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Hip Pain & Disorders

Back Clinic Hip Pain & Disorders Team. These types of disorders are common complaints that can be caused by a variety of problems. The precise location of your hip pain can give more information about the underlying cause. The hip joint on its own tends to result in pain on the inside of your hip or groin area. Pain on the outside, upper thigh, or outer buttock is usually caused by ailments/problems with the muscles, ligaments, tendons, and soft tissues surrounding the hip joint. Hip pain can also be caused by diseases and conditions in other areas of your body, i.e. the lower back. The first thing is to identify where the pain is coming from.

The most important distinguishing factor is to find out if the hip is the cause of the pain. When hip pain comes from muscles, tendons, or ligament injuries, it typically comes from overuse or Repetitive Strain Injury (RSI). This comes from overusing the hip muscles in the body i.e. iliopsoas tendinitis. This can come from tendon and ligament irritations, which typically are involved in snapping hip syndrome. It can come from inside the joint that is more characteristic of hip osteoarthritis. Each of these types of pain presents itself in slightly different ways, which is then the most important part in diagnosing what the cause is.


Iliopsoas Muscle Injury: El Paso Back Clinic

Iliopsoas Muscle Injury: El Paso Back Clinic

The iliopsoas muscle is a primary hip flexor that assists in the femur’s external rotation and maintains the hip joint’s strength and integrity. It also helps to stabilize the lumbar spine and pelvis. Athletes often overuse these muscles with all the sprinting, jumping, kicking, and changing directions when running, causing strains and/or tears. Repetitive hip flexion can result in chronic degenerative tendon changes. Chiropractic care and physical therapy can assist in the early phases of healing, safely transitioning to rehabilitation, and returning to physical activities.

Iliopsoas Muscle Injury: EP Chiropractic Functional Medicine Team

Iliopsoas Muscle

The hip flexors are the group of muscles, including the iliacus and psoas major muscles/iliopsoas and the rectus femoris/quadriceps. One of the largest and thickest muscles in the body, the psoas, extends from the lumbar vertebrae, crosses in front of each hip, and attaches to the inside top of the thigh bone. The muscle works by flexing the hip joint and lifting the upper leg towards the body. These fibers can tear if tension is more than the muscle can bear. An iliopsoas strain occurs when one or more of these hip flexor muscles become overly stretched or begin to tear.

Injury

The injury can occur from sports or everyday physical activities. This leads to inflammation, pain, and scar tissue formation. An iliopsoas injury is commonly caused by sudden movements, including sprinting, kicking, and changing direction fast while running. Individuals participating in any sports, especially cycling, running, dance, tennis, martial arts, and soccer, are more likely to experience this injury. Other contributing factors include:

  • Muscle tightness
  • Joint stiffness
  • Muscle weakness
  • Inadequate core stability
  • Not warming up correctly
  • Improper biomechanics
  • Decreased fitness and conditioning

Individuals will feel a sudden stinging pain or pulling sensation, usually on the front of the hip, groin, or abdominal area. Other symptoms include:

  • Stiffness after resting.
  • Swelling
  • Tenderness
  • Bruising around the area.
  • Anterior hip pain and/or burning sensation.
  • Groin discomfort sensations.
  • Hip snapping or a catching sensation.
  • Discomfort when flexing the leg.
  • Walking problems and discomfort.
  • Lower stomach and/or back symptoms.

Healing and recovery depend on the severity of the injury. A minor iliopsoas muscle injury can take around three weeks to recover fully. More serious strains and tears take six to eight weeks before returning to activity, as the tissue needs time to repair before starting rehabilitation.

Chiropractic Rehabilitation and Recovery

The first steps when dealing with this injury should be P.R.I.C.E. protection, rest, ice, compression, and elevation. It is important to rest and seek treatment immediately; if left untreated, the condition could worsen, lead to a chronic condition, and require surgery. A chiropractic treatment and rehabilitation plan will consist of the following:

  • Soft tissue massage
  • Joint mobilization
  • A chiropractor may recommend crutches to keep the weight off the hip.
  • A brace can help compress and stabilize the hip flexor to expedite healing.
  • A flexibility and strengthening program will be implemented to target the muscles around the hip.
  • Core strengthening exercises will improve the stability of the pelvis area to prevent any further overuse problems.
  • Wearing compression clothing could also be recommended, as the clothing helps maintain muscle temperature.

Labral Tear


References

Dydyk AM, Sapra A. Psoas Syndrome. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK551701/

Lifshitz, Liran BPt, MSc, PT; Bar Sela, Shlomo BPt MPE; Gal, Noga BPt, MSc; Martin, RobRoy PhD, PT; Fleitman Klar, Michal BPt. Iliopsoas the Hidden Muscle: Anatomy, Diagnosis, and Treatment. Current Sports Medicine Reports 19(6):p 235-243, June 2020. | DOI: 10.1249/JSR.0000000000000723

Rauseo, Carla. “THE REHABILITATION OF A RUNNER WITH ILIOPSOAS TENDINOPATHY USING AN ECCENTRIC-BIASED EXERCISE-A CASE REPORT.” International journal of sports physical therapy vol. 12,7 (2017): 1150-1162. doi:10.26603/ijspt20171150

Rubio, Manolo, et al. “Spontaneous Iliopsoas Tendon Tear: A Rare Cause of Hip Pain in the Elderly.” Geriatric orthopedic surgery & rehabilitation vol. 7,1 (2016): 30-2. doi:10.1177/2151458515627309

Different Stretches To Improve Hip Mobility

Different Stretches To Improve Hip Mobility

Introduction

The hips in the lower portions of the body allow the legs to move the host from one location to another and provide stability to support the upper body’s weight. The hips will enable the torso to twist and turn without feeling pain. This is due to the various muscles and ligaments surrounding the pelvic bone and hip joint socket that allow the motion to be possible. However, when various injuries or factors start to affect the multiple muscles surrounding the pelvis or there is a chronic condition like osteoarthritis that causes wear and tear on the hip joints can cause underlying symptoms associated with the hips and cause many individuals to have difficulty when moving around. Luckily there are ways to improve hip mobility and the surrounding muscles in the hip and pelvic region of the body. Today’s article looks at the causes of the development of tight hips in the body and how different stretches can release tight hip flexor muscles. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from hip pain and its correlating symptoms that can affect the musculoskeletal system in the hips, legs, and lumbar region of the spine. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

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What Causes The Body To Develop Tight Hips?

 

Have you been dealing with hip mobility issues? When you sit, do you feel uncomfortable, and your hip muscles become tight? Or do you have a decreased range of motion when moving your hips? It could correlate with your hips if you have been experiencing muscle pain issues in the lower extremities. The hips help stabilize the upper and lower portions of the body while providing the full leg’s range of motion. When a person begins to sit for long periods or twist their body in a weird position, it can cause the muscles that surround the hips to become shortened. Other issues, like chronic conditions, can play a role in developing tight hip flexors. Studies reveal that various pathologies affecting the hips, lumbar spine, and lower extremities could strongly correlate with restricted hip mobility that can cause harmful effects that can affect the hips. To that point, some of the symptoms associated with tight hip flexors include:

  • Instability
  • Hypermobility
  • Limited range of motion
  • Reduce muscle strength in the groin
  • Muscle cramps
  • Sharp, sudden pain in the hips, pelvis, or groin
  • Low back pain
  • Piriformis syndrome

Other research studies mentioned that hypermobility disorders could affect the hip joints. Hypermobility disorders like EDS (Ehlers-Danlos syndrome) could cause micro or macro-trauma on the hip joint and affect the ligaments surrounding the hip joint. To that point, it can cause the hip flexor muscles to become tense and potentially affect how a person moves, which then causes soft tissue injuries and chronic pain.


Hip Flexor Stretches-Video

Do you feel tight along your hips? Do you see yourself hobbling around when walking? Or do you feel aches or strains when stretching? Many of these issues correlate with tight hip flexors that could result from hip pain in the lower extremities. When a person has tight hip flexors, it could be due to them constantly sitting down, causing the hip muscles to be shortened, or chronic conditions that can affect the hip joint and muscles. However, there are various ways to prevent tight hip flexors and regain mobility back to the hips. Studies reveal that stretching combined with core stabilization can help improve the hip’s range of motion while ensuring core endurance exercises can help strengthen the surrounding muscles in the hip area. The video above shows stretches targeting the hip flexor muscles and helps improve hip mobility.


Different Stretches To Release Tight Hip Flexors

Studies have shown that the hip flexor muscles are the main contributors to lumbar spine stability when releasing tight hip flexor muscles. So when there are tight hip flexors, it can cause overlapping risk profiles to the lumbar spine, which leads to pain and impairment in performance. The best way to reduce the pain-like symptoms associated with tight hip flexors is by stretching the lower half of the body to reduce muscle strain and tightness in the hip flexors. Additional studies have found that stretching combined with exercises targeting the low back can reduce the pain caused in the low back and help improve stability and strengthen the surrounding muscles located in the hips. Now it is important to remember that stretching for at least 5-10 minutes before and after working out allows the muscles to warm up and improve flexibility. Below are some different stretches that can release tight hip flexors.

 

High Crescent Lunge

 

  • While standing on the mat, take a step forward to allow your right foot to be in a staggard stance *Think in a lunge position.
  • Bend the front knee gently while keeping the back leg straight, as this allows the heel in the back leg to be lifted off the mat; the bent front knee enables the thigh to be parallel to the floor, and the right foot is pressed flat on the mat.
  • Square up the hips, so they face toward the mat’s front.
  • Extend the arm up towards the ceiling to stretch upwards while pressing into the mat to feel the hips stretch
  • Hold for five breaths before slowly rising out of the lunge position and repeating on the other side. 

This stretch helps release tension in the hip flexors and quads while warming up the muscles and increasing blood flow to the legs.

 

Knee-To Chest Stretch

 

  • Lie on the mat with both legs extended out and feet flexed.
  • Pull on the left knee to the chest while keeping the right leg straight, and the lumbar portion of the back is pressed into the mat.
  • Hold the position while taking deep breaths for 30 seconds to 2 minutes.
  • Release slowly and repeat on the right leg *You can lift both knees to your chest and rock slowly from side to side to relieve low back tension as an alternative.

This stretch is extremely helpful for tight hamstrings and allows the tense muscles on the hips and lower back to relax while increasing blood flow back to the muscles.

 

Piriformis Stretch

 

  • On the mat, sit with both legs extended out.
  • Cross the right leg over the left and place the other flat on the floor while the left foot is flexed
  • Place the right hand behind the body while the left elbow is on the right knee.
  • On inhale, press the right leg to the left while allowing the torso to twist on the right.
  • Take five breaths for a deeper stretch and switch sides to repeat the action with the left hand *If you have low back pain issues, the modified version allows you to use your left hand to pull the right quad in and out to the left and vice versa.

This stretch helps loosen tight muscles in the lower back, hips, and glutes. If you have sciatic nerve pain associated with piriformis syndrome, this stretch helps release muscle tension from the piriformis muscle aggravating the sciatic nerve.

Happy Baby Pose

 

  • Lie on the mat with both knees bent and feet on the ground.
  • On inhale, lift the feet off the ground and grab the outer sections of the feet with your hands.
  • Then gently pull the feet towards the chest and allow the knees to lower to the ground, on either side of the body, while keeping the back flat on exhale.
  • Hold the position for at least five breaths.

This stretch helps with the inner thigh muscles or hip adductors and helps them become loose and mobile without feeling any strain or tension.

 

Bridge Pose

 

  • On the mat, lie on your back and sides, and extend your arms while your feet are flat on the floor with your knees bent.
  • Press with your heels to lift the hips and allow the feet to walk a few steps toward the body. *Keep the feet and knees hip-width apart.
  • Clasp hands together underneath the body and press them into the mat
  • Hold the position for five breaths.

This stretch helps take the pressure off the hip muscles while strengthening the glutes and abdominal muscles.

