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106 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 6 technique MYOFASCIAL TECHNIQUES Working with the Hip Joint By Til Luchau As anyone with hip pain can confirm, when the hip joint does not move easily, all manner of troubles ensue. For example, walking is more arduous, and since the average person take more than 5,000 steps per day, even a little difficulty or discomfort in each step will build through the day, dragging on the walker's body, motivation, and mood. 1 Hip joint discomfort will take the fun out of stair climbing; make getting into or out of a bed, chair, or vehicle difficult; and can make bending, side-lying, tying shoes, and many everyday movements unappealing, uncomfortable, or even unbearable. The Push Broom Sequence (from "Working with Hip Mobility," Massage & Bodywork, March/April 2012, page 114) is ideal preparation for working with the hip joint itself, as it addresses hip flexion, abduction, external rotation, and internal rotation limitations, all of which have been correlated with low-back pain. Image courtesy 1 Stiff or painful hips have far-reaching effects on the rest of the body's function, as well. Back pain is more common in those who lack hip joint mobility. 2 An easy, balanced posture, and the benefits this brings, also depends on a mobile hip joint, which may be one reason why Ida Rolf, PhD, the originator of Rolfing structural integration, called the hip joint "the joint that determines symmetry." 3 The hip joint's ball-and-socket structure allows it a great deal of potential mobility, second only to that of the shoulder. 4 In this column (and in Volume 1 of Advanced Myofascial Techniques, Handspring Publishing, 2015), we discussed techniques for the larger myofascial structures that can limit hip joint mobility, such as the Push Broom sequence (Image 1). It is also worthwhile to pay attention to the hip joint itself. Once the bigger structures of the hip have been addressed, hands-on work with the hip joint can help address mobility restrictions or pain related to the deep connective tissues that surround the hip joint, such as the iliofemoral ligaments (Image 2), said to be the strongest ligaments in the body; 5 the hip's joint capsule and surrounding bursa; the labrum and synovial membrane (Image 3); and the joint's articular surfaces.

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