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.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
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.
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.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
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.
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.
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.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
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.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
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.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
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.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
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.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
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.
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