 

Conclusion

When it comes to releasing tight hip flexors after sitting for a long time or having hip issues affecting your low back or pelvis, Doing different stretches that target the hips can reduce the pain and release tight muscles associated with other conditions that can affect the body. The hips are important to take care of since they provide mobility and stability to the upper and lower portions of the body. They support the upper body’s weight while providing a huge range of motion to the legs. Incorporating these different stretches can reduce the pain that they have been under and help warm up the other muscles that surround the lower extremities.

 

References

Lee, Sang Wk, and Suhn Yeop Kim. “Effects of Hip Exercises for Chronic Low-Back Pain Patients with Lumbar Instability.” Journal of Physical Therapy Science, U.S. National Library of Medicine, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4339134/.

Moreside, Janice M, and Stuart M McGill. “Hip Joint Range of Motion Improvements Using Three Different Interventions.” Journal of Strength and Conditioning Research, U.S. National Library of Medicine, May 2012, pubmed.ncbi.nlm.nih.gov/22344062/.

Reiman, Michael P, and J W Matheson. “Restricted Hip Mobility: Clinical Suggestions for Self-Mobilization and Muscle Re-Education.” International Journal of Sports Physical Therapy, U.S. National Library of Medicine, Oct. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3811738/.

Reiman, Michael P, and J W Matheson. “Restricted Hip Mobility: Clinical Suggestions for Self-Mobilization and Muscle Re-Education.” International Journal of Sports Physical Therapy, U.S. National Library of Medicine, Oct. 2013, www.ncbi.nlm.nih.gov/pmc/articlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027473/es/PMC3811738/.

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Plantar Fasciitis & Trigger Points On The Feet

Plantar Fasciitis & Trigger Points On The Feet

Introduction

Everyone worldwide knows that feet are important. The feet allow many individuals to run, walk, or jog for long periods without feeling pain for a moderate amount of time. To that point, the various muscles and tendons surrounding the foot provide full body flexion, extension, and stability. Even though it is very easy to get in the recommended amount of steps into being healthy, around 75% of individuals will have foot pain that can impact their ability to walk. One of the most common foot pains is plantar fasciitis, which can become a painful foot condition if it is not treated as soon as possible. Today’s article looks at plantar fasciitis, its symptoms, how trigger points correlate, and treatments for it. We refer patients to certified providers incorporating techniques and therapies for individuals dealing with plantar fasciitis. By locating where the trigger points are coming from, many pain specialists can develop a treatment plan to reduce the effects that plantar fasciitis is causing on the feet. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a terrific way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

taping-for-trigger-point-peroneal-muscles_6394f3b4

What Is Plantar Fasciitis?

 

Have you been dealing with constant heel pain? Do you feel pain shooting up your leg when you step or walk? Or do you feel a stabbing ache in your heel? Many of these pain issue people are dealing with correlate with plantar fasciitis. Studies reveal that plantar fasciitis results from degenerative irritation on the plantar fascia and its ligaments. This causes the muscle ligaments to become inflamed, swollen, and weak, which then causes the bottom of the foot or heel to hurt when a person is walking or standing. To that point, when there is a repetitive strain on the feet, it causes microtears in the plantar fascia. The plantar fascia in the foot plays an important role as it comprises three segments that support the medial arch and shock absorption when stepping down. As one of the most common causes of heel pain, the residual pain from plantar fasciitis tends to be a sharp, stabbing sensation. Plantar fasciitis is more prominent in middle-aged people. Still, anyone at any age can develop plantar fasciitis, especially if they have labor jobs requiring them to be constantly on their feet.

 

Symptoms Of Plantar Fasciitis

Since around 2 million Americans could potentially develop plantar fasciitis, it is important to know that when a person has been on their feet constantly, there will be inflammation along the tissues in the feet. Many individuals with a busy lifestyle that requires them to be on their feet frequently would often ignore the pain or discomfort. Some of the symptoms that plantar fasciitis causes include the following:

  • Pain on the bottom of the heel
  • Pain in the arch 
  • Pain that is usually worse when waking up
  • Pain that increases over months
  • Swelling on the bottom of the heel

However, when the pain becomes overbearing, many people would often think they have sore feet or low back pain from being overly tired from work, under constant stress, or over-exerting their bodies. When this happens, many would think the pain would go away in a few days after resting for a short period.

 

Trigger Points Associated With Plantar Fasciitis

 

Now many individuals would often think that plantar fasciitis just only affects the heels, however, it can affect any part of the structure of the foot since all the surrounding muscle tissues are at risk of inflammation. When people start to ignore the pain and discomfort that plantar fasciitis is causing on the feet, it can overlap and develop trigger points in other areas of the body:

  • Ankles
  • Knees
  • Hips
  • Lower back

Studies reveal that trigger points or myofascial pain syndrome are hard, discrete, small nodules that are along the taut musculoskeletal band that causes numerous issues like inflammation, hypersensitivity, and pain to the affected muscle groups in the body. According to “Myofascial Pain and Dysfunction” written by Dr. Travell, M.D., it mentions that when the deep intrinsic muscles that work with the plantar fascia are affected by trigger points, would cause symptoms of numbness and the feeling of swelling in the foot. This causes many people to have limited mobility and have intense pain when walking, which can negatively impact their lifestyle.

 


An Overview Of Plantar Fasciitis- Video

Have you been dealing with aching feet? Do you feel a sharp, radiating pain in your feet? Or do you have difficulty walking? Many often think they are dealing with sore feet or other issues causing them pain. Around 75% of Americans often have foot pain affecting their ability to walk, and one of them is plantar fasciitis. The video above explains plantar fasciitis and how it can affect the feet. When the plantar fascia tendons become overused, it causes micro-tears in the muscle ligaments. When added compressive force starts to push against the heel boner, it can lead to a pathological state whereby the plantar fascia degenerates and creates dysfunction and pain. When this happens, it can lead to other conditions like trigger point pain along the muscle fibers in the foot. The pain and tenderness caused by trigger points in the plantar muscles may mask as plantar fasciitis. To that point, when plantar fasciitis becomes an issue and causes the individual to be in immense pain, it can become problematic. As luck would have it, treatments are available to reduce the pain from plantar fasciitis.


Treatments For Plantar Fasciitis

 

When treating plantar fasciitis, many available treatments can reduce the inflammatory effects in the heel and prevent trigger points from coming back. One of the available treatments is chiropractic care. Chiropractic care is an alternative treatment option to prevent, diagnose, and treat numerous injuries and conditions associated with the spine, primarily subluxations or spinal misalignments. Chiropractic focuses on restoring and maintaining the overall health and wellness of the musculoskeletal and nervous systems through spinal manipulation and adjustments. A chiropractor can carefully re-align the spine, improving a patient’s strength, mobility, and flexibility. Regarding plantar fasciitis, chiropractic care can work with other treatments, including physical therapy, massage, and even injections, to manage the pain and treat the condition. Even though plantar fasciitis takes several months to heal, chiropractic care can involve a precise technique that involves adjustments to the feet, ankles, and spinal alignment. This provides several benefits, which include the following:

  • Reduces Stress in the Plantar Fascia 
  • Promotes Healing 
  • Provides Effective Pain Management 
  • Reduces the Risk of Further Injury 

 

Conclusion

As many individuals worldwide are on their feet constantly, foot pain can hinder one’s ability to move. One of the most common foot pain is plantar fasciitis which can correlate with trigger points along the various muscles of the foot. Plantar fasciitis results from degenerative irritation on the plantar fascia and its ligaments, which causes sharp, stabbing pain on the heel. When this happens, it can cause the heel to be inflamed, swollen, and weak. To that point, it causes instability and pain when walking. However, plantar fasciitis can be treated when it is caught early through various treatments like chiropractic care. Chiropractic care can reduce the stress in the plantar fascia and help reduce the risk of further injuries. Combined with other therapies, many people can function normally and regain their walking ability without pain.

 

References

Buchanan, Benjamin K, and Donald Kushner. “Plantar Fasciitis – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 30 May 2022, www.ncbi.nlm.nih.gov/books/NBK431073/.

Petrofsky, Jerrold, et al. “Local Heating of Trigger Points Reduces Neck and Plantar Fascia Pain.” Journal of Back and Musculoskeletal Rehabilitation, U.S. National Library of Medicine, 2020, pubmed.ncbi.nlm.nih.gov/31594202/.

Shah, Jay P, et al. “Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective.” PM & R : the Journal of Injury, Function, and Rehabilitation, U.S. National Library of Medicine, July 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4508225/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

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Foot Pain, Plantar Fasciitis, & Trigger Point Pain

Foot Pain, Plantar Fasciitis, & Trigger Point Pain

Introduction

The various muscles and tendons surrounding the foot play an important role as they provide stability to the lower parts of the body and allow the individual to move and flex their feet. These various muscles and tendons help support the ankles and allow leg movement. Many people will be on their feet constantly as the world moves and sometimes have to deal with various issues affecting their ability to walk. As the body naturally ages, many people will begin to shuffle their feet around, which causes strain on the foot muscles and can affect the calves and legs over time. To that point, it can lead to foot pain and other conditions that can affect the individual. Other issues that can affect the feet and its muscle could be incorrect footwear, how they are standing, or how they walk. When this happens, conditions like plantar fasciitis and trigger point pain can affect the feet differently. Today’s article focuses on the superficial intrinsic foot muscles, how trigger points and plantar fasciitis correlate with foot pain, and how to strengthen the foot muscles. We refer patients to certified providers incorporating techniques and therapies in the lower body extremities of trigger points affecting the feet. This helps many people with trigger point pain symptoms associated with plantar fasciitis along the intrinsic foot muscles. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a terrific way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

anatomy-amp-palpation-of-the-sartorius-muscle_63951bec

The Superficial Intrinsic Foot Muscles

 

As stated earlier, the foot has various muscles and tendons that allow stability to the ankles and allow movement when a person is walking. The foot has two muscle groups: the extrinsic and intrinsic muscles. Today we will look at the intrinsic foot muscles and how important these muscles are in the foot. Studies reveal that the intrinsic foot muscles are highly important as they are contained to the foot and contribute to supporting the medial longitudinal arch. The intrinsic foot muscles are superficial and help keep the toes straight while providing flexion and extension when in motion. The foot has about 29 muscles, including 10 surrounding the foot and ankle, while the other 19 are intrinsic and provide the roles for gait and posture. The 19 intrinsic muscles have the following:

  • Abductor Hallucis
  • Quadratus Plantae
  • Flexor Hallucis Brevis
  • Flexor Digitorum Brevis
  • Abductor Digiti Minimi
  • Flexor Digiti Minimi
  • The Interossei Muscles
  • The Lumbricals

These muscles allow individuals to walk, run, or jog without pain. However, when the intrinsic muscles become impaired, studies reveal that intrinsic foot muscle function could be linked to various foot conditions that affect a person’s walking ability.

 

How Does Foot Pain Correlate With Plantar Fasciitis & Trigger Points?

Studies reveal that foot pain can cause an unpleasant sensory and emotional experience as many factors can affect how a person is walking and can lead to various issues affecting the lower extremities’ mobility. When multiple issues affect how a person walks, the intrinsic muscle and other muscles surrounding the ankle and foot could become strained and overlap with other foot conditions. When foot pain affects the intrinsic foot muscles, co-existing muscle impairments could affect the alignment, motion, load distribution, and muscle performance that involves the legs. When these impairments are causing foot pain, it can correlate with trigger points and conditions like plantar fasciitis that can affect a person walking. But how does foot pain connect with plantar fasciitis and trigger points?

 

According to Dr. Travell, M.D.’s book “Myofascial Pain and Dysfunction,” when tension starts to overload the foot, the intrinsic muscles develop tiny nodules in the muscle fibers and reduce the muscle strength of the medial arch. To that point, it can collapse and cause the foot to develop inflammation associated with repetitive actions that cause plantar fasciitis in the feet. When this happens, it can affect a person’s ability to walk, run, stand, and affect the lower extremities’ mobility. If it is not treated right away, it can cause muscle and joint pain in the hips, legs, knees, and lower back.

