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November 12, 2004

Gracilis and Psoas Strain

A client of mine came in today with a groin injury due to a Pilates class they said was taught by an under-qualified teacher. Be sure when you join a Pilates class that the instructor incorporates synchronous breathing with the movements--this will help prevent injury.

My client presented with pain in the inguinal area that radiated up and around the hip and into the low back. I explained the anatomy of the area and surmised that she had a strain in the psoas muscle. I palpated the leg and found the adductors were exquisitely tender. I used effleurage to apply oil and gently warm the muscles. Many people are tender in their adductor muscles due to lack of use and because we sit so much in our society.

Primary pain in the adductor muscles was in the gracilis muscle which stood out like a guitar string. I worked the adductor group up toward the lesser trochanter of the femur. Upon palpating the lesser trochanter attachments, the client reported sensation along the line of their original pain. I knew I was on the right track.

Then I located the psoas muscle by having the client raise and lower their leg. This activates the psoas muscle so that I can confirm contact with the belly of the muscle. The client said the muscle area was very tender. This is not unusual. Sometimes when I work in a muscle that has been holding a lot of pain or emotion for a long time, I get very warm and will actually perspire. This was one of those situations. The client reported that they had scarring in the area due to their appendix rupturing years earlier. I suspect that was impeding the full range of motion of the muscle and may have been the reason behind the strain.

I finished working the psoas and assisted the client with stretching the muscle. They left the session pain-free. I warned that it was likely they would be sore later that evening or the next day. I recommend ice to ease any inflammation which will help keep pain in check.

Posted by linda at November 12, 2004 7:28 PM

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