Massage patients seek help to relieve their pain caused by advanced and severe stages of osteoarthritis. What can be done with those patients? Which techniques and muscles should we focus on to help them have a better quality of life in between treatments and while they are waiting to get arthroplasty of their hip. Here is an example of what works for some patients.
Client Prone or side-lying:
1. Bilateral Quadratus Lumborum release – Patients suffering from severe to advanced osteoarthritis will limp and show muscle tone and strength imbalances. Your treatment goal with this muscle is to reduce and balance the tone between both QL muscles.
2. Bilateral Erector spinae release – focus on elongating the muscle by pressing/stripping caudally against the sacrum, same reasoning as the QL muscle. Pressing caudally will decompress the lumbar spine and help with pain in this region.
3. Affected Gluteus Medius – focus on moving the Gluteus Medius femoral attachment away from the greater trochanter. The stroke direction away from the joint and the femur will decompress the hip joint and provide some relief.
4. Quadratus Femoris release – focus on elongating/stripping the tendon/belly away from the greater trochanter. It is an excellent place to ensure you are scooping the muscle. Normal muscle tone will reduce hip irritability and inflammation.
5. Iliacus release – release the tone of this muscle by pressing laterally against the iliac fossa releasing this tight muscle. This technique will help reduce the muscle tone, open the hip, and decompress the aching joint. Patients love the effect of the release on the hip joint.
6. Rectus Femoris release – muscle approximation technique works great to reduce the tone of this muscle and create an anterior opening of the hip joint. Make sure to include the proximal portion of the muscle as this is where patients have pain.
7. Tensor Fascia Latae – patients with OA tend to overuse this muscle in compensation. Ischemic compression on the iliac crest attachment or eccentric elongation is an effective technique to reduce hypertonicity and pain.
8. Hamstring – focus on muscular attachments on the ischial tuberosity and the tendon portions of the semitendinosus, semimembranosus, and biceps femoris above and below the knee, as well as including the muscle belly and its junctions. You will have to adapt your pressure to get the proper muscle response depending on where you are on the muscles.
Patients waiting to replace their hip will show different but similar symptoms. Carefully identify their needs and treat them with purpose. Join our SFH Orthopedic Massage Certification program to learn more about this.
Suppose you want to learn more about treating patients with OA or any other musculoskeletal conditions. In that case, you can join us by signing up for the 4-day certification program or breaking it into two bundles.
This post was written by Dominique Hoppe