Wednesday 15 September 2010

Finding the culprit

Yesterday's physio session at Ox city after the game revealed a new lesson after discussion with Leigh.

Player comes in complaining of tightness in anterior proximal thigh.

Q. Which muscle is it?

Process: Think what's likely to be tight in footballers? Running. What muscles originate from that area?

A. Narrowed it down to rec fem and sartorius. You had to palpate deep but resisted isometric strength test for sartorius came out on top. Resisted hip flexion did not.

Saturday 4 September 2010

The process of elimination!

I was helping out at Ox city footy club again earlier this week and we came across an acute adductor strain. When trying to diagnose which adductor muscle it was I was given a handy tip by Leigh:

"it's easier to cross off all the one's it's not than try to immediately pick which one it is"

Turned out to be adductor magnus after I'd originally guessed gracilis. When I thought about it, you could quickly cross off pectineus and brevis because they're only one joint muscles and much higher up than where the patient was complaining. Longus potentially but the magnus 2 heads:

Oblique head
ORIGIN: inferior ramus of pubis & ischial ramus
INSERTION: gluteal tuberosity, linea aspera, proximal supracondylar line of femur

Vertical head (hamstring head)
ORIGIN: ischial tuberosity
INSERTION: adductor tubercle

Remember that anatomically speaking the oblique head FLEXES & ADDUCTS the thigh @ hip
(much like pectineus) and the vertical head EXTENDS thigh at hip (like a hamstring!)

The important thing to remember though is that these muscles work differently in function, but that's for another day.