Relief From Groin Pain

The Pectineus Muscle And Groin Pain 

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney 

Fall, Glorious Fall

Happy WomanFall is glorious in my book.  I was up in New York a few weeks ago, and the trees were just changing – I was about a week too early for the best colors, but it was still beautiful. The air was crisp and clean, and I loved all the fall decorations.

In Florida we are entering our most wonderful time of year. It’s starting to get cooler, the humidity is going down, and hurricane season is over. Hooray!  It’s great to be outdoors again!

And now that the weather has turned cooler in all parts of the USA, more people are exercising outdoors.  Are you?  Be sure to warm up your muscles before you go running or cycling.

Treating the Muscles That Cause Groin Pain and Impact Walking.

I have a client who had a pain pattern I hadn’t seen before, so it was a challenge to figure out what needs to be treated to get success. We’ll call my client “Bob” although that’s not his real name.

Bob had a shooting pain just to the left of his pubic bone whenever he tried to take a wide step.  As a runner it was definitely causing him issues whenever he tried to take a long step, like while running.

There are so many muscles that are involved in moving your legs so you can walk or run that I won’t be going into them all in this newsletter.  If it’s something you want to explore, please get either of my books by going to https://julstromethod.com/shop/

The Pectineus Muscle And Groin Pain

pectineus muscleThe muscle we’re concerned with today is the Pectineus.

The Pectineus is a small muscle that runs from the front of your pubic bone to the top of the inside of your thigh bone (femur).

It’s one of the large group of muscles called Adductors.  All the Adductors originate on your pubic bone and insert along the length of your femur, all the way to the inside of your knee.  When they contract, they pull your leg in toward midline (like crossing your legs).

However, when they are tight you can’t bring your leg out to the side.  And in the case of the Pectineus, you will have pain and limited range-of-motion moving your leg forward to take a big step.

If you look at the graphic above, consider what would happen if the muscle was so tight that it won’t stretch, and the bone was being pulled forward. You can see that it will pull on both the pubic bone and the top of the thigh bone. The Pectineus muscle is so small that the pain would be in a circle that encompasses both the origination and the insertion of the muscle.

Relief From Groin Pain

That’s what was happening to “Bob.”  First you release the “knots” from the Pectineus muscle, so that it can be stretched. The treatment is easy to explain, but impossible to show in a picture because it just looks like someone lying face down on the floor.  You couldn’t see the ball or where it’s located.

Take the Perfect Ball (or a tennis ball if you don’t have the Perfect Ball) and put it exactly where you see the muscle in the graphic.

Lie down on the floor, on top of the ball.  It should be pressing into the Pectineus muscle and the top of your thigh.  Ease into it because if the Pectineus muscle is tight, it will be really painful.  Just start by pressing gently into the ball and then add more of your body weight as the tension lessens.

To stretch the muscle, you can do an adaptation of the picture to the left.

Stand up straight and put your leg behind you.

For example, if you are stretching your left Pectineus, you can have your left leg back so your right leg is straight and your toe is on the ground, or you can do a more advanced stretch by picking up your leg and putting your foot on a step or a chair.

Be sure to hold on to something secure so you won’t lose your balance and fall.

If you turn your body slightly toward the right, you’ll get an even better stretch.

This treatment and stretch helped “Bob” relieve the pressure and he was able to get back to running again!

Have a happy month, and please feel free to contact me if you have any questions about the instructional program for massage therapists.

Wishing you well,

Julie Donnelly 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Relief From Restless Leg Syndrome

Muscles, Nerves, And Restless Leg Syndrome 

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney 

Never-ending Summer

HotIt is starting to cool off in other parts of the country, but it’s still hot in Florida right now. Sometimes it feels like we have never-ending summer in Florida. Thank heaven for air conditioning!

For those of us who are old enough to remember the days before air conditioning, we are even more grateful for air conditioning.  I remember being pregnant with my son in 1967, when we were living in San Antonio, Texas.  Most people didn’t have air conditioning yet, and we certainly didn’t.  I came to realize why Southerners talk so slow (remember, I’m a New Yorker).  It was so hot we just didn’t talk at all. It took too much effort!

Fortunately, this time of year seems to pass quickly, and we’ll be getting back into cooler weather before we know it.  At least, that’s what I’m telling myself.

Restless Leg Syndrome (RLS)

confusionA reader asked me to talk about RLS this month.  Restless Leg Syndrome is a tricky topic, depending on which expert you read.  The Mayo Clinic said there isn’t a known cause of RLS, but it may be caused by an imbalance of the brain chemical dopamine.  The Mayo Clinic has also said RLS can be related to:

  • Peripheral neuropathy.
  • Iron deficiency.
  • Kidney failure.
  • Spinal cord conditions.

