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Pain in the hip, and what to do about it

1/2/2013

11 Comments

 
Picture
Tensor Fascia Lata (TFL) attaches to the iliac crest/ASIS and into the fascia lata that terminates at the lateral knee.  The primary functional movement of this muscle is to stabilize the pelvis and the knee.  Its action is hip abduction, flexion and medial rotation. Trigger points related to the TFL refer to the outside of the thigh.
Iliacus & Psoas = Iliopsoas The Iliacus attaches to the iliac fossa and the Psoas attaches to the transverse processes of L1-L5 and the lateral aspect of T12-L5.  They share a common attachment point on the lesser trochanter of the femur.  The iliopsoas flexes the hip and trunk.  
Trigger points in the iliopsoas refer to the anterior thigh and low back.
Sartorious attaches to the ASIS on the pelvic crest and to the medial aspect of the tibia. Its action is hip flexion, external rotation, abduction and knee flexion. Trigger points in the sartorious refer to the anterior and medial thigh.
Trigger points in a muscle can be the culprit in many pain disorders.  In this post, I provide a self care technique to assist with these potentially troublesome trigger points. The muscles that can refer pain into the hip area are the tensor fascia lata, iliacus, psoas and sartorious.  If you are interested in learning more about what causes trigger points and how to treat them, I have listed some websites dedicated to trigger points and myofascial pain syndromes at the end of the blog.   Click on the pictures below to enlarge the picture and to link you to triggerpoints.net, an amazing resource for trigger points and referred pain.

If you are experiencing any of these pain patterns , try this:

How to release the psoas
Release tension in the psoas,  and the surrounding hip musculature by performing a constructive rest position with a bolster.  Allow yourself to breathe and relax for 5 minutes.  For instructions on how to do this click here.

How to release tight hip flexors with a ball
Perform a release technique utilizing myofascial release balls such as Yoga Tune Up Therapy Balls for Self Massage (that's what I have and I love them),  Melt Method Products, or good old tennis balls.  There are a lot of different ways to get into the muscles.  For this technique you will take two balls held together in a sock or bag.  My finger is pointing to my ASIS on the iliac crest.  Place the balls horizontally just below the ASIS.

Femoral Triangle
You will be working near a tender area due to the superficial exposure of the femoral vein, artery and nerve at the femoral triangle.  If you start to feel tingling and nerve sensations, move to a different area.  Just underneath the vessels and nerve lies the iliopsoas.  The next muscle laterally (to the right in this pic) is the sartorious, and the muscle in red is the tensor fascia lata.  Sandwiched in between the two is one of the quadricep muscles, the rectus femoris.  This will get released as well.

myofascial release to hip flexors with tennis balls
The balls are placed as above on the left side here.  With the right leg you can adjust how much body weight you put down into the balls.  If it is more comfortable, you can prop up onto your elbows.  If you are not able to get down onto the floor, you can place the balls at your hip, and lean into the wall or a door jam. Try to allow your muscles to relax and mold over the balls.  If you find that the balls are too intense to start with, place a folded hand towel over them to disperse the pressure.  If you are holding your breath and tensing your muscles to deal with the pain, this defeats the purpose.  You should be able to feel the sensation and breathe into the area as the muscles release.   Once you feel that the muscle has let go, move the balls into a new area.  Spend 5 minutes on each side.  Enjoy how you feel when you get up to walk.  Feel the freedom in your hips!


Resources:
 http://www.triggerpoints.net/, http://saveyourself.ca/tutorials/trigger-points.php, http://www.myofascialtherapy.org/
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignintegrationandmovement.com.
11 Comments
Alisha
1/17/2013 10:05:16 pm

Susan, I love your posts and I´m so glad I´ve discovered you. I´ve now started excercising again and have all the problems you´ve named; hip thrusting, sway back, diastasis - and I´ve been in a lot of pain. So I´ve been strengthening my core but also looking at what you´re posting is a huge help. Thx! Alisha

Reply
Susan
1/17/2013 10:25:15 pm

Alisha,
Thank you for your feedback. It is so good to hear that you find value in the posts. I love it!
Susan

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fat loss factor customer review link
3/17/2013 09:16:27 am

Hi Susan,
Pretty! This has been a really wonderful post. Thank you for providing this info.

Reply
click link
6/19/2013 05:38:37 pm

I have severe pain in my hips for a very long time. Some time its really unbearable. I went to a physical therapist, but no change at all. Can you advice me on this? Anyway, I'm trying these for few days. Will let you know the result soon.

Reply
Susan
6/24/2013 12:17:03 am

Click,
I am sorry to hear about your pain. It is so hard to advise without knowing where your pain is: the hip is very general, and seeing how you present. Have you explored other options besides physical therapy: structural integration, neurokinetic therapy?
I wish you the best. If you are in Salt Lake City, contact me, Susan

Reply
Renee
9/28/2013 11:35:29 am

Is this helpful in treating trochanteric bursitis? Do you know of any other techniques that could help with that type of bursitis?

Reply
Susan
9/28/2013 01:43:49 pm

Renee,
If you look at the trigger point pictures, the TFL can refer to the trochanter area. Working with a ball in this area can be helpful. Of course it will be useful to discover the reason this area is irritated. Where are you located?
Susan

Reply
nancy link
5/5/2014 02:12:35 am

Dear Susan,
Thank you for your blog. I have tight psoas and am being treated for pelvic pain and other issues.
I performed this release but feel something went awry with the stretch that occurred in my upper back/ neck.
Directly afterwards I am shaky and weak at the neck and extremities. The shoulders and hips as well.
What could be happening?

(Several yrs ago I developed a reaction of trembling and weakness for a day after flow yoga. I more recently discovered a pinch in my very upper back near the spine which when aggravated sends lightning down my arm and into my cheek and can take months for the nerve pain and sensations to resolve. I'm not sure how all these are related but I also often feel numbness in arms after laying down (any pressure to upper back)

Thank you

Reply
Amber
7/11/2015 09:49:53 am

My pain feels as if it's in the bony landmark . It seems to have gotten worse since I have gone back to work and am sitting all day and or started Pilates . At times I have a popping sensation ( and it is relief ) in my inner thigh groin region. Which feels good , but I don't know ignites related because it's generally on the opposite leg. The feeling tends to go up my side and feels very tight . Thoughts?

Reply
johnna wood link
4/10/2017 08:16:50 am

Maybe need to recheck posting on sartorius muscle. The origin is the ASIS but the insertion is on the medial aspect of the tibia not the femur. very important as the changes it from a single joint muscle to a dual joint muscle.

Reply
Susan
4/10/2017 10:25:42 am

Johnna,

Yes, thank you. That was an editing oversight! I have corrected this. Susan

Reply



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