Massage & Bodywork

MAY | JUNE 2019

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3 4 5 With knee and hip flexed, the therapist armlocks the client's leg, as shown above. The therapist distracts, abducts, and gently internally rotates the client's hip to the first restrictive barrier. The client is asked to hip hike against the therapist's resistance to a count of five and relax. Repeat 3–5 times and retest for improved mobility. The therapist's left arm snakes under the client's flexed knees and braces above the opposite knee while the right hand controls the client's ankle. The therapist distracts, adducts, and internally rotates the client's hip by gently pushing on the ankle while lifting with the left arm to the first restrictive barrier. The client hikes the hip to a count of five and relaxes. Repeat 3–5 times and retest for improved mobility. The therapist places his right arm between the client's legs, as shown above. The client gently adducts against the therapist's resistance while slowly bridging and relaxing. Repeat 3–5 times and retest for less FAI pain. peripheral joints, it's best to approach OA from a global viewpoint, which is one of the goals of myoskeletal alignment techniques (MAT). HOW MAT CAN HELP MAT is a great foundation for exercise therapy due to its effect on pain modulation, joint limitations, and muscle hypertonicity. MAT uses graded exposure stretches and gentle articular oscillation maneuvers to optimize joint lubrication and reduce neuromuscular tone—the perfect combo for those suffering with mild to moderate hip pain. Images 3–5 demonstrate an example of a simple but effective femoroacetabular MAT routine for clients presenting with OA pain and limited functional mobility. When performing these techniques, remember that by increasing range of motion in any one cardinal plane you reciprocally increase range in the other two planes. Therefore, if you encounter a resistant or painful barrier, don't bulldoze it. Instead, perform an indirect mobilization technique and retest. For example, if hip flexion and adduction trigger FAI pain, start by decompressing the hip (Image 3) and then gently distract the femur while adding a bit of adduction (Image 4). To help restore pelvic alignment and balance, have the client adduct against your resistance while they slowly do a bridge (Image 5), then retest for less FAI pain. Always drape properly. SUMMARY It's clear hip OA is more than an overuse problem, as seen in athletes like Murray. While clients may worry that exercising with OA could harm their joints and cause more pain, research shows people with this condition can and should exercise. 2 A tailored program that includes a balance of three types of exercises—range of motion, strengthening, and endurance—can help ease OA symptoms and protect joints from further damage. MAT, combined with a comprehensive movement plan to improve joint mobility, muscle strength, and overall physical conditioning, may be the most effective non-drug treatment for reducing pain and improving movement in our OA clients. Notes 1. J. H. Abbott et al., "Manual Therapy, Exercise Therapy, or Both, in Addition to Usual Care, for Osteoarthritis of the Hip or Knee: A Randomized Controlled Trial," Osteoarthritis and Cartilage 21, no. 4 (2013): 525–34. 2. P. Nejati, A. Farzinmehr, and M. Moradi-Lakeh, "The Effect of Exercise Therapy on Knee Osteoarthritis: A Randomized Clinical Trial," Medical Journal of the Islamic Republic of Iran, 29 (2015): 186. Erik Dalton, PhD, is the executive director of the Freedom from Pain Institute. Educated in massage, osteopathy, and Rolfing, he has maintained a practice in Oklahoma City, Oklahoma, for more than three decades. For more information, visit www.erikdalton.com. Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 95

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