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Soft Tissues

Jan 11th, 2014

Gavin Garthwaite asked The Guru for the following Physiotherapy Advice:

Sorry- I have two questions…

Can you explain the ‘sticky’ feel that is felt when massaging a certain muscle. Is this scar tissues, or a knot? Is the best way to treat it using friction work?

Secondly- I have suffered from a Groin strain for nearly a year. After a prolonged spell of rest over the summer it does feel a lot stronger, although I still feel slight discomfort after a football game. My leg regularly ‘click’ on the hip joint and it feels as though my Psoas is weak. Can you give me your expert opinion on your thoughts? How best to treat and exercises you can recommend to strengthen the relevant muscle?

Your help is greatly appreciated.

Kindest regards

Gavin

The Guru Responded:

Hi Gavin
.
For the vast majority of patients, scar tissue is just something that
sits in the imagination of the treating therapist. Sounds great,
sounds potentially dangerous, but is a load of hot air…..
.
Knots are better, only slightly. If you make a muscle contract for
long enough (and so get shorter), the slack has to kept in the muscle
belly itself, rather than changing limb alignment and joint angle.
This is seen with postural muscles that are overused (and due to
something else) such as upper traps, levator scap, rhomboids etc.
.
Friction work deals with the symptom. Give it a rub and it’ll always
feel better BUT if you don’t change why the muscle is being over used,
then 2 hours later it’s back to square one. People need the ability to
move better, so they don’t overuse muscles. If they haven’t been given
ability to move better or choose not too, then the muscle will be
overused….
.
Same thing for your groin – if you’ve rested a strain for a year and
it’s the same then you haven’t got a strain or probably a problem with
the muscle, but you have got an issue elsewhere which is causing the
pain.
.
The lower part of your back moves too much due to stiffness in the
upper part of your back (posture etc). This excessive load lower down
means that the muscles surrounding your pelvis work too hard in an
attempt to stabilise your low back. This increase in effort in the
muscle causes shear and stress rather than stability around a joint.
.
Have a look at the control of a single knee squat on the affected
side. Look at control; not speed or range. You don’t need strength
(yet), but stability, control of movement and the ability to move
better when doing weight bearing, dynamic activities such as footy.
There are no short cuts, but there is treating the cause rather than
chasing the symptoms.

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