resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Make Every Day Mother's Day
May is a special month for many reasons. After a long, harsh winter, spring is at last in full swing. Memorial Day helps us honor those who have fought and fallen in the name of freedom.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
News in Brief
Dr. Frank Nicchi Receives Award at ACC-RAC; Sherman College Expands International Influence.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Applauding a Legacy of Leadership
Founding Palmer West President, John Miller, DC, HCD (Hon.), FICA (Hon.), a 1954 graduate of Palmer College of Chiropractic, passed away March 8, 2015 at age 83.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Apple Takes a Bite Out of Research
The more than 700 million iPhone users have just been given the opportunity to "do their part to advance medical research."
If Your Pro-Chiropractic Governor Resigned, Would You Be Prepared?
John Kitzhaber, MD, recently re-elected to a historic fourth term as Oregon governor, has resigned among alleged ethics violations by his fiancée' and first lady, Cylvia Hayes. I developed a personal friendship with John and consider him a good friend.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Teach Your Patients About External Healing Applications
Since the skin is the body's largest organ, and is able to respond to both internal and external stimulations, communicate sensations to the brain, protect the body, breathe and even excrete toxins, it can be an excellent source of healing.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Talking to Patients About Medial Branch Neurotomy (Part 2)
Even when lumbar facet denervation (medial branch neurotomy) is successful, relief is rarely complete or permanent. Smuck, et al., reviewed 16 articles and found the average duration of >50 percent pain relief for an initial procedure was nine months.
Functional Impingement of the Hip (Part 2): Rehab Exercises
I find functionally impinged hips that don't move properly on so many of my patients. (See part 1 of this article for a description of the condition.)
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
July, 2012, Vol. 12, Issue 07
Pelvic Pain from The Adductor Magnus
By David Kent, LMT, NCTMB
Living with pelvic pain is a daily occurrence for many people. It is very unsettling for a patient to have undergone countless medical tests and procedures with no clear source of the pain identified.Myofascial trigger points (TrPs) are one possible cause of pelvic pain. Trigger points 1 and 2 in the adductor magnus refer pain into the pelvic region (Image 2b and c). Let's talk about= the anatomy, trigger point locations, referral patterns and provide a link to an online video clip showing a treatment routine for the adductor magnus with the patient in a side lying position.
The adductor magnus is the largest muscle of the adductor group. It is tripartite, composed of three parts, an adductor minimus part, a middle part and an ischiocondylar or "hamstring" part (Image 1).The fibers of the adductor minimus part run almost horizontal. The fibers of the middle part run at an angle and the fibers of the isciocondylar or third part, run vertical (Image 1). Besides having three parts, the adductor magnus contains an opening.
The word hiatus originates from the latin term, hiare, to stand open. A hiatus is a normal opening in a membrane or other body structure. The adductor hiatus is an opening in the distal attachment of the adductor magnus muscle and is located just superior to the adductor tubercle of the femur (Image 1). As the femoral artery and vein pass through the adductor hiatus, their names change to become the popliteal artery and vein.
Two nerves innervate the adductor magnus muscle. The tibial part of the sciatic nerve supplies the ischiocondylar or "hamstring" part of the adductor magnus. This same nerve also innervates the hamstring muscles. The obturator nerve supplies the adductor minimus and middle parts of the adductor magnus.
Proximally, the adductor magnus attaches on the inferior ramus of the pubis, as well as, the ramus of the ischium and the ischial tuberosity. Distally, it attaches on the back of the femur, from the gluteal tuberousity to the adductor tubercle.
Since the adductor magnus has three parts, each with fibers pulling in differ directions and is innervated by two different nerves, the effects on posture and biomechanics are significant. For example, the middle part can rotate and tilt the pelvis, adduct and flex the thigh. While the ischiocondylar or "hamstring" part extends the pelvis. We will visit these dynamics in a future article. For now we will look at trigger points.
Trigger points can form in the adductor magnus for numerous reasons from physical trauma, activities like hiking, slipping on a wet or icy surface that causes the persons legs to extremely abduct, or from many hours of sitting in a hip flexed position on a plane, in a car or while working at a desk, to name a few.
Trigger point 1 (TrP 1) in the adductor magnus muscle is located at the level of the mid thigh. It refers an essential pain zone into the medial thigh, starting below the inguinal ligament, into the pelvic region, running distally to the medial knee (Image 2a - b), "X" indicating the common location of trigger points within the adductor magnus muscle. Solid red areas indicate an essential pain zone. Red dots indicate spillover pain zones. (Image 2 A-C) Trigger point 2 (TrP2) in the adductor magnus muscle is located proximally. It refers internal pelvic pain. Patients may describe the pain as referring into organs such as the vagina, rectum or bladder.
In addition to adductor magnus, other muscles with documented trigger points that refer into the pelvic region include the obturator internus, piriformis and obliquus internus abdominis, coccygeus and levator ani. Be sure you are properly trained, licensed and operating within your scope of practice prior to performing therapy.
I wish you the best helping patients with pelvic pain. If the cause includes trigger points in the adductor magnus, you now have information to provide a soft tissue solution. Here is a link to an online video clip showing a treatment routine for the adductor magnus with the patient in a side lying position: www.youtube.com/KentHealth.
Click here for more information about David Kent, LMT, NCTMB.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.