Wednesday, April 15, 2009

Gracilis strain

One of our baseball players was trying to run out an infield squibbler & came up hobbling. The gracilis is often thought of as a adductor, which is true. But it is the only adductor that crosses the knee joint, which adds knee flexion/internal rotation into the mix. It is often mistaken for a hamstring strain because of it's location to the inside hamstring group. Be sure to differentiate this muscle from the hammies on your evaluation. Rehabilitation is different.

Because of it's origin on the pubis, the gracilis is not a hip extensor. Because of this fact, rehab that involves hip extension is usually tolerated early on. A step up for instance, as long as you begin/end in a narrow stance. So, the step up may be a good early phase way to "tweak out" the gracilis. In other words, it's being minimally recruited in a functionally appropriate manner.

OK, I've "tweaked out" in the sagittal plane. But we know the muscle also decelerates knee/hip abduction in the frontal plane. In the transverse plane, it decelerates knee external rotation. So, how might we functionally tweak out the other 2 planes? On to you guys.


Brian said...

Though open chain but performing star excursion directions that lengthen/open the hips will cause gracilis to slow that movement down in a open chain. Doing the same directions with the involved LE WB'ing will do the same in a closed chain.
Lateral lunging/matrix especially will do it..Using a slide board allows to keep both feet closed chain. Lunge/step matrix with trung rotation will address the transverse plane.

Joe Przytula said...

Hey Brian, your stealing my steam by tweaking the gracilis back in! But, you are correct, something resembling a L SLB, RLE R 120 reach would certainly challenge that gracilis. What I'm looking for here is "quieting" the gracilis a little in a functional manner while performing the step up exercise.

JH said...

during the step up tweak the toe/tibia in a bit with internal rotation. That takes care of the transverse plane. Is it the left leg that's injured? If so, you can tweak out the gracilis with a driver to the medial-ish vector.

Brian said...

A step up but placing the involved leg across midline...?