Yes, there isn’t a definitive cause for RLS.

A friend had RLS and told me that when she took iron supplements, and totally avoided flour and sugar that her symptoms disappeared.  Then I read that iron is the worst thing to take for RLS.  Go figure!

In any case, I’m not a doctor or a nutritionist, so I look at the possible muscular cause of RLS.

Muscles, Nerves, And RLS 

The nerves that go to your leg are the sciatic and femoral nerves, which are the continuation of your spinal cord, separating at your lumbar vertebrae to go down both of your legs.

The femoral nerve goes underneath and through your psoas muscle and under your inguinal ligament.  It innervates your anterior/medial thigh muscles. The importance in this pathway will be discussed, but please make note of how the nerve passes underneath the inguinal ligament.

Your sciatic nerve is the largest nerve in the body.  Its pathway is so big that we’ll just say it innervates your buttocks and the rest of your leg and foot that isn’t innervated by the femoral nerve.

After leaving your spine at your low back, these nerves pass under and through some powerful muscles, and this can be a problem when the muscles are tightened by a repetitive strain injury (RSI).  When a muscle contracts it pulls on the insertion point and you move a joint.

As you do something over and over (something as simple as sitting down and staying still for a long period of time) a phenomenon called “muscle memory” causes the muscle to shorten to a contracted length, and you have a problem when you go to move in the opposite direction.

For Example… 

Two muscles, the psoas and iliacus, connect your lumbar vertebrae and pelvis to your upper leg (femur).  When they contract you bend forward (psoas), lift your leg (iliacus) or sit down (both muscles).  When you sit for an extended period of time, muscle memory causes the muscles to change to the shorter length.

When you go to stand up these muscles are too short to easily lengthen enough for you to stand up, and you feel a strain at your low back.  Both your lumbar vertebrae and your pelvis rotate forward and down as the muscles are being strained while they are lengthening.

As the pelvis is rotating forward and down, several things happen that impact the sciatic and femoral nerves.

First the muscles tighten and since the nerves are passing through the muscles, the nerves are “pinched” in the pelvic area.  This can cause the nerves to send impulses to the lower leg and foot.

Next, as I mentioned above, the femoral nerve passes through the psoas muscle and is then directly underneath the inguinal ligament.  As the muscle tightens it presses the nerve up into the inguinal ligament, causing potential damage to the nerve, and also sending impulses to the quadriceps muscles.

As these nerves are impinged and sending impulses to the muscles, the muscle fibers may respond with itching, burning, and twitching.  You are experiencing the results in your thigh, but the cause of the problem is actually deep in your lower pelvic area.

[I realize this description is a bit confusing, and I’m not going into detail here. However if you are interested, or if you have low back pain, I suggest you consider getting my book The 15 Minute Back Pain Solution. This book will explain all of it in detail, and it will show you how to self-treat each muscle that impacts your low back, hips, sciatic nerve, groin, and knees.]

Relief From Restless Leg Syndrome 

Most times the order of treatment isn’t important, but when it comes to the pelvic muscles, and all the related muscles, the order is vital as one muscle can stop the entire treatment protocol from working.  This is why I wrote The 15 Minute Back Pain Solution. It gives you the exact order of treatment, and has photographs of doing each treatment, along with the explanation and a graphic of where that muscle refers pain/numbness.  To try to explain it here would require my putting the book into a newsletter, so that isn’t doable.

Start by treating your anterior thigh muscles. I’m going to show you how to treat just the anterior thigh muscles that can be impacting the femoral nerve.

Use a piece of 1” x 12” PVC pipe to slide (not roll) down your thigh from the very top of your leg to your knee. Cover your entire anterior thigh and out toward the outside of your leg.

Press deeply, it should feel like “hurts so good,” not “I think I’m going to faint!”  You are in control of the pressure so keep it at your tolerance level.

If you feel a bump, that’s a knot (spasm) that is pulling down on your pelvis.  Just stop on it and roll back and forth, trying to break it up.  Keep treating any knots you find in your thigh muscles.

A Good Stretch For Your Psoas Muscle 

Next stretch your psoas muscle. There is a yoga stretch that will help to stretch your psoas muscle, rotate your pelvis back into alignment, and take the pressure off both the sciatic and femoral nerves. The stretch is called the Sphinx.

Lie down with your pelvis firmly resting on the floor.

Put your bent elbows directly under your shoulders as shown in this picture.

Lean back, keeping your pelvis and elbows on the floor.

You are stretching the psoas muscle that is rotating your pelvis.