 


An Overview Of The Intrinsic Foot Muscles-Video

Have you been dealing with issues on your feet? Do you find it difficult to step down or walk? Or have you been rubbing your feet constantly to reduce the soreness in your feet? Many of these issues correlate with trigger points affecting the intrinsic foot muscles that could cause foot issues like plantar fasciitis. The foot has various muscles, like the intrinsic muscles, that allow gait and stability to the body. Multiple factors affecting the intrinsic foot muscles can lead to instability, muscle strain, tendon stress, and muscle and joint pain. This can affect how a person moves throughout the day and their quality of life. The video above explains where each different muscles are, which ones are extrinsic and intrinsic, and how each muscle helps with foot function. When various issues begin to affect the foot and cause mobility issues, multiple techniques are available to help strengthen the foot muscles and prevent future problems from affecting the feet.


Strengthening The Foot Muscles

 

Regarding trigger point pain affecting the intrinsic foot muscles, various techniques can reduce the pain-like symptoms of trigger points and prevent foot issues like plantar fasciitis from re-occurring. Studies reveal that light, non-weight-bearing exercises like cycling and swimming can minimize muscle overload on foot. Other ways to strengthen the intrinsic foot muscles are by stretching the toe flexors to help improve stability and prevent hypermobility in the foot. Other techniques that can reduce trigger points in the foot’s muscle fibers include using a cylindrical or spherical object and rolling under the arches to massage and loosen stiff muscles. Many of these techniques could help restore foot functionality and stability while reducing future issues like plantar fasciitis in the feet. To that point, allow people to walk pain-free again.

 

Conclusion

The foot has 29 muscles, including ten extrinsic muscles surrounding the foot and ankle and 29 intrinsic muscles on the foot. The intrinsic muscles are highly important for foot functionality as they are superficial and contribute to supporting the medial longitudinal arch. The intrinsic foot muscles also help keep the toes straight and allow flexion and extension when in motion. These muscles also help a person walk and stabilize the ankle. When various factors affect a person’s walking ability, it can lead to muscle strain and tendon stress to the foot, leading to the development of trigger points in the intrinsic muscle fibers and causing pain. This could cause foot conditions like plantar fasciitis and other co-existing muscle impairments that can affect the lower extremities’ mobility while causing muscle and joint pain in the hips, legs, knees, and lower back. Luckily there are available techniques that can help massage, stretch, and strengthen the intrinsic foot muscles while reducing trigger points and their associated symptoms from re-occurring. To that point, these techniques can allow many individuals to walk without feeling pain.

 

References

Card, Ryan K, and Bruno Bordoni. “Anatomy, Bony Pelvis and Lower Limb, Foot Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 27 Feb. 2022, www.ncbi.nlm.nih.gov/books/NBK539705/.

Gooding, Thomas M, et al. “Intrinsic Foot Muscle Activation during Specific Exercises: A T2 Time Magnetic Resonance Imaging Study.” Journal of Athletic Training, U.S. National Library of Medicine, Aug. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5094843/.

Hawke, Fiona, and Joshua Burns. “Understanding the Nature and Mechanism of Foot Pain.” Journal of Foot and Ankle Research, U.S. National Library of Medicine, 14 Jan. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2631512/.

Hayter, Matt. “Why Do We Need the Intrinsic Muscles of the Foot? [Guide 2022].” Dynamic Podiatry, 2022, www.dynamicpodiatry.com.au/what-are-the-intrinsic-muscles-of-the-foot-guide-2019/#intrinsic.

Lim, Ang Tee, et al. “Management of Plantar Fasciitis in the Outpatient Setting.” Singapore Medical Journal, U.S. National Library of Medicine, Apr. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4853481/.

Soysa, Achini, et al. “Importance and Challenges of Measuring Intrinsic Foot Muscle Strength.” Journal of Foot and Ankle Research, U.S. National Library of Medicine, 26 Nov. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3544647/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

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Toe Flexors & Trigger Points

Toe Flexors & Trigger Points

Introduction

Regarding different destinations, our feet allow the legs and the lower body to move forward and stabilize the upper extremities from putting so much weight on the body itself. The lower portion of the body contains the hips, pelvis, legs, and feet. Within each section of the lower body, various muscles surround the joints and skeletal features of the lower half. For the hips, multiple muscles and tendons help support hip mobility and pelvic function. The legs work with the thigh as numerous muscles and tendons help the legs have more power to move. The lower portion of the legs works with the knee to allow extension and flexion to move as well. And finally, the ankles and feet work with various muscles to enable movement to the toes. The different muscles in the toes help stabilize the foot from causing issues to the ankles. However, when multiple injuries or factors begin to affect the muscles in the toes, it can lead to myofascial pain syndrome or trigger points to affect not only the toes but the entire portion of the legs and travel up to the hips. 

 

Today’s article looks at the flexor muscles of the toes, how calf pain is associated with trigger points affecting the toes, and how different treatments and stretches can alleviate trigger points along the toe flexor muscles. We refer patients to certified providers that incorporate various techniques and therapies in the lower body extremities pertaining to trigger points affecting the legs, calves, and feet. This helps many people with pain symptoms along the flexor toe muscles, causing pain when doing everyday actions like stepping or walking. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a terrific way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

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The Flexor Muscles Of The Toes

Have you been dealing with stability issues that are affecting the way you are standing? How about coping with unquestionable calf or foot pain? Do you feel aches in your big toe? Many of these issues affecting the feet are correlated with the flexor muscles in the toes. The flexor muscles are the flexor digitorum longus and the flexor hallucis longus. These muscles are located in the calf region of the lower leg and travel downwards to the ankle, forming the tendons for the feet and toes. Research studies reveal that the flexor digitorum longus muscle is a thin muscle located in the tibia’s deep posterior muscles and provides operational support to the four different sections of the toes and allows flexion. While other research studies reveal that the flexor hallucis longus muscle is a deep posterior muscle located in the fibula and provides flexion to the great toe while serving to plantarflex and inversion to the foot.

 

Now the flexor muscles work together to allow stability to the foot when a person is walking. Additional studies have shown that the flexor muscles are active as many people push off from the heel to allow movement to the toes and feet when stepping on the ground. This action enables the flexor muscles to contract and exerts much energy to allow the feet to move. However, when the body begins to age naturally, or various issues affect the lower body extremities, it can lead to multiple problems affecting a person’s mobility. 

 

Calf Pain Associated With Trigger Points Affecting The Toes

 

As the body ages naturally, a person’s mobility will eventually begin to decline as they shuffle in their steps instead of picking up their feet to move. Studies reveal that when older adults start to age naturally, they tend to have a decreased foot posture that enables them to have a more pronated foot than a supinated foot. When this happens, it can reduce mobility in their legs while also causing stress to the flexor muscles and have a high occurrence in lower extremity injuries like patellofemoral pain or tendon dysfunction. Stress in the flexor muscles can lead to the potential development of trigger points along the flexor muscles, which can correlate to calf pain. Dr. Janet Travell, M.D.’s book, “Myofascial Pain and Dysfunction,” mentioned that trigger points along the toe flexor muscles could potentially cause impaired mobility and strain to the foot. Since the flexor muscles are located in the calves, many individuals that incorporate running, jogging, or walking as part of their daily lives can be affected. To that point, if a person is walking on uneven ground, it can cause the foot to be hyper-pronated and lead to calf pain. At the same time, trigger points in the flexor muscles can cause symptoms of muscle spasms and cramps which can become overlapping risk profiles for ankle and foot pain.


Treating Trigger Points Along The Flexor Muscles- Video

Have you been dealing with unexplainable muscle spasms in your calves? Do you feel unstable when walking for a long time? Or do you notice you shuffle instead of picking up your feet? Many of these issues are correlated with trigger points affecting the flexor muscles of the toes that are causing pain to the calves and feet. When it comes to trigger points along the flexor muscles of the toes, studies show that it can develop a “trigger toe” where the flexor hallucis muscle that is providing flexion to the great toe, is in pain which leads to foot issues like plantar fasciitis or ankle pain. Fortunately, all is still possible as there are different stretches and treatments to reduce trigger points associated with the toe flexor muscles. The video above explains where the flexor muscles are located in the calve region of the leg and demonstrates how to stretch the flexor muscle to prevent trigger points from returning.


Different Stretches & Treatments For Toe Flexor Muscles

 

When relieving foot and calf pain associated with trigger points affecting the flexor muscles, there are different stretches and treatments to reduce pain-like symptoms associated with trigger points. Studies reveal that incorporating various muscle-strengthening exercises that target the calves could improve postural balance on the feet. Or find the right footwear to prevent trigger points from appearing in the future. Other stretches like toe grasping and flexing the foot allow many pain specialists to locate where the trigger points affect the flexor muscles and develop a treatment plan to reduce the effects of trigger points along the toe flexor muscles. Some of the treatments include chiropractic care. Now, doesn’t chiropractic care only incorporate spinal adjustments on the back? Yes, it does, but it can also alleviate other issues. As stated earlier, the feet provide stability to the lower body extremities. When problems affect a person’s balance can cause limited mobility to the hips, affect the legs and feet over time, and develop trigger points along the way. With chiropractic care, chiropractors can restore hip mobility through mechanical and manual manipulation of the spine and can help loosen the stiff joints and muscles that are causing pain. Chiropractors can pinpoint where the trigger points are located and find ways to reduce the pain in the affected muscle.

 

Conclusion

The flexor muscles of the toes, the flexor digitorum longus, and the flexor hallucis longus allow stability and flexion to the toes. The flexor muscles are located in the calve region and enable the individual to walk without complications. When issues or injuries start to affect the feet, they could develop into overlapping issues that affect the flexor muscles and causes symptoms of instability in a person’s balance. If not treated right away, it could develop trigger points in the calf region and cause pain to the flexor muscles. Trigger points in the flexor muscles can cause stress on the flexor muscles, which then leads to foot issues like patellofemoral pain or tendon dysfunction. To that point cause impaired mobility and muscle strain on the foot. Luckily there are treatments and various stretches to reduce trigger points from developing further and improve stability in the body. To that point, allow the individual to walk without any foot pain.

 

References

Fowles, J V, and N M Newman. “A Case of ‘Trigger Toe.’” Canadian Journal of Surgery. Journal Canadien De Chirurgie, U.S. National Library of Medicine, July 1984, pubmed.ncbi.nlm.nih.gov/6744145/.

Goldmann, Jan-Peter, and Gert-Peter Brüggemann. “The Potential of Human Toe Flexor Muscles to Produce Force.” Journal of Anatomy, U.S. National Library of Medicine, Aug. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3406365/.

Grujičić, Roberto. “Flexor Digitorum Longus Muscle.” Kenhub, Kenhub, 5 Dec. 2022, www.kenhub.com/en/library/anatomy/flexor-digitorum-longus-muscle.

Kusagawa, Yuki, et al. “Toe Flexor Strength Is Associated with Mobility in Older Adults with Pronated and Supinated Feet but Not with Neutral Feet.” Journal of Foot and Ankle Research, U.S. National Library of Medicine, 11 Sept. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7488436/.

Murdock, Christopher J, et al. “Anatomy, Bony Pelvis and Lower Limb, Calf Flexor Hallucis Longus Muscle …” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK539776/.

Quinlan, Shayan, et al. “The Evidence for Improving Balance by Strengthening the Toe Flexor Muscles: A Systematic Review.” Gait & Posture, U.S. National Library of Medicine, Sept. 2020, pubmed.ncbi.nlm.nih.gov/32679464/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Disclaimer

Hip Labral Tear Tests: El Paso Back Clinic

Hip Labral Tear Tests: El Paso Back Clinic

The hip joint is a ball-and-socket joint composed of the femur head and a socket, which is part of the pelvis. The labrum is a cartilage ring on the socket part of the hip joint that helps keep joint fluid inside to ensure frictionless hip motion and alignment during movement. A labral tear of the hip is an injury to the labrum. The extent of the damage can vary. Sometimes, the hip labrum can have mini tears or fray at the edges, usually caused by gradual wear and tear. In other cases, a section of the labrum can separate or get torn away from the socket bone. These types of injuries are usually due to trauma. There are conservative hip labral tear tests to determine the type of injury. The Injury Medical Chiropractic and Functional Medicine Clinic team can help. 

