Posted: Tuesday, February 1, 2011 12:15 am
Welcome to Ask Doc Dossman, a weekly column where you can ask Long Beach’s pre-eminent sports therapist…whatever you want! If you already forgot who Doc is, click here to read our introduction. To visit Doc’s website, click here, and buy his book, What I’ve Learned From Your Kids. Email questions to Doc ataskdoc@docdossman.com.
Hey Strong Beach! How are you? I’m excited as I watch two of my Long Beach guys in Hawaii at the Pro Bowl (DeSean Jackson & Marcedes Lewis). This is Marcedes' first Pro Bowl. He got to start and he just scored a touchdown! You gotta be happy for the local guys! Well, this week I have two great questions. I am keeping my column down to 1,000 words or less so that means I will be more brief with my responses. It’s a challenge when my goal is to give you all the information that I can, so I apologize in advance if it seems like it is taking forever to get around to your question. Please keep them coming. Without your questions, there would be no “AskDoc!” Let’s get started!
Hey Doc, how's it going? I want to ask for your help.
So it seems by body decided to remind me I'm not young anymore. I got up from the couch one afternoon and have had this ongoing pain in my left hip since then. I've walked with a limp all weekend. It feels like it slipped out of position or something.
I, too, am in the healthcare field. I work as a physician’s assistant in Internal Medicine, so I might be out of my element here. To give you some more detail, I have pinpoint tenderness along the region of the greater trochanter. Just internal to this is an area that hurts more with internal rotation of my hip. It gets slightly worse with hip flexion.
I’m pretty confident this isn’t internal! I've tried stretching to "pop" it back in but nothing works. Any suggestions? This is embarrassing. LOL.
Old at 33,
Nulma C.
Hey Nulma!
It certainly helps to know your anatomy! You just made this a slam-dunk diagnosis for me. This is virtually all the detail I need to figure this out!
The pinpoint area over your hip is where the muscles that rotate your hip in and out are located. The fact that you have pain when rotating your hip in means you’re placing tension on the muscle that does the opposite movement. When your hip rotates in, you stretch your external hip rotator. This muscle is called the piriformis and the muscle belly is just internal to the greater trochanter. So…it’s the piriformis muscle that is causing your trouble.
I have two recommendations. I would get a softball and put it on the ground. Sit on the softball, positioning it right over the piriformis region. Roll around on it and let your bodyweight apply pressure to the muscle. It will hurt, but it should “hurt good.” Roll around on the ball until you can’t take anymore.
Second, learn how to stretch the piriformis. There are many ways to “skin a cat” so I won’t give you just one way to go about doing this. My suggestion is to go to YouTube and enter “piriformis stretch” into the search box.
Between the ball workout and the stretch, you should be fine! Let me know how that helps. Write me back okay?
Hi,
Can you tell me why I keep having hamstring pain? I have been receiving treatment on them for almost two months now. I’ve tried everything from cold laser therapy to deep tissue massage to acupuncture. I rested it for three weeks straight and with all the work done, nothing seems to make a difference! I am confident in my therapist. She has amazing hands. The trainers at school work really hard for me and I think that they are just as frustrated as I am. I just don’t know what to do.
By the way! I am a sprinter. My main event is the 200-meter dash. I never really had any accident or major precipitating event that I can recall. This is just something that has worsened over time. I feel helpless to the point of depression. Please help.
Desperate Sprinter
Hi there!
Thank you for your detailed statement. Though I can feel your pain as I read, your description is very helpful to me. I will keep this very simple. Unless there is some type of trauma directly to a muscle, never limit your treatment to the area that hurts. Always be willing to look above and below the area of complaint. In your case, you can have the greatest hands on your hamstring and it will not matter if you are not properly diagnosed. This is why it is of great importance that you are accurately diagnosed before treatment. You need to see your doctor for an initial examination. Once you know exactly what problem you’re dealing with, you can more forward without wasting time.
Now, about your situation, it’s an easy one because I see this all the time. There are two main areas that need to be checked when there is a hamstring complaint. One of these areas is your calf region. The gastrocnemius muscles run across the knee joint and overlap the hamstrings. When this muscle is short or restricted, it causes problems and a feeling of “grabbing” on the adjacent hamstrings. Have your trainer assess for gastrocnemius tightness and spend time there if needed.
The other area to check is the gluteal region. The gluteal muscles cover the attachment point of the hamstrings. When the glutes lock up, they also lock down the hamstrings. If your practitioner releases your gluteal muscles, your hamstrings will feel better. Even if you have no issues with your legs, releasing the glutes and calves will always make your hamstring feel better. This is a good place to start!
Be encouraged. As I said before, I have seen this problem many times. Believe it or not, I actually see it more than I see true hamstring strains. You will bounce back from this. With no history of trauma, it’s highly unlikely that you have an actual muscle strain. Even if you did, it would’ve healed by now. You just have to get the right diagnosis so that you don’t waste any more precious time. Let me know how things work out for you. I am confident you will be just fine!
Well, that was pretty fun! I love this stuff! Of course I always wish I had more information. My perception of things is limited to the information you give me, so be careful when taking my recommendations over your own physician who actually examines you regularly. The more information you give me, the more I can help. It helps me to give you the best recommendations when you provide information like age, sex, date of injury, past injuries, and things of that nature. Well, that is all we have time for today folks! Until next week, stay STRONG BEACH!!!
To visit Doc’s website, click here, and buy his book, What I’ve Learned From Your Kids. Email questions to Doc ataskdoc@docdossman.com.
Posts
No comments:
Post a Comment