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Groin strain/pulled muscle (Adductor strain)
A strain is an injury/overstretch/tear to a muscle-tendon unit. Strains are graded in terms of severity:
• Grade I: Mild – muscle-tendon unit is over-stretch small tears in the fibres may or may not occur.
• Grade II: Moderate – muscle-tendon unit fibres are torn but not a complete tear.
• Grade III: Severe – complete tear.
Can be caused by a sudden change of direction when running, or any activity that overstretches the adductors. Rapid movements of the leg against resistance e.g. kicking a ball, can be a cause. Any hip muscle weakness can also contribute
How we can help, special orthopaedic tests,
Piriformis Syndrome: What is It?
• The piriformis muscle is one of the deep six lateral (external) hip rotators,
• Anatomical differences mean the sciatic nerve may run deep to the piriformis (90% of population) or it pierces/splits the muscle and travels through it (10% of population) predisposing them to this condition.
• Piriformis syndrome is a neuromuscular condition characterised by pain, tingling and numbness in the buttocks and along the pathway of the sciatic nerve (down the thigh and lower leg).
• Low back pain frequently occurs with this condition.
• Primary piriformis syndrome: anatomical cause:- split piriformis or sciatic
nerve. Only around 15% of all cases.
• Secondary piriformis syndrome: precipitating cause:- including trauma
and ischemia (restriction of blood supply to the tissues).
Causes
• Tight/short piriformis
• Compression from external sources e.g. wallet in back pocket, sitting
on hard surfaces
• Macro trauma – fall or blow to the buttock region
• Micro trauma – over use especially seated activities that involve
strenuous leg movements e.g. rowing, but also long- distance walking /
running
• Weak / inactive gluteal muscles and over active hip flexors (caused by
sitting for prolonged periods)
• Anatomical variations
Orthopaedic testing!
1. Signs and Symptoms
• Pain and/or parenthesis (numbness / tingling) radiating from sacrum through gluteal area and down posterior aspect of thigh
• Tenderness on palpation of piriformis
• Low back pain
• Pain decreases with movement, especially walking with affected side
hip externally rotated (foot turned outwards)
• Pain increases with prolonged sitting / inactivity
• Potentially causes groin and pelvic pain due to either mechanical
stress on hip bone or compression of pudendal nerve (controls the muscles of the bowels and bladder)
SIJ dysfunction
• The SIJ is a joint that joins the sacrum to the pelvis.
• The joint contains numerous ridges and depressions, indicating its function is for stability more than motion. Stability is provided by the ridges present in the joint and by the presence of generously sized ligaments. .
• Essentially SIJ dysfunction refers to hypermobility (too much movement) or hypomobilty (not enough movement) of the sacroiliac joint.
Causes:
1. Causes
• Trauma, pregnancy, biomechanical or muscle length imbalances
1. Signs and Symptoms
• Pain:
• Pain in one or both buttocks.
• Pain radiating to the hip, back of the thigh and even the calf, The pain is often described as a dull ache or sharp and stabbing
• Sciatic type pain radiating down leg
• Pain worse after sitting for prolonged periods of time
• Pain worse after twisting or rotation movements
• Pain worse in the morning and resolves with exercise
How we can help – special orthopaedic tests of which 4 out of 5 need a positive outcome for diagnosis.
Massage!!!! Direct and indirect facial work.