Issue link: https://www.massageandbodyworkdigital.com/i/81195
6 The "B" (external rotation) variation of the Push Broom Technique. Image courtesy Advanced- Trainings.com. Watch Til Luchau's technique videos and read his past Myofascial Techniques articles in Massage & Bodywork's digital edition. The link is available at Massageandbodywork. com, at ABMP.com, and on Advanced-Trainings. com's FaceBook page. we rotate the femur so that the lower leg is high. By using the grip and position shown in Image 7, gently take the femur to its soft end-range of internal rotation; hold and wait for tissue response. Remember to keep the hip flexed at least 90 degrees (that is, keep the femur perpendicular to the body, or even a little past this position toward the head). As in the "B" variation, be mindful to avoid strain or discomfort on the knee. Once you've completed these three Push Broom variations on one leg, return it to anatomical position. Clients will often comment that this leg feels significantly longer and freer than the one you haven't worked yet. Repeat these techniques with the other leg to balance left and right sides. OTHER CONSIDERATIONS Although we've described these three variations as hip-joint techniques, they also affect the ligamentous adaptability of the pelvic girdle itself, mobilizing the sacroiliac joints by addressing sacrotuberous, sacrospinous, and sacroiliac ligament restrictions, and balancing the torsion and flaring movements of the ilia on the sacrum. To drape these techniques, simply grasp the leg through the top sheet in variation "A," and move the sheet together with the leg. Alternatively, especially for the "B" and "C" variations, the leg can be out from under the edge of the drape, with the sheet gathered around the thigh so as to give a sense of security and privacy to the client. When applying the techniques described here, it is important that they do not cause pain. In addition to soft-tissue restrictions to mobility, there can be boney restrictions as well, such as the shape or orientation of the acetabula or femoral ABMPtv.com "Working with Hip Mobility" 116 massage & bodywork march/april 2012 heads. These can cause pain or irritation when pushed to their physiologic limit. Femoral acetabular impingement (FAI) syndrome is a painful restriction of hip movement caused by abnormal contact between the femur and the rim of the acetabulum, probably due to both genetic and usage factors. Although often addressed surgically, techniques that increase mobility are also effective in managing FAI pain, though pushing a stretch too aggressively can aggravate this condition. WHAT ABOUT HIP REPLACEMENTS? It is likely that maintaining balanced hip mobility can help prevent or ameliorate the joint pain, degeneration, or arthritic conditions that if otherwise unaddressed, can lead to hip replacement (Image 8) or resurfacing. If your client has had hip replacement surgery, special considerations may apply to using these techniques. Hip replacement surgery involves cutting through tissues and dislocating the joint being replaced, either posteriorly or anteriorly, depending on the type of surgery. This can leave the hip with less support in the direction of the surgical dislocation, at least during recovery. (To learn more about the procedures involved in a posterior replacement, I recommend checking out Edheads's interactive hip surgery simulator at www.edheads.org/ activities/hip. The squeamish need not be concerned—the animated procedures keep it all neat and tidy, unlike real posterior hip surgeries, which can appear downright gory and brutal to the uninitiated.) Different types of hip surgeries have different movement restrictions associated with their recovery period. Surgeons also differ widely in their recommended movement restrictions after surgery. In a recent informal survey of hip surgeons' recommendations to yoga teachers, a third of surgeons responding said they required no movement restrictions