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August 14, 2007

When The Hip Feels Too Tight In The Socket

A new client arrived yesterday with leg tension. Working in a assembly plant on cement floors and being forced to squat and bend while doing a job can leave a person in a condition similar to an athlete. However, in this case, the client exerts little physical effort with the upper part of the body compared to the lower portion of the body. This leaves them out of balance.

Compounding this client's problem is the difficulty they had finding a therapist willing do the right work on their legs to balance out their body. After hearing their frustration about not getting the work they needed peppered with a couple of misunderstandings, I advised this client to seek therapists who specialized in sports massage.

Their primary imbalance started with tension in the hamstrings and adductor muscles. I worked the semitendinosus and semimembranosus with emphasis at the attachment site on the ishial tuberosity.

Then I worked the adductor muscle group. The upper attachment for these muscles can be a dicey area to work and many therapists will shy away from working here. I solve the problem by having the client place their hand over their privates and, if necessary, move them out of the way. With their hand and the drape as a natural border, there is no risk of inappropriate secondary contact.

The tendon of adductor longus can be very tight and contracted. What this feels like to the client is that the head of the femur is held too tightly into the acetabulum. Clients will often ask if I can just pull their leg to get that feeling to go away. After loosening the adductor muscles, it is important to stretch them. On the table, again with the drape held securely in place, I bring the knee to the chest and open the leg outward like a gate until the client feels I have reached the end of the comfortable mobility. I hold the leg in that position for 12 to 20 seconds, back off the stretch for 5 seconds and move back into the stretch. The leg will open further with relative comfort. This can be done two or three times.

I also leave my client with homework. I have four or five stretches I like people to do for their legs, but if I give people too many exercises or stretches, they forget how to do them. With too much to remember, they either abandon their homework all together or do it incorrectly. In this case, I asked the client where they needed work the most. Based upon their response, I assigned adductor stretches and got down on the floor with them to demonstrate the proper way to do the stretch. This insures that the client takes advantage of the flexibility that they got with the massage and helps program the proper feel of the stretch into their brain so they can do it again properly once they are away from the office. They booked a second appointment, and I'll give them another stretch (just one) to do the next time they come back.


Posted by linda at August 14, 2007 7:32 AM

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