Hi Laurie,
Is there a section missing in your video training for iliopsoas strains? It goes straight from detection to eccentric muscle strengthening with nothing about manual therapies that might be used. Your handout says lumbar and hip mobilisations, would that be the IVDD rotational tx plus SI mobilisations, anything else? Mobilising the hip itself?
Thanks
Kriszty
Iliopsoas video
Re: Iliopsoas video
Hi Kriszty!
Excellent fodder for another Training Video! Firstly in regards to treatment, you have the acute painful stage, where modalities are best. And then you can move into exercise. I would say (with research to back me up) that targeted exercise is the best treatment for tendons. In regards to mobilizations, really, the point of that being in the handout is that we should (and owners should know that we should) be looking for secondary or adjunctive issues. The same mechanisms that can strain the iliopsoas could also cause an SIJ or lumbar spine dysfunction. The hip joint itself should be looked at, but I find low correlation with hip and iliopsoas... but it should be looked at. So treating any dysfunction found in these three regions would be smart. You could argue that mobilizations of the lumbar spine could have a neuromodulatory effect for the nerves that exit the spine an supply the iliopsoas, which could provide a secondary pain management benefit. But where should you spend your time? 1) Modalities, then 2) eccentric exercise & stretching 3) you could do some manual therapy (myofascial release / stretches), and 4) perhaps also some acupuncture (I do spinal segments) and/or mobilizations.
In regards to choices for L/S mobilizations - flexion mobs or side-bend mobs would be my preference.
But perhaps I'll throw that into a video. THANKS for the inspiration!
Cheers,
Laurie
Excellent fodder for another Training Video! Firstly in regards to treatment, you have the acute painful stage, where modalities are best. And then you can move into exercise. I would say (with research to back me up) that targeted exercise is the best treatment for tendons. In regards to mobilizations, really, the point of that being in the handout is that we should (and owners should know that we should) be looking for secondary or adjunctive issues. The same mechanisms that can strain the iliopsoas could also cause an SIJ or lumbar spine dysfunction. The hip joint itself should be looked at, but I find low correlation with hip and iliopsoas... but it should be looked at. So treating any dysfunction found in these three regions would be smart. You could argue that mobilizations of the lumbar spine could have a neuromodulatory effect for the nerves that exit the spine an supply the iliopsoas, which could provide a secondary pain management benefit. But where should you spend your time? 1) Modalities, then 2) eccentric exercise & stretching 3) you could do some manual therapy (myofascial release / stretches), and 4) perhaps also some acupuncture (I do spinal segments) and/or mobilizations.
In regards to choices for L/S mobilizations - flexion mobs or side-bend mobs would be my preference.
But perhaps I'll throw that into a video. THANKS for the inspiration!
Cheers,
Laurie
LAURIE EDGE-HUGHES
