OA of the hip has taken on a new perspective for me in the last number years
since I have incorporated more sensitive methods of functional evaluation and
treatment of kinetic chain imbalances. Lewitt and Janda have elucidated
specific kinetic chain imbalances that produce instability and characteristic
adaptive "scar" tissue formation. (I.E. upper and lower crossed syndrome) This
tight-weak pairing appears to be neural adaptive, causing abnormanl postural
patterns, compression, wear and tear and hypoxia.
Classic orthopedic tests do little more than identify a diagnosis. Although
there are many more positive tests the main classic dysfunctional patterns I
see is are:
1) Hard end play on prone hip IR and ER rotation with the knee at 90.
2) Tight hip flexors, TFL and quadriceps attachments to the ASIS.
3) Weakness and flaccidly of the glut med/min
4) Weakness-tightness of the adductors
Underlying the classic and predictable kinetic chain imbalances, each patient
possesses unique individual layering of these patterns. Sitting in chairs
versus sitting as our ancestors did are certainly contributory to these
certain adaptive imbalance patterns. The question is, are these patterns
reversible. According to the research, they are.
Quit by accident I discovered that training on rubber gym and Swiss balls
using very specific co-activation, high intensity, short duration kinetic
chain loading patterns produced rapid adaptive changes. The movements are very
specific and must be directed by the individuals immediate findings. It is
critical that the individual identify and sense the areas being loaded and
released a well as sense the resulting changes. What I describe to my patients
as finding the "OH OH that's it factor".
> OA of hip .. so common in.. western nations is so rare in India .. I see
> less than 10 cases per year... Is this something to do with sitting
> cross-legged or squatting which is a part of everyday life of majority i.e
> during defecation ,micturation (squats) to sitting in prayers or in
> condolence or in marriage functions (cross-legged ) .
Any prolonged posture whether good or bad will produce adaptive changes. An
interesting study would be to see if after sitting cross-legged, the
individuals immediately performed specific movements to counteract the effects
produced this posture.
> Does it protect the hips and damage the knee?
Regards
Keith A Zenker D.C.
Performance Dynamics
4067 Cory St. Suite 3
Soquel, CA 95073
831-462-3344
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