Hip Labral Tear Tests: EPs Chiropractic Team

Symptoms

Symptoms are similar regardless of the type of tear, but where they are felt depends on whether the tear is in the front or the back. Common symptoms include:

  • Hip stiffness
  • Limited range of motion
  • A clicking or locking sensation in the hip joint when moving.
  • Pain in the hip, groin, or buttocks, especially when walking or running.
  • Night discomfort and pain symptoms when sleeping.
  • Some tears can cause no symptoms and can go unnoticed for years.

Hip Labral Tear Tests

A hip labral tear can occur anywhere along the labrum. They can be described as anterior or posterior, depending on which part of the joint is affected:

  • Anterior hip labral tears: The most common type of hip labral tear. These tears occur on the front of the hip joint.
  • Posterior hip labral tears: This type appears on the back of the hip joint.

Tests

The most common hip labral tear tests include:

  • The Hip Impingement Test
  • The Straight Leg Raise Test
  • The FABER Test – stands for Flexion, Abduction, and External Rotation.
  • The THIRD Test –  stands for the Hip Internal Rotation with Distraction.

Hip Impingement Tests

There are two types of hip impingement tests.

Anterior Hip Impingement

  • This test involves the patient lying on their back with their knee bent at 90 degrees and then rotated inward towards the body.
  • If there is pain, the test is considered positive.

Posterior Hip Impingement

  • This test involves the patient lying on their back with their hip extended and their knee flexed and bent at 90 degrees.
  • The leg is then rotated outward away from the body.
  • If it results in pain or apprehension, it is considered positive.

Straight Leg Raise Test

This test is used on various medical conditions that involve back pain.

  • The test begins with the patient sitting or lying down.
  • On the unaffected side, the range of motion is examined.
  • Then the hip is flexed while the knee is straight on both legs.
  • The patient may be asked to flex the neck or extend the foot to stretch nerves.

The FABER Test

It stands for Flexion, Abduction, and External Rotation.

  • The test begins with the patient lying on their back with their legs straight.
  • The affected leg is placed in a figure four position.
  • The physician will then apply incremental downward pressure to the bent knee.
  • If there is hip or groin pain, the test is positive.

The THIRD Test

This stands for – the Hip Internal Rotation with Distraction

  • The test begins with the patient lying on their back.
  • The patient then flexes their knee to 90 degrees and turns it inward around 10 degrees.
  • The hip is then rotated inward with downward pressure on the hip joint.
  • The maneuver is repeated with the joint slightly distracted/pulled apart.
  • It is considered positive if the pain is present when the hip is rotated and diminished pain when distracted and rotated.

Chiropractic Treatment

Chiropractic treatment involves hip adjustments to realign the bones around the hip and up through the spine, soft tissue massage therapy to relax the muscles around the pelvis and thigh, targeted flexibility exercises to restore range of motion, motor control exercises, and strengthening exercises to correct muscular imbalances.


Treatment and Therapy


References

Chamberlain, Rachel. “Hip Pain in Adults: Evaluation and Differential Diagnosis.” American family physician vol. 103,2 (2021): 81-89.

Groh, M.M., Herrera, J. A comprehensive review of hip labral tears. Curr Rev Musculoskelet Med 2, 105–117 (2009). doi.org/10.1007/s12178-009-9052-9

Karen M. Myrick, Carl W. Nissen, THIRD Test: Diagnosing Hip Labral Tears With a New Physical Examination Technique, The Journal for Nurse Practitioners, Volume 9, Issue 8, 2013, Pages 501-505, ISSN 1555-4155, doi.org/10.1016/j.nurpra.2013.06.008. (www.sciencedirect.com/science/article/pii/S155541551300367X)

Roanna M. Burgess, Alison Rushton, Chris Wright, Cathryn Daborn, The validity and accuracy of clinical diagnostic tests used to detect labral pathology of the hip: A systematic review, Manual Therapy, Volume 16, Issue 4, 2011, Pages 318-326, ISSN 1356-689X, doi.org/10.1016/j.math.2011.01.002 (www.sciencedirect.com/science/article/pii/S1356689X11000038)

Su, Tiao, et al. “Diagnosis and treatment of labral tear.” Chinese medical journal vol. 132,2 (2019): 211-219. doi:10.1097/CM9.0000000000000020

Wilson, John J, and Masaru Furukawa. “Evaluation of the patient with hip pain.” American family physician vol. 89,1 (2014): 27-34.

Dealing With Upper Thigh Pain? Could Be Trigger Points In the Hamstrings

Dealing With Upper Thigh Pain? Could Be Trigger Points In the Hamstrings

Introduction

Many individuals utilize their lower muscles to move around and stay active as each muscle does its job and allows mobility to the hips and thighs. In sports, the thigh muscles are utilized constantly to extend the legs and bend the knees, allowing a powerful force to win any sports competition. At the same time, various sports injuries can occur to the hips, thighs, and legs and can affect the muscles causing pain and discomfort to the lower extremities. A hamstring injury is one of the most common injuries that can affect the thighs, which can cause many athletes to be taken out of their favorite sport to recover from the injury. Today’s article looks at the hamstring muscle, how trigger points correlate with a hamstring strain, and how various stretches can reduce muscle strain on the hamstrings. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like upper thigh and hip pain treatments correlating to myofascial trigger point pain, to aid individuals dealing with pain symptoms along the hamstring muscles. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Are The Hamstring Muscles?

 

Do you experience pain in the back of your upper thigh? When walking from one place to another, do you hear a popping sound in the back of your thigh? Or are you dealing with muscle tenderness in the back of your upper thigh? Many of these symptoms correlate with issues affecting the hamstrings causing trigger points to affect the upper thighs. As one of the most complex muscles comprising three muscles (semitendinosus, semimembranosus, biceps femoris), the hamstrings play a crucial part in daily activities. From simple actions like standing to explosive movements like sprinting or jumping, the hamstrings are known as posterior thigh muscles that begin from the pelvis and run behind the femur bone and cross the femoroacetabular and tibiofemoral joints. The hamstring muscles in the body play a prominent role in hip extension and is a dynamic stabilizer of the knee joint. To that point, the hamstring muscles are the most susceptible muscle that succumbs to injuries that can lead to disability in the legs and affect daily activities.

 

Hamstring Strain & Trigger Points

 

Since the hamstrings are the most susceptible muscles that can succumb to injuries, it takes a while for the muscle to heal, depending on the severity of the damage. Studies reveal that the hamstrings can occur injuries when a person is running or sprinting due to their anatomic arrangement, which causes the muscles to strain. To that point, depending on how much force has impacted the hamstrings, the injuries can lead to 3 of the following:

  • Grade 1: Mild pain or swelling (no loss of function)
  • Grade 2: Identifiable partial tissue disruption with moderate pain and swelling (minimal loss of function)
  • Grade 3: Complete disruption of the tissue with severe pain and swelling (total loss of function)

The pain that patients experience can be painful when walking, causing them to limp. In “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., stated that when patients are dealing with pain in their hamstrings, it could potentially be associated with trigger points along the three muscles, causing pain and disability in the upper thighs. The book also mentioned that when trigger points affect the hamstrings, it can lead to muscle inhibition, compromising hip stability. Another issue that trigger points associated with hamstring strain causes in the body are that when individuals are sitting down are likely to experience posterior pain in the buttock, upper thighs, and back of the knees. Luckily, there are various ways to reduce the pain along the hamstring muscles. 

 


Trigger Point Of The Week: Hamstrings- Video

Have you dealt with pain along the back of your upper thighs? Does it feel uncomfortable when you are sitting down? Or do your hamstrings ache or feel tight after running for a long period? People dealing with issues in their hamstrings could be dealing with muscle strain associated with trigger points. The hamstring muscles play a vital role in the body as it allows the individual to walk, run, bend the knees and even extend the legs. The hamstring muscles are also the most susceptible to injury, causing disability to the legs. Studies reveal that trigger points associated with the hamstring muscles can lead to soreness or irritability in the muscle fibers that may interfere with the biomechanics and normal functioning of the lower limbs. The video above explains where the hamstrings are located and how the trigger points can cause referred pain to the hamstrings. To that point, trigger points can affect a person’s ability to walk and affect the surrounding muscles in the lower body while mimicking other chronic conditions.


Various Stretches To Reduce Muscle Strain On The Hamstrings

 

When the hamstrings become injured, the healing rate usually depends on how severe the injury is in the hamstrings. If a hamstring injury is mild, the tears or strains can heal within about three to eight weeks, and if the hamstring injury is severe, the tears or strains could be long as three months. When the hamstrings are tense and on the verge of tearing, many people should stop overusing the muscle. Various stretches can reduce muscle strain on the hamstrings and relieve tension from the hamstrings to allow mobility back to the legs. Studies reveal that manual ischemic compression on the upper thigh muscles can significantly reduce pain in the lower limbs. This allows the individual to manage the trigger points associated with the hamstrings and reduce the chances of them re-occurring in the legs.

 

Conclusion

As the most important muscle in the lower body extremities, the hamstrings play a crucial part in the body as they allow the individual to walk, run, and stand without feeling pain. However, even though they are important muscles, they are susceptible to injuries. When the hamstrings become injured, the recovery process varies depending on the severity and can develop trigger points along the muscle fibers. To that point, it causes referred pain along the upper thigh muscle and affects a person’s ability to walk. Fortunately, incorporating various stretches to the hamstrings can alleviate the pain and reduce the trigger points from re-occurring in the muscle. This allows mobility back to the legs, and many individuals can resume their daily activities.

 

References

Esparza, Danilo, et al. “Effects of Local Ischemic Compression on Upper Limb Latent Myofascial Trigger Points: A Study of Subjective Pain and Linear Motor Performance.” Rehabilitation Research and Practice, Hindawi, 4 Mar. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6425406/.

Poudel, Bikash, and Shivlal Pandey. “Hamstring Injury – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 28 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK558936/.

Rodgers, Cooper D, and Avaias Raja. “Anatomy, Bony Pelvis and Lower Limb, Hamstring Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK546688/.

Thummar, Ravindra C, et al. “Association between Trigger Points in Hamstring, Posterior Leg, Foot Muscles and Plantar Fasciopathy: A Cross- Sectional Study.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 7 Aug. 2020, pubmed.ncbi.nlm.nih.gov/33218537/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Disclaimer

Pain In Your Adductor Muscles? Could Be Myofascial Trigger Points

Pain In Your Adductor Muscles? Could Be Myofascial Trigger Points

Introduction

The hips and thighs have a working relationship as their jobs are to maintain stability for the legs and pelvis while supporting the upper body’s weight. These two body groups have various muscles, tendons, and nerves that have specific jobs that allow mobility to the lower body. Many athletes in multiple sports events use their thighs to exert a huge amount of power to be the best. This is due to the adductor muscles in the thighs that allow the athlete to win the event. These adductor muscles are voluminous in size and can become overstretched if the muscles have been worked out too much or injuries have caused dysfunction in the surrounding muscles, causing mobility issues. To that point, the adductor muscles will develop myofascial trigger points and cause hip and thigh pain. Today’s article looks at the two adductor muscles (Longus and Magnus), how myofascial trigger points affect the adductor muscles, and available treatments to manage hip adductor trigger points. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh and hip pain treatments correlating to myofascial trigger point pain, to aid individuals dealing with pain symptoms along the adductor muscles. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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Adductor Longus & Adductor Magnus

Have you been dealing with groin pain located near your thighs? Do you feel muscle tenderness or stiffness when stretching your inner thighs? Or have you been feeling unstable in your hips or thighs when walking? Many individuals, especially athletes and older adults, could be experiencing myofascial trigger points associated with groin pain along their adductor muscles. The thighs contain several muscles and functions that allow many people to bend and extend their knees and hips. The adductor muscles allow the legs to move inward toward one another. The adductor muscles have five muscles: magnus, brevi, longus, pectineus, and gracilis. These muscles enable functionality to the thighs and hips, and we will look at two adductor muscles in the inner thighs. The long adductor muscle is a large, fan-shaped muscle that starts from the superior aspect of the pubis bone and travels down to connect at the thigh bone. Studies reveal that the adductor longus is a long and thin muscle with many actions for the thighs, including external/lateral rotation and thigh flexion.

