Top 5 Fridays! 5 Common Hip Patterns | Modern Manual Therapy Blog

Top 5 Fridays! 5 Common Hip Patterns


Just as a partner piece to go with last Friday's Top 5 Shoulder Patterns, here are my 5 go to patterns when looking at a "hip" issue.




 1) Lumbar Sidegliding in Standing to the involved side
  • right hip pain = look at SGIS to the right
  • this means hips to the left and shoulders to the right, don't confuse this!
  • many unilateral LQ problems have a loss of unilateral loading to the involved side starting with the spine, and the LQ is similar to the UQ cervical SB to the involved side
  • ANY loss of SGIS to the involved side I start with manual "shift" corrections to that side and then check for hip, knee, ankle issues
  • Last week, a runner with a painful great toe extension was resolved by SGIS loading to the ipsilateral side (I actually tried repeated toe flexion first)
  • lock it with with self SGIS against the wall in standing 


2) Psoas
  • forget "releasing" the psoas for 5-10 minutes with all kinds of crazy painful UE and LE movements 
  • instead try
    • diaphragmatic breathing instruction
    • then 4-5 good deep breaths for tone reduction
  • then re-measure or test the limited motion
  • this often leads to a rapid change
  • lock it in with repeated end range loading hip flexion


3) IT Band, or as my wife calls it the ITB Band, the extra B is for uhhh.. I got nothing
  • Forget painful grasturbating! Here's a video of me using some PNF and manual tone reduction of an ITB for decrease of FAI like complaints
  • I actually prefer to use the EDGE or EDGEility as lightly as possible, as in just skin scraping to the point where any lighter you would not be touching, but I had forgot lubricant that day
  • this will not only improve hip mobility, but also SGIS to the involved side


4) Loss of hip IR - Mulligan MWM with belt
  • one of my favorite mobs, works well, rapid response, pain free! The Right Stuff!
  • you'll see a loss of ipsilateral hip IR with many hip, knee, ankle, lumbar issues

5) Loss of flexion
  • yes the above improves everything, but the patterns are to look for loss of hip IR/flexion, SGIS to the same side which is unilateral spine loading
  • often seen with FAI and painful end feel, many of the techniques above help and again lock in with repeated hip flexion to end range, with some abduction and ER to go further if needed and possibly followed by SGIS to the same side
Have a safe and happy holiday weekend for my US readers, everyone else, enjoy your most likely shorter one!



10 comments:

  1. Great post Erson! I always pick up little nuances from your posts and videos to help improve my skills. Also great to see how your techniques and intentions change as we constantly learn more about neurophysiological (and other) influences in tissue dysfunction. Keep up the great work!

    ReplyDelete
  2. Also a Bank Holiday in the UK!!! Lets enjoy the break!

    ReplyDelete
  3. Much lighter than when I taught you. Thanks Shaun

    ReplyDelete
  4. Agree with Shaun, much appreciated!

    ReplyDelete
  5. Would you mind expanding on your reasoning/the possible link/relationship between loss of side glidning of the lumbar spine and lower extremity complaints? How do you explain this to the patient (compliance for HEP, if the effect on functional movements is not instant)? Future post maybe?

    ReplyDelete
  6. I'll shoot a vid for next Wednesday already have one for this week, thanks!

    ReplyDelete
  7. Dr. E,


    I have been implementing various techniques shown on this site to help treat my patients. Quick example: Providing PT coverage at a local Crossfit event = person complained of severe L neck pain during pullup or overhead activity for 5 months. No previous PT helped. I did Cervical retraction with backbend and the wiggle. Immediately after he had less pain, 2-3 min after he stated he had no symptoms at all with any neck movement. He was floored and asked why his MD and PT had not tried any of this. Pretty awesome.

    ReplyDelete
  8. Great! Effective and easy... that's the best part! Great job Jeremy!

    ReplyDelete