Dear Paul,
I have read the other replies and I almost guarantee Wendy Johnson,
whose replies are always worthwhile, thanks Wendy!, is right about
SIJ and pelvis.
If it started with a cramp, I suspect he may have a posteriorly
rotated innominate putting the h'string in an inner ROM position.
He may also have a sacral shear. His piri is probably going nuts, or
at least posterior glut med.
The groin pain is secondary, because the psoas and iliacus are now
in a lengthened positioned by the innominate rotation, and are spasming
to hold his ilium in place.
Now look at his foot, posterior innominate rotation occurs with
people who have high arches. Is his arch higher on the injury
side. Remember to look at him in gait, because he may have what
you think is a flat foot in stance, but not be over pronating or
pronating for a long period, but rather maintaing too high an arch.
? any recent ankle injury.
If you want to know any tests etc let me know, but quickly
check his ASIS and PSIS heights in stance and sitting, then let
me know ok.
Scott Epsley,.
--
On Wed, 09 Feb 2000 17:34:36 Paul Sumner wrote:
>Here is the history of a very fit athlete running over 26 miles a week + swimming/cycling
>
>In November he began to get a cramp whilst running in the proximal musculo-tendinous junction of the medial hamstring.which eventually prohibited further running and Partial Weight Bearing only
>
>3 weeks rest all pain had gone and he started swimming again with no increase in symptoms, but then he began to develop pain in the antero-lateral groin area and the ischeal tuberosity area.
>
>Past tissue based treatments have helped, but on return to his swimming an increases in pain is experienced.
>
>Objectively there is nothing specific. He has full range of hip mov't L/sp mov't full muscle power of hip musculature and stretch. Neural tensioning is full as is L/sp palpation. His pubic bone is okay to palpation. I think he has a hyperalgesic area due to returning to swimming to early. Any ideas or tests.
>
>Many thanks
>paul sumner cornwall uk
>
>
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