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.
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
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/.
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
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/.
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
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.
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
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.
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 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:
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.
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
The body’s lower extremities have a very important role as it helps support the upper body’s weight and provide stability to the lower body. The lower half of the body consists of the lower abdominals, hips, pelvic, and buttock regions, which have various muscles surrounding the lumbar and pelvic areas of the spine. These muscles help protect the lower vital organs and work with the central nervous system to utilize the sensory-motor function of the legs and feet. When normal factors like prolonged sitting or standing begin to affect the lower body, it can cause referred pain to travel down to the legs and push the lower extremities to develop symptoms associated with trigger points on the lower torso. Today’s article looks at the lower torso, how trigger points affect the lower torso, and therapeutic ways to manage trigger points in the lower torso. We refer patients to certified providers who incorporate various techniques in more inadequate body pain treatments related to trigger points to aid people suffering from pain-like symptoms along the lower torso muscles along the body’s lower extremities. 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
What Is The Lower Torso?
Have you been feeling stiffness around your hips lately? Have you noticed that you are leaning forward constantly, causing strain on your lower back? Or have you been experiencing pain in one location in your lower half? When dealing with these issues in the lower half of the body, it could correlate with somato-visceral symptoms associated with trigger points in the lower torso. The lower torso of the human body, or the lower abdominals, is defined as the anterior region of the trunk between the thoracic diaphragm and serves as the cavity to house the digestive, urinary, endocrine, and parts of the reproductive system. The lower torso has various muscles and nerves that surround the lower back, the hips, the pelvis, and the buttock region of the body that stabilizes the legs when in motion and supports the upper body. The muscles in the lower torso also surround the lumbar and pelvic areas of the spine to protect the joints and vertebrae from becoming dysfunctional. When issues begin to rise and affect the lower torso, it can lead to overlapping problems affecting the body’s lower extremities.
How Do Trigger Points Affect The Lower Torso?
Some of the issues affecting the lower torso that most people don’t realize are that prolonged sitting or standing can cause problems to the legs, hips, pelvis, and feet. This causes the blood supply to pool into the legs and feet, thus causing swelling and muscle weakness in the lower torso muscles. Another issue is when the lower torso has been through a traumatic event that can cause the affected muscles to develop tiny nodules known as trigger points to cause problems in the lower back, hips, pelvis, and buttock region of the body. Studies reveal that trigger points are often characterized by pain causing a limited range of motion in the joints while causing muscular contracture and mimicking other chronic conditions affecting the muscles. When trigger points affect the muscles in the lower torso, “Myofascial Pain and Dysfunction,” written by Dr. Janet Travell, M.D., pain associated with movement can cause tingling or electric sensations down to the lower extremities causing somato-visceral referred pain to the lower torso. Since the nerve roots from the spinal cord branch out to the various muscles and become irritated, causing referred pain to different areas of the lower extremities.
Trigger Point Therapy For The Abs- Video
Have you been dealing with hip mobility issues? What about experiencing low back pain after being in a hunch position for an extended period? Or have you been experiencing problems in your pelvic region? Many of these issues are correlated with trigger points associated with the lower torso. Trigger points or myofascial pain syndrome are caused when the affected muscles have been overused or been through a traumatic event that causes referred pain to different body locations. The video explains where trigger points are located in the lower torso, especially in the abdomen and how to release them through palpations and massage. These techniques can help reduce the pain symptoms that affect the lower torso and manage myofascial pain from developing in the future.
Therapeutic Ways To Manage Trigger Points In The Lower Torso
Pain specialists like chiropractors and massage therapists will use various techniques to reduce the pain and alleviate the trigger points from the affected muscles. Many often go to a pain specialist who deals with trigger points through recommendations by their primary doctor. They will go through an examination process and explain to the pain specialist where the pain is located. Afterward, they will devise a treatment plan with the patient’s primary doctor, allowing them to follow a routine to prevent the pain from returning. Various techniques like stretching the abdominals, exercising, and resting can manage trigger points from returning to the affected muscles and even help bring muscle strength back to the body.
Conclusion
The lower torso consists of the hips, lower back, pelvis, and buttock region while protecting the body’s vital organs. The lower torso helps stabilize, the lower body extremities and supports the upper body’s weight. When normal issues like prolonged sitting or standing start to cause muscle strain to the lower torso region, it can develop trigger points to cause various problems to that region and cause mobility issues in the lower abdominal area. When the pain becomes unbearable, many individuals go to a pain specialist to help manage the trigger points from affecting the lower torso region and bring back mobility function to the lower extremities.
