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  1. #1
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    Brief Medical History Overview

    Age: 28, Female, Presenting Problem Since: 3 years, Symptom Behaviour: constant, Symptoms Worse (24hr Behaviour): N/A, Aggravating Factors:: Kicking with knee extended. Abduction movement. V-sits., Easing Factors:: Active release of iliopsoas and adductors., Investigations: MRI- gluteal tendinopathy identified in same side. Nothing found in adductors at source of pain., No Diabetes, No history of High Blood Pressure, Medications: NSAIDs for back pain (osteoarthritis), No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues, Other Info: History of osteoarthritis and SI joint issue on LHS.

    Major problem / Symptomatic Areas

    Thigh, Quadriceps - Anterior - Left

    Restricted abduction and persistent adductor tearing

    Physical Agents In Rehabilitation
    Dear All,

    I have had an ongoing issue for 3 years where my abduction movement is severely limited on my left side and stretching beyond the limit (only while my knee is in extension) leads to regular tearing.
    I had an MRI scan last week which revealed a gluteal tendinopathy but nothing regarding the adductors/thigh (no scar tissue found as was suspected). The tear always occurs in the same spot (a third of the way down my inner thigh towards the hamstrings). However, I notice that if I press very hard into the top of my adductor longus at the pelvis, I can get a much better range of movement and very little pain while it is depressed.

    What could potentially be going on that didn't show up on the MRI scan?

    Thank you in advance. This has really been troubling me for many years.

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  2. #2
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    Re: Restricted abduction and persistent adductor tearing

    Hi,

    I would challenge you to think of what you are feeling in the leg as a symptom. A sign indicating that the limb and arguably the body has deficiencies.

    I would be looking at what your range of motion deficits are first. So what positions can you not get into. And not just related to the leg.

    I would also look into what loads or forces can the tissues take. So more dynamic loading.

    Once deficits are identified you would then move onto addressing them which would involve, soft tissue management like self myofascial release, specific mobility work (yoga poses etc) and then strengthening work starting with positional holds and slowly graduating to dynamic movements of increasing loads and speeds.

    Let me know if that makes any sense.


  3. #3
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    Re: Restricted abduction and persistent adductor tearing

    Understood. Thank you for your response. So although the adductor is the point of failure, it is unlikely to be the cause?
    In general my flexibility is very good. The only exception is the abduction movement on the side in question (which is approx. half of what it was formerly). The same tightness-to-the-point-of-failure can be experienced in the adductor/hamstring in straight leg hip flexion and opposite hip internal rotation.
    The following have been observed: anterior pelvic tilt, weak gluteals & adductors, tight hamstrings & iliopsoas, SI joint pain and now oedemas in both greater trochanters.


    I have been working on my glute and adductor strength through bridges, squeezes, clams, static holds etc. But I do not understand what is likely to be the primary cause in all of this. I don't seem to be getting anywhere at all with the adductor...


  4. #4
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    Re: Restricted abduction and persistent adductor tearing

    Aircast Airselect Short Boot
    Obviously it is impossible to give specifics in a written exchange. For all we know it well could be a adductor specific problem.

    I would challenge that your flexibility is unlikely to be very good. There will be glaring deficits as you noted already with "tight hamstrings & iliopsoas".

    For example can you assume a full saddle pose, full pidgeon pose, full dragon pose, pancake pose etc etc. Feel free to google for reference.

    If your flexibility is very good however the issue will be load tolerance.

    You need to find a clued on therapist that isn't going to just stick some acupuncture needles on or tape or any other passive therapy.

    Ask around for recommendations in your area. It may require trying many.

    Hope it helps in some way



 
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