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And The
Hip Bonez Connected To the . . .
By
Victoria L. Magown,
CMTPT, LMT and George S. Pellegrino, LMT, CMTPT
The
American Heritage Dictionary defines the word hub as “the center of
activity”. If we think of our body as our own personal universe, our
hips, or more specifically, our pelvis can be defined as the center of
our bodies’ universe.
The
pelvis is the foundation of the spine, that is, the base upon which the
spine rests. This base for the spine can affect the rest of your torso
all the way up to the head. It also plays an important role as an anchor
for many muscles of the lower limbs. When the pelvis becomes
dysfunctional, besides causing low back and hip pain, it can cause pain
and dysfunction of your shoulders, neck and head. (See “Follow the
Leader”)
When evaluated
for pelvic dysfunction, we find a particular group of muscles are almost
always involved. This group of muscles crosses the joints of the hips
and when myofascial
 trigger
points develop in any of them, dysfunction occurs. These muscles include
the quadratus lumborum (Illustration A and referred to as the QL),
rectus femoris (Illustration B) and rectus abdominis (Illustration C).
A
myofascial trigger point is a hypersensitive spot in a muscle that when
stimulated, usually produces pain referred in a predictable pattern away
from the trigger point. These points also trigger contractions in
muscles that are called taut bands. These triggered taut bands cause the
dysfunction of the pelvic joints. When trigger points are activated in
these muscles, both the muscles and the joints need to be treated.
Trigger
points in the QL can be activated during a slip and fall or a motor
vehicle accident at speeds as slow as 5 mph. Injury to this muscle
doesn’t even require landing as the result of a fall to activate trigger
points, a near fall is sufficient.
When
trigger points are activated in the QL, it can shorten as the result of
contracture on one side more than the other. This pulls the back of the
hip up on that side and rotates the front of the hip down on the same
side. At this point, noticeable pain begins. Since the rectus femoris
is attached to the front of the hip, when the front of the hip is
rotated downward, this muscle develop points that trigger causing
continued hip dysfunction and frequently knee pain (Illustration B).
Trigger
points in the rectus abdominis can also become activated during a motor
vehicle accident by virtue of the impact from the seatbelt (Illustration
C). Since it is attached to the pubic bone in the front of the pelvis,
when the pelvis becomes dysfunctional, this muscle is involved. When
the rectus abdominis develops trigger points, pain is referred across
the low back. It can also cause all the symptoms of a bladder infection
without any positive laboratory findings.
If you
have low back, hip, buttock and/or knee pain, you could perform this
simple test. Lie flat on your back and have a friend sit at your side
facing you. Have them place the palm of the hands on the “bump”
(Anterior Superior Iliac Spine) that marks the front of the hips. Now,
they place the thumbs just under that “bump” (ASIS). If one “bump” (ASIS)
is lower (closer to your knee) than the other, that hip bone is said to
be anteriorly (downward) rotated.
At
MyoRehab both the muscles and joints are treated. Once we have
eliminated the points that trigger the pain and taut bands, the joints
of the pelvis can be coaxed back to their neutral, functional position.
With a specific home exercise program, the involved muscles are
retrained and pain relief becomes permanent.
For many
of our patients, Myofascial Trigger Point Therapy solves the misery of
many failed attempts to decrease/eliminate low back, hip, buttock and
often, knee pain.
Are your
hip bonz connected to pain at the hip, buttock or knee? Give us a call at MyoRehab
OR click here to set up your thirty minute consultation |
