds a lot of tension in her glutes.
During her last appointment, she mentioned having a hard time with a type of "squat" - I can't remember the name of it, but you hold your arms out, shoulder height, parellel to the ground, then do the same with one leg. Then you squat low to the ground and shoot back up. On one side, she can do this very easily and smoothly (she said it took a lot of training). On the other side, everything is perfect until she shoots back up, at which time she can DO it, but she looks as though she's about to fall over from how wacky her hip goes. She said when she does the squat she feels it in her quads, hamstrings and glutes. Since these are areas that we always work, I'm wondering if I'm missing something? Is there a specific muscle or area or technique that anyone knows of that could be causing one side to be so much more unstable than the other?
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Replies to This Discussion
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Permalink Reply by Frank J on
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It sounds as if it may be a neuromuscular miscommunication somewhere. But also on the side that seems to wobble or whatever, her psoas, illiacus or maybe even her core may be weak. It is really hard to tell without actually being there and doing a complete eval
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Permalink Reply by Alyson C Schlobohm on
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Hmmm, thanks, Frank! She said her trainer mentioned something about one femur being longer than the other, but I'm not really sure how that would relate. I would imagine she has a pretty strong core with the amount of yoga and training she does, but that was also my first thought as well!
Just looked at some psoas and illiacus stretches...you might be on to something!!!
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Permalink Reply by Barbara Sharp on
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Do thorough muscle testing along the quads, TFL, Psoas, Iliacus, Gracilis, Sartorius, Gluteus Medius and even the Adductors. One or more of those are weak, and that's why the client can't balance the standing up movement. My bet is Rectus Femoris, Glute Medius and/or Sartorius.I would also look at testing the Y ligament of Bigalow, one of the internal ligaments holding the head of the femur into the acetabular joint. To test it, first find a strong arm muscle on the supine client. I typically use Deltoid. When muscle testing, remember to first meet the client's arm strength and only then lightly exceed it to test if it can withstand the increased pressure while holding its contraction. Once you've found a strong muscle, use one hand to grasp the anterior thigh and push it firmly up into the acetabulum. This is the joint challenge. Retest the Deltoid muscle to see if it remains strong during the acetabular challange. If the deltoid goes weak, then your client has a twist in the internal connective tissue/ligaments of the hip joint including a probable twist in the original tendon of the Rectus Femoris. Use your massage techniques to work those tissues, and you will need some good distal traction on the femur. Wasleski had a good technique for it. Also a chiropractor can reset that joint. I also teach a self fix "Hip Kick" developed by Camden Clay, DC that often fixes this problem, at least temporarily. The client basically kicks their leg using gravity and a modicum of force to stretch the hip joint. Inflammation in the joint is a contraindication. Take Bromelain tablets on an empty stomach to help inflammation clear.
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WOW, thanks, Barbara!!!!
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Permalink Reply by michael anthony on
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could be the trigger that rides on the hip, there are two points there same times that helps
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Permalink Reply by Dr. Ross Turchaninov on
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You
must examine the possible irritation of the L5-S1 nerves or sciatic nerve (its tibial portion) which supply hamstring muscles. There are three major areas you should evaluate: lumbar erectors on the level L5-S1, medial surface of the SI Joint (be sure to apply pressure under 45 degrees angle next to the medial edge of the joint) and piriformis muscle. In cases when muscle pathology becomes chronic problem in majority cases the low grade irritation of the supplying nerves is a real reason for the trigger point formation. All necessary tests (in the video format) for the piriformis muscle evaluation you may find in our article in March-April 2010 issue of JMS http://scienceofmassage.com/dnn/som/journal/1003/toc.aspx
Good luck!
Dr. Ross Turchaninov
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Alyson,
Sorry, but 'You' got there accidentally. Also it seems that link I tried to create didn't work. Just go to www.scienceofmassage.com and click on March-April 2010 issue of JMS.
Dr. Ross Turchaninov said:You
must examine the possible irritation of the L5-S1 nerves or sciatic nerve (its tibial portion) which supply hamstring muscles. There are three major areas you should evaluate: lumbar erectors on the level L5-S1, medial surface of the SI Joint (be sure to apply pressure under 45 degrees angle next to the medial edge of the joint) and piriformis muscle. In cases when muscle pathology becomes chronic problem in majority cases the low grade irritation of the supplying nerves is a real reason for the trigger point formation. All necessary tests (in the video format) for the piriformis muscle evaluation you may find in our article in March-April 2010 issue of JMS http://scienceofmassage.com/dnn/som/journal/1003/toc.aspx
Good luck!
Dr. Ross Turchaninov
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For another client with some major hip issues, I did some psoas/iliacus work and she said could feel it sooooooooo much in her hips - she said it was wonderful!!! Thanks again for the suggestions, can't wait to try the L5/S1 stuff with my other client!
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Thank you Dr. Turchaninov for the link to ScienceofMassage.com. It was right up my alley, and I am encouraged to try out the self TMJ massage tool and protocol found therein. I have found on several occasions that client's psoas and
transverse abdominal muscles strengthen after TMJ massage techniques are applied to the masseter muscles with intention to lengthen the connection of the jaw and psoas in Tom Myer's deepest anatomy train.
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