Hi Mukunda
posting my question and your answer to the forum.
Q)
A lady comes to my class who has tibial torsion. She asked if this is why
her hamstrings are tight. Considering that the hamstrings wrap around the knee I thought that it could make the hamstrings feel tight in forward bend but I said that working to stretch them should not cause any problems in the knee as long as she continues to keep the quads strong and makes sure she is not twisting the knee in a way that is not aligned for her. Does that sound about right?
A)
OK is unlikely to cause any other problems is correct answer.
Q)
The other question is about Pam. She came up to LA with her daughter Annalee who had a bad back.
Pam cannot move into Gomukhasana very far. When she tries to come into the asana she feels a “painful stretch” in her inner left thigh. It does not matter which knee is on the top.
A)
this cannot be stretch but must be adductor contraction. suggest checking out eagle and see if it is there too. if so then is adductor issue. if not then is hip flexor issue.
Q)
However it is affected by how high she holds the knee and how much she rounds her back. If she sits up straight the pain is less if she rounds her back it is worse (lumbar extension, spinal flexion). If she lets her knee drop so less hip flexion, then the pain is worse. If she supports the weight of her leg with her hand bringing the knee towards the chest the pain is less.
A)
sounds like weak adductors when in full hip flexion.
Q)
She feels the same sensation when put into the psoas MT position. attepting to do the MT increases the feeling of the painful stretch. Pain therefore weak psoas?
A)
could be have her point to reaction and find out could be pectineus.
Q)
Coming into the position for sartorius test she also feels it but the test
does not make it feel worse. The area she points to is the valley next to the gracilis that we look for during the psoas test.
The position of the leg in Gomukhasana requires the psoas to bring the leg into ext rot and adduction and the lumbar extension/ flexion would relate to the psoas. Her lunges are deep so I don?t think the psoas is tight.
A)
deep lunge is more likely hamstrings or quadricepts stretch not psoas. unless legs are placed wider than pelvis.
Q)
However, I?m not sure it is the psoas as the pain continues down the medial thigh about for about 4 inches starting from the groin. The psoas would not extend that far down the thigh would it?
A)
no so is more likely to be an adjacent adductor.
Q)
I have started to have her strengthen her hip adductors, which are weak, so will see how that goes. I thought it may be due to weakness in the adductors but not sure why the rounding of the back would make much difference.
A)
it takes the psoas out of the picture. the adductors all interact with with psoas.
Q)
Do you think it is a weak psoas, if not what do you think it is?
Since Mukunda’s response i discoverd that Pam was perorming a movement in Pilates that was painful. A couple of weeks have past resting the hip adductors and how we are starting to strenghten again. She feels much improvemnet
Max