 

 

Now the adductor Magnus is a large triangular-shaped muscle of the inner thighs that are important for thigh and hip function and stabilizing the pelvis. Studies reveal that even though the adductor Magnus is a large muscle in the inner thighs, its primary function is to allow the thigh to move in a larger range of motion without any pain inflicted on the thigh muscles. However, the adductor muscle can succumb to various issues affecting the thighs and groin regions of the body that can be overstretched and strain the body.

 

Myofascial Trigger Points Affecting The Adductor Muscles

 

Groin pain is a multi-factorial pain issue that affects the lower limbs, and its often due to muscle strain in the inner thigh muscles. This pain increases during vigorous activities and when there is a sudden twist in the hips. When the adductor muscles suddenly change in motion when the body is active, they can be overstretched and correlate to myofascial trigger points that can affect the inner thigh and groin regions. According to “Myofascial Pain and Dysfunction,” by Dr. Travell, M.D., patients with active myofascial trigger points in the two adductor muscles (Longus and Magnus) would become frequently aware of the pain in their groin and medial thigh. When the adductor muscles have myofascial trigger points in the inner thigh, diagnosing is difficult since the individual thinks they are suffering from groin pain when the pain is in their inner thighs. To that point, studies reveal that many individuals participating in various sports would suffer from groin pain due to myofascial trigger points affecting the adductor muscles. Luckily, there are multiple treatments to reduce the pain in the adductor muscles.

 


Hip Adductors: Trigger Point Anatomy- Video

Have you been dealing with groin pain when you are walking? What about experiencing unquestionable thigh pain that affects your daily activities? Or does stretching your inner thigh muscles seem difficult, causing muscle tenderness? Many of these symptoms correlate with groin pain associated with myofascial trigger points affecting the adductor muscles in the inner thighs. The adductor muscles allow mobility function to the thighs and enable the hips to have a wide range of motion. When the adductor muscles are overstretched due to a sudden change of hip rotation or injury has occurred on the thighs can lead to referred pain in the groin and inner thighs and develop myofascial trigger points. The video above shows where the trigger points are located in the hip adductor muscles. The video also explains where the pain is localized in the adductor muscles and the symptoms it produces that can affect the lower body extremities. Fortunately, even though diagnosing myofascial trigger points are a bit challenging, available treatments can manage trigger points along the hip adductors.


Available Treatments To Manage Hip Adductor Trigger Points

When myofascial trigger points affect the hip adductor muscles, many individuals complain about stiffness in their inner thighs and how they feel miserable when they don’t have mobility from their thighs and hips. As stated earlier, trigger points are a bit challenging when diagnosed, but they are treatable when doctors examine patients dealing with myofascial pain in their hips and thigh muscles. Once the diagnosis is complete, doctors work with pain specialists who can locate the trigger points and devise a treatment plan to relieve the pain. Available treatments like trigger point injections can minimize the pain and reduce the chances of trigger points returning. Other available therapies like exercising or stretching, especially for the hips and thighs. Specific exercises for the hips and thigh muscles can help strengthen the adductor muscles from suffering pain and can help reduce the pain symptoms. Another treatment is applying moist heat on the hip adductor muscles to release the tension from the tight muscles and allow mobility back to the hip adductors.  

 

Conclusion

The adductor muscles work with the hips and thighs to allow a wide range of motions and extension to the knees and hips. The hips and the thighs allow stability to the lower body and support the weight to the upper body. When injuries or sudden changes start to affect the adductor muscles, it can lead to symptoms of groin pain associated with myofascial trigger points. Myofascial trigger points produce tiny nodules in the affected muscle that causes referred pain to the muscle group. When this happens, it causes the body to be dysfunctional and can affect a person’s mobility to function in the world. Luckily myofascial trigger points are treatable through various techniques and treatments that can reduce the chances of trigger points from re-occurring in the body.

 

References

Jeno, Susan H, and Gary S Schindler. “Anatomy, Bony Pelvis and Lower Limb, Thigh Adductor Magnus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 1 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK534842/.

Sedaghati, Parisa, et al. “Review of Sport-Induced Groin Injuries.” Trauma Monthly, Kowsar, Dec. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3864393/.

Shahid, Shahab. “Adductor Longus Muscle.” Kenhub, Kenhub, 30 June 2022, www.kenhub.com/en/library/anatomy/adductor-longus-muscle.

Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Takizawa, M, et al. “Why Adductor Magnus Muscle Is Large: The Function Based on Muscle Morphology in Cadavers.” Scandinavian Journal of Medicine & Science in Sports, U.S. National Library of Medicine, 27 Apr. 2012, pubmed.ncbi.nlm.nih.gov/22537037/.

van de Kimmenade, R J L L, et al. “A Rare Case of Adductor Longus Muscle Rupture.” Case Reports in Orthopedics, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4397006/.

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Myofascial Pain Syndrome Affecting The Quadriceps Femoris

Myofascial Pain Syndrome Affecting The Quadriceps Femoris

Introduction

The hips and the thighs have an established relationship where mobility and stability play a part in the body’s lower extremities. The lower extremities’ main job is to support the upper body’s weight while stabilizing the hips and allowing movement from the thighs to the legs and feet. When it comes to the thighs in the lower body, the various muscle surrounds the thighs and skeletal joints to allow the legs to move from one place to another. One of the muscle groups in the thighs is known as the quadriceps femoris. This muscle group is activated when a person is in motion and can succumb to injuries from trauma or normal factors. When this happens, issues like myofascial pain syndrome can affect the thigh muscle and cause referred pain to travel to the knees. Today’s article focuses on the quadriceps femoris, how myofascial pain syndrome is associated with thigh pain, and trigger point therapy on the quadriceps. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh and hip pain treatments correlating to myofascial pain, to aid individuals dealing with pain symptoms along the quadriceps for muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

how-to-stretch-the-masseter-muscle-trigger-point-therapy_63546cd8

What Are The Quadriceps Femoris?

 

Have you been dealing with knee issues when you are walking? What about muscle tenderness or soreness in your thighs? Or have you been experiencing knee complaints when you are running? These areas of complaint are correlated with trigger points associated with thigh pain along the quadriceps femoris. As one of the most voluminous muscles in the human body, the quadriceps femoris is a group of muscles predominant in the thighs and is extraordinarily important. This muscle group is essential for daily activities like climbing the stairs or getting up from a seated position, allowing repercussions on the knees and hip joints. The quadriceps femoris consist of four thigh muscles to allow extension to the knees:

  • Vatus medialis
  • Vatus lateralis
  • Vatus intermedius
  • Rectus femoris

Studies reveal that these four different muscles fuse to form the quadricep tendon and stabilize the patella and thigh flexion at the hips and knee extension. This muscle group is highly important for athletes participating in sports events but can succumb to injuries through muscle strain.

 

Myofascial Pain Syndrome Associated With Tigh Pain

When the thigh muscles, especially the quadriceps femoris, can be overstretched and overused when in motion. Thigh pain is nothing to be alarmed about in its acute form; however, it can develop small nodules along the four muscle fibers that can cause referred pain to the hips and knees. To that point, it can correlate through quadriceps muscle strain to the thighs. Studies reveal that normal factors like kicking, jumping, or a sudden change of direction of running can potentially cause the muscle fibers to be overstretched and develop pain due to localized swelling corresponding to loss of motion from myofascial pain syndrome.

 

 

In “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., the book states that myofascial pain syndrome can invoke referred pain to the affected muscle or muscle group, causing the body to be dysfunctional. Myofascial pain syndrome associated with thigh pain can be managed through various treatments and could allow mobility back to the thighs, legs, knees, and hips. The book even mentions how the four muscles in the quadriceps femoris cause different pain issues in various body parts due to myofascial pain syndrome. For the rectus femoris, many people would complain about knee pain and weakness when climbing stairs. The vatus medialis would initially produce a toothache-like pain deep within the knee joint, often misinterpreted as joint inflammation. The vatus intermedius causes many individuals to have difficulty fully straightening their knees and causes them to develop buckling knee syndrome. And finally, the vatus lateralis could cause many individuals to complain about feeling pain when walking and that the pain is being distributed on the lateral aspect of the thigh, including the knees.

 


Trigger Point Therapy: Stretching The Quadriceps- Video

Have you been dealing with pain in your thighs and knees? Do you find it difficult to climb up or down the stairs? Or have you been experiencing inflammation in your knee joints? All these symptoms that you are experiencing in your thighs, knees, and hips correlate with trigger points created by myofascial pain syndrome affecting the quadriceps femoris. The quadriceps femoris is a voluminous group of muscles that allows the individual to do daily activities like climbing up or down the stairs, running, jumping, and getting up from a seated position. When various issues can cause the quadricep femoris to become overstretched and overused, it could develop myofascial pain syndrome/trigger points along the muscle fibers to mimic knee pain and cause dysfunction in knee mobility. Even though myofascial pain syndrome is poorly diagnosed, individuals can manage it through various treatments that target myofascial trigger pain. The video above explains where the quadriceps femoris muscles are located on the thigh and where the trigger points are in the muscle fibers. The video also provides various stretching techniques on the quadriceps to reduce pain-like symptoms along the thighs.


Trigger Point Therapy On The Quadriceps

 

When it comes to releasing myofascial pain syndrome on the quadriceps, treatments like dry needling, acupuncture, or manual stretching can help loosen and lengthen the quadricep muscles from becoming shorten and can reduce myofascial trigger points from causing more issues on the knees and thighs. At the same time, treatment alone can only go so far in rehabilitation unless the person dealing with myofascial pains syndrome associated with thigh pain do some corrective actions to prevent trigger points from reproducing on the quads. Actions like:

  • Avoid prolonged sitting
  • Stretching the quads as part of your warm-up
  • Sleeping with a pillow between the knees

These actions allow the quadriceps to relax and prevent pain-like issues from affecting the knees. To that point, these actions can help many individuals have mobility back to their legs and allow them to bend their knees without feeling pain.

 

Conclusion

The quadriceps femoris consists of four thigh muscles that fuse to enable mobility functions in the knees without pain. As the most voluminous muscle group in the body, the quadriceps femoris allows the thighs to function when in motion and allow the knees to extend. When various issues cause the quadriceps femoris muscles to be overstretched, it can develop trigger points/myofascial pain syndrome that mimics knee pain and can affect how a person is walking. Thankfully, various treatments specializing in myofascial pain syndrome can reduce the pain symptoms from the quadriceps femoris and bring back knee mobility to the legs.

 

References

Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Bony Pelvis and Lower Limb, Thigh Quadriceps Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 10 May 2022, www.ncbi.nlm.nih.gov/books/NBK513334/.

Kary, Joel M. “Diagnosis and Management of Quadriceps Strains and Contusions.” Current Reviews in Musculoskeletal Medicine, Humana Press Inc, 30 July 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2941577/.

Rozenfeld, Evgeni, et al. “The Prevalence of Myofascial Trigger Points in Hip and Thigh Areas in Anterior Knee Pain Patients.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 14 May 2019, pubmed.ncbi.nlm.nih.gov/31987560/.

Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Waligora, Andrew C, et al. “Clinical Anatomy of the Quadriceps Femoris and Extensor Apparatus of the Knee.” Clinical Orthopaedics and Related Research, Springer-Verlag, Dec. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2772911/.

Disclaimer

Inner Thigh Pain Associated With Trigger Points

Inner Thigh Pain Associated With Trigger Points

Introduction

When many individuals begin to work out or start training for an event, they incorporate various muscles to give optimal output and strength when doing a set of exercises. Many athletes or individuals trying to train for an event or to better themselves have to do a pre-workout routine involving various stretches to warm up the muscles before the actual workout and do stretches post-workout again. This ensures that the muscles are ready to give it their all when a person is working out. The body has various parts with different functions and jobs that help the body’s motor function. The upper body has the shoulders, arms, hands, elbows, neck, head, and chest to allow movements and stability. At the same time, the lower body has the hips, low back, thighs, legs, knees, pelvis, and feet to support the upper body’s weight and stabilize the lower extremities from collapsing. When various factors affect the body, it can lead to dysfunction and causes referred pain to different body locations that can mask chronic conditions. Today’s article looks at one of the lower body muscles located at the inner thighs, known as the pectineus muscle, how trigger point pain affects the inner thighs, and various stretches to strengthen the hip adductors. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh and hip pain treatments correlating to trigger point pain, to aid individuals dealing with pain symptoms along the pectineus muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

how-to-stretch-the-masseter-muscle-trigger-point-therapy_63546cd8

What Is The Pectineus Muscle?

