Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
I just got finished with a ...
resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
March, 2014, Vol. 14, Issue 03
Resolving Hip Flexor & Rotator with Rehabilitation of the Core
By Don McCann, MA, LMT, LMHC, CSETT
A common client complaint is hip pain that can be acute such as pain after a sports event, hike, car trip or sleeping wrong, or as major and chronic as a dislocation, degeneration or long term sciatic pain.The interesting key to effective long term treatment is that the above issues stem directly from an imbalance in the pelvis that all clients have with one ilium rotated anteriorly and the other ilium rotated posteriorly. This is the core distortion which is observable to some degree in everyone.
As mentioned in previous articles, the core distortion can be observed in 16-week-old fetuses and we have yet to find anyone who is not in the core distortion when evaluated. The only exceptions are clients who have been previously treated with the cranial/structural core distortion release combined with myofascial protocols. The vast majority of your clients will have the ilium rotations of the core distortion that create both structural imbalances and issues with their flexor and rotator muscles of the hips. It can be assumed that, except for the very rare exception, the clients who walk into your clinic with problems in their hips are in the core distortion and could dramatically benefit from unwinding this distortion into weight bearing support and balance. Let us look at some brief case histories that demonstrate the problems and the solutions for hip issues.
Ginny, a 19-year-old tennis player, strained her left hip flexor in a tennis match. She continued playing to finish the match and then spent a night in pain. When she presented for treatment, she was in significant pain and having difficulty walking. Her evaluation revealed an anterior rotation of her left ilium and a posterior rotation of her right ilium. She was in the core distortion. Of note, when an ilium is rotated more than 15 degrees, the flexor muscles of that ilium can only operate at a 50% or less strength and efficiency. The left hip flexors that had been strained were the anterior fibers of the gluteus medius which were weakened due to the core distortion.
The cranial/structural core distortion release was applied to release the anterior/posterior ilium rotations and provide stability for the sacrum and spine. This also equalized the functional leg lengths caused by the rotation of the iliums. There was an immediate strengthening of the quadriceps and gluteus medius on the left side which immediately increased the strength, range of motion and flexibility of the strained tissues. This was followed by a specialized myofascial/soft tissue protocol to further release ischemia, swelling and inflammation, the old myofascial holding pattern from the core distortion and scar tissue and fibers from previous strains and injuries. Since the anterior/posterior rotations of the iliums in the core distortion affected the soft tissue differently in each leg, this soft tissue protocol was designed to release the different tensions and holding patterns specific to each leg. After two sessions, Ginny was back playing tennis pain free and moving with more speed strength and flexibility than before the injury.
Charlie, a 61-year-old salesman with a large territory necessitating a lot of driving, was having severe right side sciatic pain when sitting in the seat and driving for more than 45 minutes. This had gotten so bad he had to consider retiring early. A structural evaluation showed that Charlie was in the core distortion with a left anterior ilium and a right posterior ilium. This created the functional long left leg/short right leg consistent with the core distortion. Charlie's right gluteus maximus, posterior fiber of gluteus medius and piriformis all tested weak using kinesiology which indicated more than a 15 degree posterior rotation of his right ilium. These muscles were also tightly contracted to compensate for the weakness. The cranial/structural core distortion release was applied to release the anterior/posterior rotation of the iliums and provide stability for the sacrum and spine. This also equalized the functionalleg length and allowed some unwinding of the soft tissue myofascial holding pattern of the core distortion.
Specific soft tissue myofascial protocols were applied to assist the anteriorly rotated ilium to unwind back to balance and the posteriorly rotated ilium to unwind forward into balance. These protocols released the chronic inflammation and ischemia, the myofascial holding pattern of the core distortion and lengthened individual muscles and fibers that were compressing the sciatic nerve. Charlie noticed immediate improvement with less sciatic pain. He was treated weekly for four weeks and had decreased pain with longer periods of pain free driving. At the end of the fourth treatment, Charlie was no longer having sciatic pain, was able to maintain his improvements and was able to resume his normal life activities.
Steve, a 69-year-old business owner and avid golfer, had severe hip pain. Over the years, he experienced left hip pain that had originally been diagnosed as arthritis and was now being viewed as major degeneration of the hip requiring a hip replacement. Steve had been told when the pain became bad enough that he would have the replacement. Steve's x-rays showed arthritic spurring and a significant thinning of the cartilage on the anterior superior surface of the femoral head (ball) of the femur. He had been receiving injections into the joint that had initially helped some, but now the pain had intensified and become more consistent.
Upon evaluation, Steve had an anterior rotation of the left ilium and posterior rotation of the right ilium which indicated the core distortion. With the anterior rotation of the left ilium, the anterior fibers of the gluteus medius and gluteus minimus were shortened, tightened and weakened resulting in more pressure on the femoral head (ball) where the cartilage had thinned and the spurring was occurring. This anterior rotation of the ilium also produced a functional long leg which was further jamming the femoral head into the hip socket and involving the hip flexors.
Steve's body was compensating for the longer leg by rotating the knee medially and the foot laterally to the knee which was also putting pressure in the hip. This degeneration is common with the core distortion as a person goes through life deteriorating further into this distortion due to wear and tear and life experiences. The cranial/structural core distortion release was applied to bring the anterior ilium posteriorly into balance, the posterior ilium anteriorly into balance, level the sacrum for spinal support and even the functional leg length. Soft tissue myofascial protocols were applied to the left leg and hip to further balance the pelvis, bring the medial rotation out of the upper leg and knee and the lateral rotation out of the foot. This shifted the weight bearing pressure in the hip more to the middle of the femoral head (ball) away from the area of greatest degeneration on the anterior superior part of the ball. In addition, the fibers of the gluteus medius and quadriceps were strengthened when the rotation of the iliums was reduced and they started functioning with greater support, strength, range of motion and flexibility. Additional protocols were also applied to the right ilium so both iliums could function in balance and support and would not be compensating for the imbalances in the opposite hip.
Steve's first three sessions reduced the core distortion in the leg and hips and prepared the area for deeper work into the deepest fibers of the gluteus medius and gluteus minimus. There was also significant fiber and scar tissue that built up around the femoral head that was trying to compensate for the imbalance due to the rotation from the core distortion. Sessions four through seven worked deeper on these deep fibers until they softened and lengthened and were in themselves no longer a cause for pain. Steve was then able to spread his sessions out from weekly to once every two weeks then once every three weeks as the new pattern became progressively stronger and the pressure was shifted off of the anterior portion of the femoral head. Steve resumed playing golf without pain. The release of the core distortion and balancing of the leg rehabilitated Steve's hip to the point that he no longer needed a hip replacement and was able to golf. Steve's hip flexors had played a major role in the degeneration due to their weakness and chronic shortness from the core distortion helping to hold the pressure of the hip on the anterior portion of the femoral head.
Hip flexor problems are involved in the core distortion both by being weakened and susceptible to injury and in helping to maintain dysfunction and imbalance in the hip joint. The rotators can be overstretched due to the medial rotation of the upper leg on the side of the anterior rotation of the ilium or can be over contracted as part of the myofascial holding pattern and muscle compensation of the posteriorly rotated ilium in the core distortion. These common conditions can create significant problems throughout the hip. Preventing problems in the soft tissue or hip joints, or rehabilitating already existing problems can be very effective long term when integrating cranial/structural core distortion releases with specialized myofascial soft tissue protocols.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.