I got in touch with an old massage therapist friend over the holidays and was dismayed to find out she had taken a backwards flop over a storage box several months ago and had been working in pain.
She had tried a few massages and had some acupuncture and some energy work, but the hip had kept throbbing. It was slowly getting worse, and it was getting very hard to do massages. “I had to go to work,” she said. “So I just kept working through the pain, hoping it would clear up.”
After pointing out she had violated all the advice we give our clients (if I am your friend you can count on me to do so) we arranged for a massage over the Christmas holiday.
The pain had gotten a little better and a lot worse, waffling back and forth for several months, making it hard to walk, to drive, and especially to do massage. Sometimes it hurt to sit. It especially hurt to play racquetball. The pain was deep inside the hip joint, radiating around the capsule and now heading down the leg to the knee.
To make all of this more fun, my friend is hyper-mobile. She easily Gumbys through all kinds of twists and turns and impossible yoga stances. I like a challenge.
The pain and discomfort was evident when she came in for a massage. She stood, sort of, the affected side flamingo-ing up her good leg. A very frightening injury, to say the least. I asked her to stand up for me, feet even and weight 50-50 on each leg, while I looked at her feet.
“Do you want the good news or the bad news?” I asked. “The good news is I think I see what has gone wrong and can massage it. The bad news is you are just as human as the rest of us.”
Most of the time I look for hip trouble in the low back, but this was different. Here I was dealing with deep-seated pain, hypermobility, a backwards fall, and a few months of pain-enforcing activities. I checked the glutes for trigger points, massaging through the sheet to make the experience less gruesome. The glutes were sore and the sacrotuberous ligament felt taut on both sides. On the affected side, the right, the quadratus femoris felt like stone.
I had her go sideline to check the adductor magnus. Oh yes, this felt like a speed bump. I cross-fibered up and down the hump, hoping to feel some sign of the muscle letting go. I did the stretch, finding about half the expected range. Figure on a hyper mobile person, one-fourth the range.
It took another session, this one also to balance out the super-stressed pectineus and adductor brevis. The second time the adductor magnus felt more like muscle, but it still held trigger points like a string of pearls. I ended up working all the stressed muscles in the glutes and groin.
“So what did you mean about me being human?” she asked.
Ahh. Forceful lateral rotation of the right foot. She was massaging, and doing probably a lot of other things, with the right foot pointing laterally, heel in, toes out.
A pretty basic lesson that we all might take for granted. I had done a forceful lateral rotation while flipping out Wii bowling last year. I had to scream every time I took my foot off the gas pedal to touch the brake. While driving to work.
“Remember that both feet point in the direction of your stroke,” I said. A simple bit of advice that hopefully all student therapists hear in school. And if we forget, our hips will remind us.
1 comment:
Good description of body assessment, interesting to read the process you use to determine your treatment method. I always appreciate being educated, on the table and here at findtouch.com!
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