 

Have you been experiencing pain in your inner thighs? Do you find it difficult to play various sports? Do you feel tenderness or soreness in your thighs or near your groin? Most of these symptoms are associated with trigger point pain along the pectineus muscles that affect the thighs. The pectineus is part of the anterior thigh muscles that extend the leg to the knee joint. The pectineus works with another muscle known as the sartorius and a muscle group known as the quadriceps femoris. The pectineus muscle is responsible for flexion, adduction, and medial rotation since it is a hip adductor for the thighs. This muscle is important for various sports activities like running, skating, soccer, or basketball and can become overused due to overstretching the legs too far, thus developing trigger points in the pectineus muscle.

 

Trigger Point Pain Affecting The Inner Thighs

 

When athletes overuse their legs and overstretch the pectineus muscle, it can cause issues with the thighs, hips, and legs’ mobility causing referred pain to the lower body. This is known as trigger point pain and can be challenging when diagnosing where the pain is located. Studies reveal that trigger point pain affecting the inner thighs, especially the pectineus muscle, can mimic groin and hip pain, causing various symptoms in the lower extremities. The multiple symptoms can include:

  • Weak adductor muscles
  • Muscle fatigue
  • Decreased range of motion
  • Leg-length discrepancy

Various reasons can lead to the development of trigger point pain associated with the inner thighs along the pectineus; according to “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., stated that when patients are dealing with pectineus trigger points would complain about the referred pain surrounding the muscle but not the muscle itself. The book also mentioned that nerve entrapment could also be an issue since trigger points like to mimic other chronic conditions. Trigger points along the pectineus muscle can also develop associated with hip joint diseases like advanced osteoarthritis.

 


Treating Trigger Points In Hip Adductors- Video

Are you experiencing issues when moving around constantly? Do you experience pain in your inner thighs and hips? Or do you have difficulty rotating your thighs or hips? If you have been dealing with these issues throughout your entire life, it could be due to your pectineus muscles being affected by trigger points along your inner thighs. Trigger points (myofascial pain syndrome) develop tiny nodules along the muscle fibers, causing referred pain to the surrounding muscles that can cause dysfunction in the lower extremities. Studies reveal that myofascial trigger points can cause the affected muscles to be intensely sensitive and irritable, predominantly near the reflex muscle. To that point, it causes hip and thigh disability in the lower body. Fortunately, there are ways to reduce the pain and manage the trigger point pain along the pectineus muscle, as shown in the video above. The hip adductor muscles are being stretched and treated for trigger point pain and allowing mobility back to the hips and inner thighs. 


Various Stretches To Strengthen Hip Adductor

 

Since the pectineus muscle is part of the hip adductor muscles, various stretches can reduce the chances of trigger points from future development while minimizing the pain that it is causing along the surrounding muscles. Studies reveal that multiple exercises and stretches for the pectineus muscle can help with hip flexion and stabilization. These stretches can help stretch and strengthen the hip adductor muscles while preventing groin pain associated with trigger points. Incorporating these stretches before and after a workout can reduce trigger points and allow hip mobility and thigh rotation back to the legs. This ensures that the trigger points along the pectineus muscle are managed, and the individual doesn’t have to suffer from referred pain issues on the thighs and can move around without pain.

 

Conclusion

As part of the hip adductor muscles, the pectineus is a small muscle that extends the leg to the knees and allows the thighs to flex, adduct, and rotate without pain. This muscle is important for many athletes participating in sports and can be easily overstretched to cause referred pain around the thighs. To that point, it can develop trigger points along the pectineus muscles can correlate to groin pain in the lower extremities. All is not lost, as various stretches and exercises can strengthen the hip adductor muscles and improve thigh and hip mobility. This allows athletes and individuals to continue playing the sport they enjoy.

 

References

Giphart, J Erik, et al. “Recruitment and Activity of the Pectineus and Piriformis Muscles during Hip Rehabilitation Exercises: An Electromyography Study.” The American Journal of Sports Medicine, U.S. National Library of Medicine, July 2012, pubmed.ncbi.nlm.nih.gov/22523373/.

Khan, Ayesha, and Abdul Arain. “Anatomy, Bony Pelvis and Lower Limb, Anterior Thigh Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 10 June 2022, www.ncbi.nlm.nih.gov/books/NBK538425/.

Kiel, John, and Kimberly Kaiser. “Adductor Strain.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 21 June 2022, www.ncbi.nlm.nih.gov/books/NBK493166/.

Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Wada, Juliano T, et al. “An Anatomical Basis for the Myofascial Trigger Points of the Abductor Hallucis Muscle.” BioMed Research International, Hindawi, 22 Jan. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC6998759/.

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Myofascial Trigger Pain Affecting The Sartorius Muscle

Myofascial Trigger Pain Affecting The Sartorius Muscle

Introduction

The lower body extremities help provide stability to the various body parts, including the hips, thighs, pelvis, legs, knees, and feet. The hips and thighs comprise multiple muscles and nerves that provide mobility to the lower half and allow the host to move around in different locations. While the hip muscles act on the thigh muscles at the hip joint and stabilize the pelvis, the thigh muscles allow the lower body to bend, flex and rotate while bearing most of the upper body’s weight and keeping alignment with the hips and legs. One of the thigh muscles is the sartorius muscle, and if it becomes overused and injured can lead to complications in the form of myofascial pain syndrome. Today’s article post examines the sartorius muscle, how myofascial trigger pain is associated with the sartorius, and the effectiveness of myofascial pain treatment on the thighs. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh pain treatments correlating to myofascial pain syndrome, to aid individuals dealing with pain symptoms along the sartorius muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

trigger-point-release-serratus-anterior_63546d25

What Is The Sartorius Muscle?

 

Are you experiencing pain in the upper, mid, or lower parts of your thighs? Do you have difficulty walking for long periods? Or do your knees hurt more than usual? Most of these issues correlate with myofascial trigger pain associated with the sartorius muscle. As the longest muscle that spans from the hips to the knee joints, the sartorius muscle, or the “tailor muscle,” serves as both a hip and knee flexor while working with other muscles that allow hip mobility. The sartorius shares its origin location with the TFL (tensor fascia latae) muscle at the anterior superior iliac spine and is responsible for internal rotation at the hips. In the book, “Myofascial Pain and Dysfunction,” the author Dr. Janet G. Travell, M.D., mentioned that the sartorius muscle assists the iliacus and the TFL muscles in hip flexion while assisting the short head of the bicep femoris in the knees for knee flexion, allowing the individual to walk for long distances. Even though this long muscle assists in hip and knee flexion, it can succumb to injuries and create issues with the hips and knees in the lower body.

 

Myofascial Trigger Pain Associated With The Sartorius Muscle

 

When traumatic forces or normal factors begin to affect the sartorius muscle, the surrounding muscles on the thighs and hips are also affected. The sartorius muscle allows the individual to move around and allows flexion to the hips and knees when injuries or the muscle is being overused; it can cause pain-like symptoms that correlate with hip and knee issues associated with myofascial trigger pain. Myofascial trigger pain along the sartorius muscle doesn’t usually occur in the muscle but can occur in conjunction with trigger point involvement in the surrounding muscles. Studies reveal that myofascial trigger pain is found in the hip muscles and can cause issues in the lumbopelvic-hip muscles of the lower body. This causes referred pain on the sartorius to be more diffused and superficial to the knees. When myofascial trigger pain is associated with the sartorius, many individuals often mistake it for knee pain. To that point, myofascial trigger pain could affect how a person walks and bends at the knees. 

 


Anatomy & Palpation Of The Sartorius Muscle- Video

Are you experiencing issues when you are walking? Do your knees hurt constantly? Or are you experiencing tenderness or pain in your thighs? Most of these issues correlate with myofascial trigger pain associated with the sartorius muscle. The sartorius is a long muscle that connects the hips and spans to the knee joints to provide hip and knee flexion. The sartorius muscle works with the other muscles in the thighs and hips, allowing hip mobility and motor function to the legs. When multiple issues affect the sartorius and the surrounding muscles, it can develop into myofascial trigger pain and cause overlapping risk profiles to the knees and hips. To that point, it causes referred pain issues in the hips and knees, making the individual have difficulty walking from place to place. However, there are available treatments to reduce the pain in the hips and knees and manage the myofascial trigger pain from affecting the sartorius muscle on the thighs. The video above explains the anatomy of the sartorius muscle location and how palpation is used to locate the muscle to see if it is tight or could be affected by trigger points along the muscle fibers. This is one of the techniques that is used when a person is dealing with myofascial trigger pain associated with the sartorius muscle.


The Effectiveness Of Myofascial Pain Treatment On The Thighs

 

When a person is dealing with myofascial trigger pain in their thighs, and it is affecting the sartorius, many will often try to find available treatments to alleviate the pain. Treatments like dry needling are one of the various myofascial pain treatments that can reduce pain and related disability on the thighs, hips, and knees. Studies reveal that dry needling treatments can help manage knee pain syndrome associated with trigger points on the thighs. However, treatment alone can not be the only solution to reduce myofascial trigger pain in the thighs. Various hip stretches can loosen up tight hip flexors and help elongate the sartorius muscles to break up the nodules and improve mobility function to the hips and knees. People can even utilize self-ischemic compression to allow a more effective stretch on the sartorius muscle.

 

Conclusion

As the longest muscle in the thighs, the sartorius helps provide a service to hip and knee flexion while working with various muscles to keep the legs moving. When the sartorius muscles become overused and start to cause referred pain to the hips and knees, it can develop into myofascial trigger pain along the sartorius muscle. This can make many individuals believe they are suffering from knee pain when it’s their thigh muscle. However, myofascial trigger pain is treatable through treatments and corrective actions that people can incorporate into their daily activities to prevent pain from escalating and manage trigger points along the sartorius muscle. This can allow people to get back their mobility in their legs.

 

References

Rahou-El-Bachiri, Youssef, et al. “Effects of Trigger Point Dry Needling for the Management of Knee Pain Syndromes: A Systematic Review and Meta-Analysis.” Journal of Clinical Medicine, MDPI, 29 June 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7409136/.

Samani, Mahbobeh, et al. “Prevalence and Sensitivity of Trigger Points in Lumbo-Pelvic-Hip Muscles in Patients with Patellofemoral Pain Syndrome.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 15 Oct. 2019, pubmed.ncbi.nlm.nih.gov/31987531/.

Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Walters, Benjamin B, and Matthew Varacallo. “Anatomy, Bony Pelvis and Lower Limb, Thigh Sartorius Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK532889/.

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Myofascial Pain Syndrome On The Tensor Fasciae Latae

Myofascial Pain Syndrome On The Tensor Fasciae Latae

Introduction

The thighs in the lower half of the body work together with the hips to stabilize the legs when the body is in motion. The thighs and the hips also support the weight of the upper half of the body and are surrounded by muscles, ligaments, and nerve roots to supply blood and sensory-motor function to the legs. One of the thigh muscles that work with the hips is the tensor fasciae latae (TFL) muscle. When the thigh muscles are being overused or suffer from injuries, tiny nodules known as trigger points (myofascial pain syndrome) can affect a person’s ability to function worldwide. Today’s article examines what the tensor fasciae latae muscles do, how myofascial pain syndrome affects the thighs, and various stretches/techniques for the thighs. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh pain treatments correlating to trigger points, to aid individuals dealing with pain symptoms along the tensor fasciae latae muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

trigger-point-release-serratus-anterior_63546d25

What Does The Tensor Fasciae Latae Muscle Do?

