Re: Pain in the ...psoas for Tuck-San

April 12, 2004

HI Ed:

I think that's correct. I feel the pain when I lift my knee high. However I

can reduce the pain dramatically if I pull my pelvis backwards while lifting.

I discovered that my adaption to the pain was to use the back muscles to lift

the knee - by tilting the pelvis forwards so that it didn't hurt so much. Now

that action actually causes me pain in the inner thigh, possibly because the

thigh muscles are working harder now and still haven't strengthened enough.

Your description of where the pain is seems accurate.

My understanding is that because it previously hurt to push the hip forwards

while standing up straight, I would keep the hip back and as a result, the

psoas probably shortened and contracted a bit. It stayed that way so long as my

movements were affected by the hip pain.

Now that the hip pain is gone, I am trying to lengthen the psoas again and

get it working normally. I think there's probably some adhesion on the muscle

because if I don't pull the pelvis back when I lift the knee, I feel a pop. When

I apply pressure with my fingers on the muscle while lifting the knee, there

is no pop. That's why I " ve concluded that it's the muscles rubbing over one

another that causes it.

If you look at the muscle anatomy of the inner thigh, you'll see that there

are several layers of muscles overlapping one another and they all need to move

freely and loosely in order for the whole hip joint to function. When one of

them is out of whack, the whole system is compromised. You have to get all of

them working together in order to have normal flexibility in every plane.

I suppose it is possible that the psoas was traumatized by surgery in my

case, but I do have a distinct recollection of when the pain began - it was as I

was getting out of bed for the first time after my first (left) BHR. I was

extending my left leg to get out of bed and the right one kind of stayed behind

on

the bed. As I put my left foot down, I felt the pull in the right thigh, and

it's hurt ever since then. Also I think Ronan Treacy is such a fastidious

surgeon that he wouldn't have done that, and if he had, he would have told me.

At the time I just thought it was the other one saying " Hey, what about me?

It's my turn for surgery. " But since then I've thought it through with the

benefit of my Heller therapist's input and my description above seems to make

more

sense.

I'll take a look in my Pilates book for the exercises to see if I can refer

you to something. However I have a feeling my therapist uses a potpourri of

exercises and frankly I can't remember them from one time to the next.

Des

In a message dated 4/12/2004 4:06:04 PM Pacific Standard Time,

edderksen@... writes:

Des,

- Am I correct that the psoas is important for lifting the knee up

high, especially while stretching the leg?

Is your psoas pain a sharp pain at the top of the thigh, in the fold

near the belly, deep, under the quad?

Do you know a reason why the psoas took so much longer than the other

muscles to get back to normal(if indeed that was the case)?

I read in an article on http://www.totaljoints.info/ that the psoas

tendon runs so close the hip joint that a small protrusion

(prosthesis) could cause irritation although it was rare. It seemed

certainly possible that the psoas would be traumatized by the surgery.

- Like Cindy, I would be interested to know about the spine

stretching exercises that helped you so much.

Have a enjoyable trip.

April 12, 2004