Saturday, July 10, 2010

Great Overview

" Extensor Coxae Brevis: Treatment Strategies for the Deep Lateral Rotators in Pelvic Tilt"- Thomas Myers (of Anatomy Trains fame), Journal of Bodywork and Movement Therapies- July '10.

If we look at the inominate (ilia) bones as the pelvis as the lower extremity scapulae, and the femur as the LE humerus, these muscles would make up the LE rotator cuff. Like the scapulae, the ilia are only dumb bones, and do what the muscles tell them to do. If they are given erroneous information the deep hip rotators, like the rotator cuff of the shoulder they will become stiff and painful.  It's nearly impossible to treat them by traditional methods like ultrasound, electrical stimulation, and therapeutic heat and cold.  They are too deep.

It's common for these muscles to become stiff and fibrotic in any lower extremity injury. In the case of the ankle sprain, it can even set you up for another injury, as lack of hip internal rotation has been indicated as a causative factor in inversion ankle sprains.  Myers also makes the comment that when these muscles are hypertonic, the adductor magnus is should also be suspected (he is correct).   Remember any injury is an opportunity for the athlete to do remedial work on things they didn't have time to focus on before.

While well intended, traditional exercises prescribed for lower extremity injuries, such as a stationary bike, may exacerbate this problem.  Many common Yoga exercises address this area.  Non weight bearing hurdle steps are also a good alternative.

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