 

Do you have difficulty walking for a long period? So you feel that your hips feel unstable when you move? Or do you feel radiating pain down from your thighs to your knees? Thigh pain associated with these symptoms can affect a person’s ability to move around from one location to another due to trigger points affecting the tensor fasciae latae muscle. The tensor fasciae latae (TFL) muscles are located at the proximal anterolateral thigh and originate from the anterior superior iliac spine. The TFL muscle is between the superficial and deep muscle fibers of the iliotibial (IT) band, as its attachment assists with knee flexion and lateral rotation. The TFL muscles also work together with the gluteus muscles in various hip movements. Studies reveal that the primary function of the TFL muscles is providing balance to the body’s weight and the non-weight-bearing leg to walk. The TFL muscles allow the individual to walk, run, and assist with movement and stabilization to the hips and knees without pain inflicted on the joints and muscles. 

 

Myofascial Pain Syndrome Affecting The Thighs

Since the TFL muscles allow the person to walk and run, this muscle can become overused and strained through repetitive motions causing many issues to the hips, knees, and thighs. When these issues affect the TFL muscles, they can develop nodules along the muscle fibers known as trigger points or myofascial pain syndrome. Myofascial pain syndrome is a musculoskeletal disorder that can invoke referred pain in one location of the body while affecting the surrounding muscles in a different body location. Myofascial pain syndrome associated with the TFL muscles can cause issues to the hips, thighs, and knees while affecting a person’s ability to walk. Studies reveal that the prevalence of myofascial pain syndrome on the TFL muscles correlates to pain and disability in the thighs. When myofascial pain syndrome affects the TFL muscles, it can mimic chronic knee osteoarthritis. 

 

Even though myofascial pain syndrome is challenging to diagnose, it is treatable through various stretches and techniques. In Dr. Janet G. Travell, M.D.’s book, “Myofascial Pain and Dysfunction,” it mentioned that when patients have active trigger points in their TFL muscles, they become aware of the referred pain affecting their hip joints and are unable to lie comfortably on their sides due to the body-weight pressure pressing on the affected TFL muscle. The book also points out that when pain is referred to from trigger points associated with the TFL muscles, it can be mistaken for pain in the glutes.

 


Trigger Point Of The Week: Tensor Fasciae Latae- Video

Have you been experiencing difficulty walking from one location to another? Do you feel pain in your thighs or knees? Or do you have a problem lying down on your side that is causing you pain? If you have been dealing with walking issues, it could be due to myofascial trigger pain in your tensor fasciae latae (TFL) muscles affecting your ability to walk. The TFL muscles help provide stability to the hips and thighs and assist with knee flexion and lateral rotation. This muscle also allows people to walk and run without any pain inflicted on the joints and muscles. When repetitive motions start to cause the TFL muscles to become overused and strained, it can lead to myofascial pain syndrome or trigger points developing, causing referred pain to the thighs. The video above explains where the TFL muscles are located and where the trigger points on the TFL muscles are causing pain to the thighs. Myofascial pain syndrome can mimic other chronic conditions like knee osteoarthritis, which causes pain and disability to the lower half of the body.


Various Stretches & Techniques For The Thighs

 

Now myofascial pain syndrome is challenging to diagnose in an examination due to the referred pain affecting one location of the body than the actual source of where the pain is coming. However, it is treatable through various techniques and stretches for the thighs to restore leg mobility. Studies reveal that direct stretching of the TFL (tensor fasciae latae) muscles can reduce long-term pain effects on the hips, thighs, and lower back and improve hip and thigh mobility. Various stretches like hip extensions and laterally rotating the hips can break the myofascial trigger points in the TFL muscle. Using a foam roller on the hips can gently stretch and loosen the muscle fibers on the TFL and help warm up the muscle before working out. Sitting down correctly in a chair can help the hips from causing more muscle strain to the thighs and prevent the TFL muscles from being shortened. Incorporating these stretches and techniques can improve hip and thigh mobility in the legs, allowing the individual to walk or run without pain.

 

Conclusion

The TFL (tensor fasciae latae) muscles are located on the proximal anterolateral thigh between the IT (iliotibial) band, which assists with knee flexion and lateral rotation. The TFL muscle also works with the gluteal muscles and allows the person to walk, run, and help with stability movement to the hips and knees with inflicted pain on the joints and surrounding muscles. When the TFL muscles become overused, they can develop myofascial trigger pain on the TFL, causing referred hip, knee, and thigh pain. This can cause the individual not to be able to walk for long periods and think they might have osteoarthritis in the knees. Fortunately, people can incorporate various stretches and techniques to reduce the pain in the thighs and hips while managing myofascial trigger pain along the TFL muscles. These various stretches and techniques allow mobility back to the hips and thighs so the individual can walk without pain.

 

References

Gottschalk, F, et al. “The Functional Anatomy of Tensor Fasciae Latae and Gluteus Medius and Minimus.” Journal of Anatomy, U.S. National Library of Medicine, Oct. 1989, www.ncbi.nlm.nih.gov/pmc/articles/PMC1256751/.

Ohtsuki, Keisuke. “A 3-Month Follow-up Study of the Long-Term Effects of Direct Stretching of the Tensor Fasciae Latae Muscle in Patients with Acute Lumbago Using a Single-Case Design.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, May 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4047246/.

Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Sánchez Romero, Eleuterio A, et al. “Prevalence of Myofascial Trigger Points in Patients with Mild to Moderate Painful Knee Osteoarthritis: A Secondary Analysis.” Journal of Clinical Medicine, MDPI, 7 Aug. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7464556/.

Trammell, Amy P, et al. “Anatomy, Bony Pelvis and Lower Limb, Tensor Fasciae Muscle – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 8 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK499870/.

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Piriformis Syndrome & Myofascial Pain Syndrome

Piriformis Syndrome & Myofascial Pain Syndrome

Introduction

The lumbar region of the spine has various muscles and nerve roots that work together with the lower body extremities, like the hips, buttocks, legs, knees, and feet, for mobility and walking function. The various muscles in the buttock region include the gluteal muscles. They have a casual relationship with the hip muscles as they work together for hip mobility and erect good posture in the body. These various muscles and nerves also supply sensory-motor function for the legs to be mobile and provide hip mobility. The piriformis is one of the muscles assisting in the hips and buttock region. When this muscle becomes overused, it can cause mobility issues in the legs and affect a person’s ability to walk. Today’s article looks at the piriformis muscle, how trigger points are associated with piriformis syndrome, and how to manage piriformis syndrome associated with trigger points. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like sciatic pain and piriformis syndrome treatments related to trigger points, to aid individuals dealing with pain symptoms along the piriformis muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

exercises-for-neck-and-shoulder-pain-from-myofascial-trigger-points-by-dr-andrea-furlan-md-phd_63543ea0

What Is The Piriformis Muscle?

 

Have you been having issues walking from one place to another? Do you feel muscle tightness in your hips or buttock region? Or are you experiencing radiating pain traveling to your knees and feet? These pain symptoms are correlated with trigger points affecting the piriformis muscle. The piriformis is a flat, pear-shaped muscle, one of the six short rotator muscle groups in the gluteal region of the hips and thighs. The rotator muscle groups consist of the following:

  • Gemelli
  • Quadratus Femoris
  • Obturator Internus
  • Obturator Externus

This muscle is parallel to the posterior margins of the gluteus medius and deep into the gluteus maximus. This muscle is very important to the body as it provides lower-body movement by stabilizing the hip joint and can lift and rotate the thighs away from the body. The piriformis muscle also surrounds the sciatic nerve, as this long nerve runs deep beneath the piriformis and enters the gluteal region of the rear. When the piriformis muscle becomes overused or suffers from associated traumatic factors, it can aggravate the sciatic nerve and even develop tiny nodules known as trigger points, causing mobility issues. 

 

Trigger Points Associated With Piriformis Syndrome

 

When abnormal factors affect the piriformis muscles, they can develop into trigger points associated with piriformis syndrome and cause issues in the pelvic and hip regions of the body. According to Dr. Janet G. Travell, M.D., “Myofascial Pain and Dysfunction,” trigger points can be activated when repetitive strain affects the piriformis muscle and causes symptoms of muscle weakness and pain in the hips. This causes overlapping issues in the surrounding muscles and the sciatic nerve, making diagnosing tricky for trigger points. Studies reveal that trigger points associated with piriformis syndrome may potentially cause muscle spasms or an inflammatory process to irritate the sciatic nerve that may be presented as identical to lumbar disk syndrome without neurological findings. Trigger points associated with piriformis syndrome may mimic chronic issues like fibromyalgia. Even though trigger points are tricky to pinpoint in a thorough examination, there are various ways to reduce the pain and prevent trigger points from affecting the piriformis muscle causing sciatic nerve pain. 

 


Trigger Point Of The Week: Piriformis Muscle- Video

Have you been dealing with sciatic nerve pain? Have you found it difficult to walk for a short period? Or are you dealing with muscle tenderness or soreness in your buttock or hips? People experiencing these symptoms could be dealing with piriformis syndrome associated with trigger points. The piriformis is a small, fan-shaped muscle, one of the six short rotator muscle groups that help with hip and thigh mobility through stabilization. The piriformis muscles also surround the sciatic nerve and can succumb to injuries. When traumatic forces affect the hips and thighs, the piriformis muscle develops nodules known as trigger points, causing the muscle to irritate the sciatic nerve and cause pain in the legs. The video above shows where the piriformis muscle is located and how trigger points can mimic sciatic nerve pain in the leg without neurological findings. Studies reveal that trigger points could be a rare anatomical variation that can correlate with piriformis syndrome associated with sciatica. However, there is some good news, as there are ways to manage piriformis syndrome associated with trigger points.


Managing Piriformis Syndrome Associated With Trigger Points

 

Various techniques can help manage piriformis syndrome associated with trigger points to relieve the piriformis muscle. Studies reveal that Kinesio tape on the piriformis muscle can help reduce pain and improve many individuals’ hip joint range of motion. Other techniques like stretching or deep tissue massage can help loosen up the stiff muscles and relieve trigger points from forming on the piriformis. For sciatica pain associated with trigger points along the piriformis muscle, decompression therapy can help the piriformis muscle lay off pressure on the sciatic nerve and reduce aggravated pain. These techniques can help improve hip joint mobility and increase the range of motion to the hips and lower extremities.

 

Conclusion

The piriformis is a small muscle that provides hip and thigh mobility. This small muscle surrounds the sciatic nerve, which helps give motor function to the legs. When traumatic factors affect the piriformis muscle, it can develop trigger points and cause sciatic pain in the hips. This causes mobility issues and pain around the hips. Various treatments are provided to help reduce the trigger points along the piriformis muscle and reduce sciatic nerve pain from causing more problems to the hips and legs mobility.

 

References

Chang, Carol, et al. “Anatomy, Bony Pelvis and Lower Limb, Piriformis Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 3 Oct. 2022, www.ncbi.nlm.nih.gov/books/NBK519497/.

Pfeifer, T, and W F Fitz. “[The Piriformis Syndrome].” Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete, U.S. National Library of Medicine, 1989, pubmed.ncbi.nlm.nih.gov/2618150/.

R;, Hashemirad F;Karimi N;Keshavarz. “The Effect of Kinesio Taping Technique on Trigger Points of the Piriformis Muscle.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 8 Feb. 2016, pubmed.ncbi.nlm.nih.gov/27814861/.

Ro, Tae Hoon, and Lance Edmonds. “Diagnosis and Management of Piriformis Syndrome: A Rare Anatomic Variant Analyzed by Magnetic Resonance Imaging.” Journal of Clinical Imaging Science, Medknow Publications & Media Pvt Ltd, 21 Feb. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5843966/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Disclaimer

Pelvic Floor Muscles & Trigger Points

Pelvic Floor Muscles & Trigger Points

Introduction

The body’s pelvic region has many functions crucial for functionality with the host. The various muscles surrounding the pelvis help provide stability to the body’s core, allow circulation to the heart in the cardiovascular system, support the reproductive and abdominal organs, and much more the body requires. The pelvic joints’ various muscles also allow hip mobility and function for the lower body extremities. When traumatic injuries or abnormal activities start to affect the pelvic floor muscles, the various issues can affect the functionality of the pelvic region and cause problems in bladder control for both the male and female bodies. Many of these issues correlate with trigger points surrounding or on the pelvic floor muscles that can affect how the vital organs operate in the body. Today’s article examines the pelvic floor muscles, how trigger points correlate with pelvic pain, and managing pelvic pain is associated with trigger points. We refer patients to certified providers who incorporate multiple techniques in the lower body extremities, like pelvic pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the pelvic floor muscles near and surrounding the pelvis. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

trigger-point-week-spelenius-cervicis

What Are The Pelvic Floor Muscles?