When you are comfortable doing this stretch, then you can do it standing up:

Put your calves up against the cabinet under your kitchen sink, and your butt gently pressing on the front of the sink.  These must stay still, don’t change the pressure at all or you have moved your pelvis.

Pivot at your lumbar vertebrae, leaning back with your upper back, while keeping your head as shown in the picture.

If you feel increased or decreased pressure on your butt, you have moved your pelvis.  Keep trying until you can lean back without moving your pelvis at all.

This is a start to treating the muscles that may be causing RLS.  Since muscles are the one thing the medical profession doesn’t look at, there’s a good chance this will help you!

Wishing you well,

Julie Donnelly 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Relief From Jaw Pain

A TMJ Story That Has A Happy Ending 

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney 

Summer And The Living Is Easy

good newsAs the song goes: ”…Summertime and the living is e-a-s-y….”  Here in Florida, we know that the living is easy because it’s so hot who wants to be doing anything except either sitting in the shade, or inside in the air conditioning.  Personally, I don’t think this summer was so bad, especially the evenings, but then, I really hate the cold so maybe my opinion is biased.

To stay in alignment with “living is easy,” I’m taking the advice of a few experts who teach easy ways to stay calm, motivated, and happy.  I’m taking a 30-day break from the news.  It’s so much in my face lately that it’s really affecting me in a very negative way.  I am going on a “news fast” for 30 days. Absolutely no negative news of any kind for a full month.  I’m surrounded by news all day so it’s a challenge, but I’ve found a great substitute:  www.GoodNewsNetwork.org.  Their mission is to be an antidote to the barrage of negativity experienced in the mainstream media.

This month I had several requests to explain how muscles can be a primary cause of TMJ.  The initials “TMJ” stand for Temporal Mandibular Joint.  Basically, it’s the hinge that enables you to open your mouth and chew.  The problem is when it is pulled out of alignment you have jaw pain. You may also have some painful clicking in the area that is behind your last molars, the location of the joint.

A TMJ Story That Has A Happy Ending

tmj painAbout 15 years ago I was seeing clients in my office, which was located in Dr. Zev Cohen’s medical office.  Frequently Dr. Cohen would ask me to look at one of his patients because he felt their problem was muscular, and each time it was being caused by tight muscles.  He liked the results we were achieving, and I was happy to be a valuable part of his Internal Medicine team.

On day a young woman, around 32 YO, came in on a Sunday because she had forgotten to have her own doctor fill in a form she needed in order to have surgery performed the next day. Dr. Cohen was open on Sundays (closed on Saturday) so she came to get surgical clearance. I just happened to be there doing some work in my office, but not to see clients.

Dr. Cohen asked the woman why she needed surgery and she explained that her jaw was locked tight, and the Oral surgeon was going to sever the masseter muscle.  That simple-sounding surgery has a serious side-effect….you can’t close your mouth!  She would have walked around with her mouth hanging open for the rest of her life!  Plus, when your mouth is open, you drool. That would have been her life if she hadn’t forgotten to get that form signed!

When Dr. Cohen looked at her masseter muscle, he found it felt like she had stuffed her cheeks with nuts.  There were so many spasms that it was locking her back teeth together and she couldn’t open her mouth.  She didn’t need surgery, she needed to untie the knots in her masseter muscle.

Since I was there, Dr. Cohen had me work on this muscle, and then as always, I showed her how to do it.  It took only about 15 painful minutes to release all the spasms.  When I was finished, I had her sit up and I showed her what to do.  At the very end I had her pressing on both sides of her jaw, and slowly open her mouth.  She was shocked to see that she could do it.

Then I had her take her hands away and just open her mouth.  We both started to cry when she opened her mouth all the way without any pain.  She was saved from a surgery that would have had a lifetime of drooling and dryness.

I don’t know why her doctor, or the oral surgeon didn’t know to tell her to do this, but it’s something I try to share with as many people as possible.  I hope you will pass this newsletter along since you may save someone from the same potential surgery.

The Masseter Muscle

tmj pain relief muscleThe masseter muscle (circled in red) connects your cheekbone to your jawbone.  When it contracts you chew your food or clench your teeth.

If you put your flat fingers (fingerprints) on your cheeks and then clench, you will feel your masseter contract.

If you chew gum or clench your teeth frequently the muscle contracts and then shortens.  The problem is, when it is shortened and you try to open your mouth to yawn or put food into your mouth, the muscle won’t lengthen to allow them movement.

If one side is tighter than the other side, your jaw will pull toward the tight side, “click” and hurt when you try to open your mouth.  This is the common symptom of TMJ.  If both sides are shortened, you won’t be able to open your mouth fully. This is what was happening to the woman I mentioned above.

