Hip Treatment Part 2

A demonstration for hip pain and massage therapy/movement treatments for runners or general public in Flagstaff, Arizona.  Geoffrey Bishop of Stay Tuned Therapeutics demonstrates.

For more information or book a session at Stay Tuned Therapeutics contact Geoffrey at 928-699-1999

Piriformis as an internal rotator?

I’d like to hear from you.  What’s your take on this?

Why is it that we can stretch piriformis by externally rotating the leg as we bring the knee toward the opposite shoulder?  Or in yoga pigeon pose?

Piriformis. The piriformis muscle is a deep muscle located beneath the gluteal (butt) muscles. The piriformis muscle laterally rotates and stabilizes the hip. This muscle is important for athletes who participate in running sports that require sudden changes of direction. The piriformis works along with other hip rotators to turn the hips and upper leg outward (external rotation of the hip). Strong and flexible hip rotators keep hip and knee joints properly aligned during activity and help prevent sudden twisting of the knee during quick side-to-side movements, quick turns, lunges or squats.

Save Your Body In The Snow. Winter Aches & Pains contd.

Break Time

Having just received more than 2 feet of heavy snow, with more to come, there are good times on the way for residents of Northern Arizona.  But before the good times roll, there is a lot of hard work to be done.

At Stay Tuned Therapeutics, when it snows, we see an influx of patients with sciatic nerve irritation, leg pain, rotator cuff impingement, arm pain & low back pain.  Mindful shoveling techniques will keep you safe, saving your low back, legs, hips and shoulders for the fun to come.

The most operated on disc in the back in L5-S1.  This is the very lowest disc in the back, between Lumbar spine and the sacrum.  Repetitive motions can wear this disc out, cracking the annular fibers…a simple one time movement of forward bending and rotation, with a heavy load, may be what finally lands you in the emergency room.  Forward head postures and rotation of the shoulders inward will lead to pinching and possible damage in the shoulders.

Here are some tips for preventing injury.

• Warm up, stretch some, and take breaks.  Dress accordingly, don’t get too hot!
• WATER IN THY BODY.
• If you must bend over to shovel, come to a standing position before twisting the trunk to unload the snow.
• Bend at the knees, at least every other effort.
• Take small scopes of snow, start with the top layer. (A 12 lb load can translate to 586 lb compression to L5-S1 disc w bad body mechanics)
• Push snow down hill when you can.
• Alternate sides.
• Bring your head back and shoulders blades down before pitching the snow to save shoulders.
• Keep the shovel close to your body.
• Take a break.
• Plan on taking a while.  Don’t rush!

Follow these steps, enjoy the day.  Save your body for the snowshoeing, CC skiing, and get to the mountain when you can!

Winter Aches & Pains Pt. 2

Hip ABduction Test

In part one of this discussion I introduced a common injury that may present in a clinical setting.  Injury, weakness (inhibition) or tightness (facilitation) of the adductor group of the thigh.  I’d like to now introduce you to a test that may be administered by the clinician or as a take home assessment of recruitment and compensation patterns in hip abduction.

In a side lying position I simply ask the client to raise a straight leg toward to ceiling.  In doing so glute med and min should “fire” at approximately the same time, lifting the leg straight laterally, toward the ceiling.  In the presence of inhibition of glute med., min., and potential facilitation of the adductor group, there may be a variety of substitution patterns.  Normal range of motion should be at least 45 degrees of abduction (toward the ceiling).   Try this on yourself and see what you find.

Lie on your side, raise top leg toward the ceiling.

Compensation patterns that may present are as follows:

Tight Adductors = ROM below 45 degrees abduction.

Piriformis Facilitation = External rotation of femur, evident by the toes pointing toward the ceiling.

Tensor Fasciae Lata Facilitation = The hip will come into flexion, draw the thigh anterior (toward the front).  Also may be seen that the trunk twist posterior (back) still creating hip flexion.

Quadratus Lumborum Facilitation = In an attempt to raise the leg, the hip will hike toward the shoulder, creating a slight side bend in the low back.

Any of these conditions may create or add to low back and hip pain, and may be a contributing factor in dysfunction of the rest of the kinetic chain.  Try this test, and let me know what you find.  In future installments we will look at what you find, and discuss treatment options from a clinical standpoint, and what you can do at home in self treatment.