 

Have you been experiencing bladder issues that constantly make you go to the bathroom? Have you been dealing with severe cramps that mimic sciatica pain? Or does it hurt when you are sitting down? Many of these issues correlate with muscle pain associated with trigger point pain along the pelvic floor muscles. The pelvic floor muscles are a unique anatomical body location with a balance of different pressures (visceral, muscular, or liquid) that play a fundamental role in the body’s lower extremities. The pelvic floor muscles have four divided compartments but have different parts and functions to allow optimal bodily function. The four pelvic floor compartments include:

  • Anterior or urinary (bladder)
  • Medium or genital (uterus in women, prostate in men)
  • Posterior or anterior (anus, anal cavity, and rectum)
  • Peritoneal (endopelvic fascia and perineal membrane)

Some of the functions that the pelvic floor muscles allow the body to perform properly include proper contraction for sexual function, allowing respiration in the abdominal organs, maintaining bodily fluid actions like going to the restroom, and maintaining good posture by working together with the thoracolumbar and lumbosacral columns of the spine. Studies reveal that the spine’s autonomic nerves, which include the sympathetic and parasympathetic, help supply the posterior and anterior compartments in the pelvic floor. When traumatic factors affect the pelvic floor muscles, it can lead to correlating issues regarding trigger points in the pelvic muscles.

 

How Do Trigger Points Correlate With  Pelvic Pain?

The pelvic floor has four different components to allow the muscles to function properly when traumatic factors start to invoke pain-like symptoms that can affect pelvic functionality in both the male and female body, thus developing trigger point pain associated with pelvic pain. For the female body, trigger points along the bulbospongiosus muscle (part of the pelvic floor muscles) may cause aching pain in the perineal region. In contrast, in the male body, trigger points along the retroscrotal area may cause discomfort while sitting erect. According to the book, “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., stated that many individuals that are dealing with trigger point pain along their pelvic floor muscles would often complain about feeling localized aching pain in their anal region and may experience painful bowel movements when going to the bathroom.

 

Studies reveal that myofascial trigger points develop “muscle contraction knots” of the pelvic floor muscles, may be identified in many patients suffering from pelvic pain syndrome (urological, colorectal, and gynecological), and are associated with trigger points. Trigger points are tricky when diagnosing where the pain is located since myofascial pain syndrome mimics other chronic conditions of the surrounding muscles, causing referred pain. Additional studies reveal that the location and severity of pelvic floor myofascial pain was significantly correlated with various pelvic pain symptoms that can affect both males and females with different conditions. When doctors recognize that their patients are dealing with trigger points associated with pelvic pain after an examination, they devise a treatment plan and work with other specialists to manage trigger points and reduce pain in the pelvic region.

 


Top 3 Pelvic Floor Exercises- Video

Have you been dealing with urinary issues that make it tricky to go to the bathroom? Do you have trouble finding a comfortable position when you are sitting down? Or do you feel pain radiating down your buttock and leg? Pelvic pain is a common issue that can affect both men and women that can cause various pain symptoms that correlate with trigger points along the pelvic floor muscles. When trigger points affect the pelvic floor muscles, it can lead to referred pain that connects with pelvic pain in the body’s lower extremities. Many factors can affect the pelvis, like issues affecting the digestive, reproductive, or urinary systems, a trauma in the surrounding pelvic muscles that causes them to be weak or corresponding issues on the hips and lower back. Trigger points associated with pelvic pain may be tricky. Still, they can be treatable with different therapies that can reduce the pain and help strengthen those weak muscles in the pelvic region. The video above demonstrates three other pelvic floor exercises that can help support the pelvic muscles and reduce the trigger points from reoccurring in the pelvic area of the lower body.


Managing Pelvic Pain Associated With Trigger Points

 

Various treatments can manage pain associated with trigger points through multiple therapies that can reduce pain-like symptoms along the pelvic floor muscles. Many therapies, like trigger point therapy and muscle training, can help reduce the pain along the pelvic floor muscles and bring back bowel function to the pelvic region. Studies reveal that doctors provide a range of protocols designed to strengthen the pelvic floor muscles and the different muscle groups around the pelvic area while improving function. However, treatment alone can only go so far, as people must take corrective actions to ensure that the trigger points do not return in the future. Movements like corrective posture exercises focusing on the lower back, hips, and pelvis and eating a fiber-rich diet can reduce pelvic pain. This allows the individual to get their lower half mobility back. 

 

Conclusion

The pelvic floor muscle has four divided components that will enable optimal bodily function that has different jobs in the male and female bodies. The pelvic floor muscles have many crucial functions that provide the host stability in the body’s core, allow circulation to the cardiovascular system, and, most importantly, support the reproductive and abdominal organs. When issues affect the pelvic floor muscles, it can lead to pelvic pain associated with trigger points that can disrupt many from going to the bathroom or disrupting sexual functionality. All is not lost, as various therapies can reduce the pain and strengthen the pelvic muscles in the lower body. This allows lower body mobility back to the host and prevents unnecessary issues from reoccurring.

 

References

Bordoni, Bruno, et al. “Anatomy, Abdomen and Pelvis, Pelvic Floor.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 18 July 2022, www.ncbi.nlm.nih.gov/books/NBK482200/.

Marques, Andrea, et al. “The Status of Pelvic Floor Muscle Training for Women.” Canadian Urological Association Journal = Journal De L’Association Des Urologues Du Canada, Canadian Medical Association, Dec. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2997838/.

Meister, Melanie R, et al. “Pelvic Floor Myofascial Pain Severity and Pelvic Floor Disorder Symptom Bother: Is There a Correlation?” American Journal of Obstetrics and Gynecology, U.S. National Library of Medicine, Sept. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6732028/.

Moldwin, Robert M, and Jennifer Yonaitis Fariello. “Myofascial Trigger Points of the Pelvic Floor: Associations with Urological Pain Syndromes and Treatment Strategies Including Injection Therapy.” Current Urology Reports, U.S. National Library of Medicine, Oct. 2013, pubmed.ncbi.nlm.nih.gov/23943509/.

Raizada, Varuna, and Ravinder K Mittal. “Pelvic Floor Anatomy and Applied Physiology.” Gastroenterology Clinics of North America, U.S. National Library of Medicine, Sept. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2617789/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

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Sacroiliac Joint Surgery: Back Clinic

Sacroiliac Joint Surgery: Back Clinic

The function of the SI joints is to allow torsional or twisting movements when moving the legs that act as levers. Without the sacroiliac joints and the pubic symphysis at the front of the pelvis, which allow these precision movements, the pelvis would be at higher risk of a fracture. The sacroiliac joints transmit body weight and all the physical forces down through the sacrum to the hips and legs. Individuals, especially athletes with pain in the lower back, hip, groin, or leg, could be experiencing SIJ/sacroiliac joint dysfunction. A physician or surgeon could recommend sacroiliac joint surgery for severe SI joint dysfunction and pain that has not resolved with conservative treatment.

Sacroiliac Joint SurgerySacroiliac Joint Surgery

There are two sacroiliac joints. They connect the large iliac bones that make up the sides of the pelvis and the sacrum or triangle-shaped vertebrae between the iliac bones at the base of the spine. Pain in this area can come from sacroiliitis or inflammation of an SI joint, and referred pain may present. A doctor will consider causes such as:

  • Trauma
  • Sports
  • Biomechanical abnormalities
  • Wear and tear from weight-bearing stress
  • Pregnancy
  • Leg length discrepancy
  • Hypermobility
  • Systemic inflammatory conditions
  • Degenerative joint disease
  • Scoliosis
  • Infection, but this is rare.

Sports

There is a pathology of sacroiliac joint dysfunction in athletes. Sports that require repetitive and/or asymmetric loading that includes:

  • Kicking
  • Swinging
  • Throwing
  • Single-leg stance

Any athlete can develop sacroiliac joint dysfunction, but the highest prevalence activities include:

  • Soccer
  • Football
  • Basketball
  • Gymnastics
  • Golfing
  • Powerlifting
  • Cross-country skiing
  • Step aerobics
  • Stair stepper machines
  • Elliptical machines

Fusion Surgery

Surgery is not for patients with less than six months of confirmed localized pain or impairment with other causes ruled out. Surgery is the last option for SI joint pain unless it is an emergency. Doctors and surgeons will recommend non-invasive treatment methods before recommending surgery. Surgery recommendations come when the pain has become intolerable, and the individual can no longer move or operate.

  • Sacroiliac joint fusion is a minimally invasive procedure involving a small incision less than two inches long.
  • Under image guidance, titanium implants are inserted across the sacroiliac joint to provide stability.
  • Holes in the hardware allow for adding bone or for the bone to grow naturally across or onto the area to maintain stability.
  • This surgery can be either outpatient or overnight, depending on surgeon preference and the type of support available.

Surgery Recovery Time

For most individuals, recovery time is around three weeks on crutches.

  • Pain management depends on whether screws or bolts are involved; bolts tend to be more uncomfortable.
  • Post-op pain dissipates in a few days or a couple of weeks.
  • Fusion itself takes six or more months to complete.

Conservative Treatment Options

Conservative treatment modalities to reduce the inflammation can include:

  • Chiropractic
  • Physical therapy
  • Nonsurgical spinal decompression
  • Medications
  • Injections

Rest

  • Staying off your feet for a few days can help decrease pressure on the SI joint.
  • Using an ice or heating pad on the lower back and/or buttocks.
  • Massaging the surrounding muscles may help if the apparent cause is an injury.
  • A doctor could suggest using a cane, walker, or crutches under medical supervision.

Medications

  • Medications include anti-inflammatories such as ibuprofen, naproxen, or prescription alternatives.
  • Acetaminophen helps with pain but not inflammation.

Corticosteroids

  • Steroids are the most powerful anti-inflammatory.
  • A common nonsurgical treatment is cortisol steroids, injected under X-ray guidance.
  • Injections go directly to the source.
  • Oral steroids spread throughout the body but can cause undesirable side effects.

Chiropractic and Physical Therapy

  • Depending on the severity of the condition, chiropractic and physical therapy may be able to strengthen the muscles around the area and realign the joint.
  • A chiropractor will level the pelvis through sacroiliac joint manipulation and mobilization.

Sacroiliac Support Belt

  • Wearing a sacroiliac support belt may help remove the joint’s strain and relieve symptoms.
  • It works by applying compression around the hip and across the joint.

Back, Hip, and Radiating Pain


References

Brolinson, P Gunnar, et al. “Sacroiliac joint dysfunction in athletes.” Current sports medicine reports vol. 2,1 (2003): 47-56. doi:10.1249/00149619-200302000-00009

Heil, Jessica. “Load-Induced Changes of Inter-Limb Asymmetries in Dynamic Postural Control in Healthy Subjects.” Frontiers in human neuroscience vol. 16 824730. 11 Mar. 2022, doi:10.3389/fnhum.2022.824730

International Journal of Spine Surgery. (2020*) “International Society for the Advancement of Spine Surgery Policy 2020 Update—Minimally Invasive Surgical Sacroiliac Joint Fusion (for Chronic Sacroiliac joint Pain): Coverage Indications, Limitations, and Medical Necessity.” doi.org/10.14444/7156

Peebles, Rebecca DO1; Jonas, Christopher E. DO, FAAFP2. Sacroiliac Joint Dysfunction in the Athlete: Diagnosis and Management. Current Sports Medicine Reports: 9/10 2017 – Volume 16 – Issue 5 – p 336-342
doi: 10.1249/JSR.0000000000000410