Relief From Jaw Pain

tmj pain treatment reliefPress your three fingers into the masseter muscle on both sides of your jaw, but only use pressure on one side.

Press as deeply as you can tolerate and hold the pressure for 5-10 seconds.  Lighten up the pressure on that side and repeat on the opposite side.

Do this alternating press/release all over the muscle. Continue alternating, and eventually moving along the entire length of the muscle until you have covered it from your cheek bone to your jawbone.

Finally, press both sides at the same time and slowly open your mouth as wide as possible.  Slowly close your mouth, and then repeat this stretch 3-4 times.

Do this as often as needed to get total relief.  Since this problem happens because of a repetitive movement, it may return.  Just do the treatment before it becomes a problem, and the situation will be eased.

Wishing you well,

Julie Donnelly 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Can Tight Muscles Make You Pigeon Toed?

Treatment To Straighten Your Ankle 

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney 

Happy July

sunThings are hot here in Sarasota – today the temperature was 95 degrees in the sun. Fortunately, my office is in the shade. On the plus side it rained, and my garden was dancing with delight.

I’m happy to say I taught a live, in-person class last weekend. It came together quickly, so there were only a few massage therapists attending, each bringing their own model. I’m so happy to get back to teaching live classes again. Zoom gets really old (as I imagine a lot of you already agree). Later this month things ramp up and I’m heading to the Florida State Massage Therapy Association Convention in St. Augustine. I’ll be teaching there too, and happily communicating with a lot of massage therapists.

My therapy practice is back to normal again. Most people (including me) have had both shots. And if someone hasn’t, I just ask them to wear a mask. Not the worst thing in the world, and much better than being in pain. I’ve missed my clients and I look forward to seeing them again.

Meanwhile, I’ve been seeing many clients who are in pain, and I’m pleased to say, the results have been really excellent. There is one person who stands out because she had a condition I hadn’t seen before, or at least I don’t remember seeing before.

A Turned-In Ankle

My client was actually in to see me for a totally different condition, but while I was working on her I noticed that her left foot was turned in.

I thought it might be a bone/structural problem, but when I took my hand, I was able to make her ankle go almost straight. As a result, I knew it was muscular, and therefore there was a good chance treating the muscle could make a big difference.

It turns out her foot had been turned in for a very long time, not debilitating, but more annoying. She didn’t know what could have caused it, but my guess was she sprained her ankle at some time in the past. She said it had been sprained years earlier.

One of the interesting facts about a muscle that is sprain, or otherwise repetitively strained muscle, is it can shorten to that new length and stay that way for years and years. I had a client in New York who sprained his ankle in 1964, and I met him in 2005. The muscles were so tight that he walked as if his ankle was fused, there was absolutely no ankle movement at all. It turned out to just be severely tightened muscles holding his ankle firm, preventing the joint from moving in any direction. It took a lot of treatments, and him doing self-treatments, but we got his ankle back to normal even after all those years!

Back to my Sarasota client……

The muscles involved ended up being the Tibialis Anterior and Extensor Hallucis Longus. Both muscles originate on the front of your lower leg.

Both muscles invert your foot (turn it in toward midline) so, in this case, her left toes were pointing toward her right arch, as shown in the picture above.

Treatment To Straighten The Ankle

The self-treatment for these muscles is easy, but it can be painful at about the point where you see the ball in the picture to the left, and again closer to the bottom of your ankle.

Just put the ball to the outside of your shinbone and press down, moving your leg so the ball is rolling down toward your ankle. You are actually making the Tibialis Anterior muscle a little longer as you press out the knots in the muscle fibers.

Curl your toes as shown if you feel like your arch is going to cramp.

In the next photo I’m showing the right ankle in pain and working with my left hand.

 

Sit with your sore right leg crossed over your left leg. It helps if you have your right ankle on top of your left knee (I couldn’t do it because I’m taking my own picture and couldn’t get the right angle).

 

Press your left fingers as deeply into the Extensor Hallucis Longus muscle as you can. If your right ankle is on top of your left knee, you will be able to use two hands to do the treatment. Just put your fingers on top of each other to get more pressure.

 

The Results

I treated all the muscles of the lower leg, paying special attention to the two muscles mentioned. I’m happy to say that when I finished and she stood up, her feet were almost straight. With more self-treatment every day, her foot will straighten out.

 

My client was originally here on June 11th, and as an update, she came in today – July 1st – and her foot looked just fine. She continued to do the self-treatments I taught her, and we are happy to say, the problem is solved!

 

I love what I do for a living, it really makes a difference in people’s lives. Sometimes in small ways, and many times in really big ways.

Wishing you well,

Julie Donnelly

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Health Tips From The Professor