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.
Many people don’t often realize that stability and balance are two of the most reliable abilities to keep the body from falling, and it is often taken for granted from the earlier stages, where infants and toddlers are learning to stand upright, to adulthood where we are walking, running or performing any physical activities. Our bodies are complex machines comprised of upper and lower portions that provide balance and stability. The lower half of our bodies helps stabilize and balance the upper half weight and allows us to move around. This is known as gait. However, when the body begins to age naturally or chronic issues begin to affect the muscles and cause an imbalance in the lower half, it can lead to many disorders associated with these imbalances. Today’s articles examine what gait is, how gait disturbances are associated with the body, and how the MET technique improves gait. We provide information about our patients to certified medical providers that offer available therapy techniques like MET (muscle energy techniques) for individuals dealing with chronic conditions associated with gait disturbances that could affect a person’s ability to walk. We encourage each patient appropriately by referring them to our associated medical providers based on their diagnosis results. We accept that education is a spectacular way when asking our providers the most crucial questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., assesses this information as an educational service. Disclaimer
What Is Gait?
Have you been dealing with issues when walking for a short or long distance? Do your feet or ankles seem to feel tired or ache when stepping? Or have you been dealing with mobility issues in your hips? Many of these issues are associated with gait and can cause balance disturbances in the body. So what is gait? In the book by Leon Chaitow, N.D, D.O., and Judith Walker DeLany, L.M.T, titled “Clinical Applications of Neuromuscular Techniques,” gait is defined as how you walk and how each lower body section contributes to how you walk. This includes:
Feet
Ankles
Knees
Hips
Spine
The book also mentions how a person progresses from one location to another using muscular action and gravity to make them walk. Two functional units are in a casual relationship contributing to gait: the passenger and locomotor units. The passenger unit consists of the upper extremities, like the head, neck, arms, trunk, and pelvis, to be the center of gravity when moving forward. At the same time, the locomotor unit comprises the pelvis and lower extremities, like the legs, knees, feet, and ankles, to support the weight of the upper extremities and perform structural stability and mobility to make the body move forward.
Gait Disturbances Associated With The Body
So what happens when traumatic factors or natural aging begins to affect the body and causes gait disturbances. Research studies reveal that since gait depends on the interplay of the nervous, musculoskeletal, and cardiorespiratory system which can be influenced by age and other factors that can lead to issues in the lower extremities causing falls and injuries. Many factors can lead to gait disturbances that can affect how a person walks and how it can affect the joints and muscles, which can lead to pain-like symptoms. Additional studies mentioned that gait disorder affects elderly adults, increasing their fall risk and leading to mobility issues in their hips. Muscle shortening and joint health are other issues that can cause gait disturbances in the lower extremities. When the muscles in the lower extremities are tight and weak, it can cause them to be short and be accompanied by joint dysfunction. The health of the joints in the lower extremities depends on the balancing strength of the opposing flexor muscles. When the flexor muscles lose part or all of their function, it can cause the joint to be hyperextended. To that point, it causes abnormal joint stress, corresponding to lower back pain associated with gait disorders affecting a person’s ability to walk and keep their body balanced.
An Overview Of Gait Analysis-Video
Have you been dealing with mobility issues in your joints? Do you find yourself becoming unstable every time you walk? Or do your leg muscles feel tight? If you have been dealing with these issues, it could be due to a gait problem. Many people have different ways of walking; if there are issues, they can be pointed out in an examination. When there is an issue with gait, it can indicate pain and other revealing problems that can affect the entire body. The video above explains the gait cycle and gait analysis of a person’s walk. Gait analysis is often used in a normal examination to evaluate how a person walks, their body mechanics, and muscle activity to provide insight into the issue. A person’s gait can offer many important clues that doctors and pain specialists can see and identify the problem by developing a treatment plan to improve a person’s gait and reduce pain-like symptoms.
How The MET Technique Improves Gait
So many treatment plans can effectively improve balance and gait disorders in the body. Many pain specialists like chiropractors use manual spinal manipulation to re-align the spine to loosen stiff joints that may have contributed to imbalances in the lower extremities. MET (muscle energy technique) and physical therapy can help stretch the tight muscles and strengthen the muscle groups affected. MET and other approaches to improve gait allow many individuals to regain their stamina and adopt new strategies for their posture and movement. These therapy treatments will enable a person to feel more confident and more aware of how they walk while providing muscle strength to the affected muscles to prevent fatigue and decrease the chances of injuries in the future, as studies reveal.
Conclusion
Walking is determined by a person’s gait and how they move in different scenarios. Our bodies are comprised of upper and lower portions that correspond with gait and allow us stability and balance when we are in motion. When various issues like traumatic factors or just normal aging affect the body, the joints and muscles can cause problems with a person’s gait, leading to balance issues and fall injuries. Incorporating treatment plans to improve gait can help prevent future chances of injuries and help stretch and strengthen the affected muscles while loosening up stiff joints. This allows a person to regain their balance and improve stability in their bodies.
References
Baker, Jessica M. “Gait Disorders.” The American Journal of Medicine, U.S. National Library of Medicine, 27 Dec. 2017, https://pubmed.ncbi.nlm.nih.gov/29288631/.
Chaitow, Leon, and Judith Walker DeLany. Clinical Applications of Neuromuscular Techniques. Churchill Livingstone, 2003.
Pirker, Walter, and Regina Katzenschlager. “Gait Disorders in Adults and the Elderly : A Clinical Guide.” Wiener Klinische Wochenschrift, U.S. National Library of Medicine, Feb. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318488/.
Van Abbema, Renske, et al. “What Type, or Combination of Exercise Can Improve Preferred Gait Speed in Older Adults? A Meta-Analysis.” BMC Geriatrics, U.S. National Library of Medicine, 1 July 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488060/.
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
The hip flexors are the group of muscles, including the iliac 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:
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: https://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
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
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, https://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, https://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, https://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, https://www.ncbi.nlm.nih.gov/pmc/articlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027473/es/PMC3811738/.
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
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, https://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, https://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, https://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.
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 walking ability. As the body naturally ages, many people will 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 their muscles 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 to ask 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
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 their importance to 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. Many factors can affect how a person walks, leading to various issues affecting the mobility of the lower extremities. When multiple problems affect a person’s walking, the intrinsic muscle and other muscles surrounding the ankle and foot could become strained and overlap with other foot conditions. Coexisting muscle impairments could affect the alignment, motion, load distribution, and muscle performance that involves the legs when foot pain affects the intrinsic foot muscles. When these impairments cause foot pain, it can correlate with trigger points and conditions like plantar fasciitis, affecting a person’s walking ability. 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 create 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, and stand and affect the lower extremities’ mobility. If 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 muscle is, 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 the 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. Different techniques to 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, people should be allowed 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, developing 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, available techniques can help massage, stretch, and strengthen the intrinsic foot muscles while reducing trigger points and preventing their associated symptoms from recurring. 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, https://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, https://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, https://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, https://foothealthguy.com/hammer-toes-causes-and-treatment/
Lim, Ang Tee, et al. “Management of Plantar Fasciitis in the Outpatient Setting.” Singapore Medical Journal, U.S. National Library of Medicine, Apr. 2016, https://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, https://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.
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
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, https://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, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406365/.
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, https://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, https://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, https://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.
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.
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). https://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, https://doi.org/10.1016/j.nurpra.2013.06.008. (https://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, https://doi.org/10.1016/j.math.2011.01.002 (https://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.
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