References
Akamatsu, Flavia Emi, et al. “Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle.” BioMed Research International, Hindawi, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5733974/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Wade, Christian I, and Matthew J Streitz. “Anatomy, Abdomen and Pelvis, Abdomen – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 July 2022, www.ncbi.nlm.nih.gov/books/NBK553104/.
Uneven hips can throw the back out of natural alignment and cause back stiffness, tightness, discomfort, and pain. Hips that are off-balance unhealthily affect standing, sitting, sleeping posture, walking gait, and overall movements. Biomechanics issues cause the core and spine stabilizing muscles to become weakened and fatigued from overcompensating to keep the body up and moving. Over time this can lead to chronic pain in the back, hips, knees, and feet. Chiropractic care can restore proper hip and spinal alignment and wellness.
Uneven Hips
Misaligned hips can be caused by work or sports injury, exercise, vehicle collision, and/or general wear and tear. When hips are out of alignment, they have shifted from their centered position. They could be rotated forward or backward, forcing the spine and the lower limbs to compensate, resulting in the spine tilting that can make the legs appear uneven. Discomfort may be one-sided low back pain near the sacroiliac joint, causing a stiff/tight back, limited motion, and/or pain symptoms. Because the spine and lower limbs have to compensate for the unevenness, the shoulders and upper back, connected to the pelvis through the spine, are also affected and result in:
Back pain.
Hip and gluteal muscle pain.
Uneven leg length.
Knee, ankle, and foot issues and pain.
Uneven shoulders.
The shoulder blades can stick out on the side of the lower hip.
Rib discomfort and pain.
The rib cage could protrude out on one side. However, this could be due to advanced scoliosis.
Therapy
Staying active is recommended and includes stretching and core strengthening. General stretches recommended to optimize hip equity include:
Hamstring stretch
For this stretch, lie on a flat surface with your legs extended straight out.
Bend the right leg at the knee, placing the right foot on the ground.
Use a towel, belt, or band to grab and wrap around the left foot.
Keep the hip/buttock on the left side planted on the floor.
Slowly raise the left leg upward as far as possible until you feel the stretch.
Once you feel a stretch or restriction in the hamstring, hold the position for 30 seconds.
Repeat on the other side.
Perform 2 to3 times.
Hip flexor stretch
Kneel on the affected leg and bend the healthy leg out in front with the foot flat on the floor.
Back straight.
Slowly push the hips forward until you feel the stretch in the upper thigh and hip.
Hold the stretch for around 15 to 30 seconds.
Chiropractic Care
Chiropractic treatment is a highly recommended non-surgical option for uneven hips and pelvic tilt. Depending on the severity of the misalignment, underlying issues, and body scanning images, hip alignment treatment could include:
Soft tissue therapeutic massage
Chiropractic muscle release for tight hip flexors, quadriceps, hamstrings, and glutes.
Kiapour, Ali et al. “Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain.” International journal of spine surgery vol. 14, Suppl 1 3-13. 10 Feb. 2020, doi:10.14444/6077
Lee, Jeong-Hoon, et al. “The effect of Graston technique on the pain and range of motion in patients with chronic low back pain.” Journal of physical therapy science vol. 28,6 (2016): 1852-5. doi:10.1589/jpts.28.1852
Patel, Rikin V et al. “Pelvic Tilt and Range of Motion in Hips With Femoroacetabular Impingement Syndrome.” The Journal of the American Academy of Orthopaedic Surgeons vol. 28,10 (2020): e427-e432. doi:10.5435/JAAOS-D-19-00155
Rivière, C et al. “Spine-hip relations add understandings to the pathophysiology of femoro-acetabular impingement: A systematic review.” Orthopaedics & traumatology, surgery & research : OTSR vol. 103,4 (2017): 549-557. doi:10.1016/j.otsr.2017.03.010
Suits, William H. “Clinical Measures of Pelvic Tilt in Physical Therapy.” International journal of sports physical therapy vol. 16,5 1366-1375. 1 Oct. 2021, doi:10.26603/001c.27978
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Sacroiliac Joint Surgery
