Hamstring strain due to Glute max late firing : Part 2

Read part 1 if you have missed…….

What can be the different diagnosis?

1 )Sciatic nerve entrapment
2)Gluteus trigger point
3) Trochetric bursitis
4) Piriformis syndrome

Here we have explained about trochentric bursitis between gluteal nerve affection relationships:

When a patient preset a complaint of pain while lying on one side , the therapist should suspect trochanteric bursitis. However , if the pain frequency is altered in the absence of hip movement, one should suspect superior gluteal nerve problems in SI joint dysfunction.

Inferior gluteal nerve pain is one of the most common incorrectly assessed in pain practices. When usually SI problems the inferior gluteal nerve refers pain into the gluteus maximus. The reason for this , gluteal nerve locates anterior side of sacrum . This irritation is commonly treated as piriformis syndrome. Beating on the piriformis, particularly the muscle belly, will cause even greater irritation of the inferior gluteal nerve.

Frequently, this type of arthrokinetic dysfunction is so intense that it excites alpha and gamma gain in surrounding muscles causing sympathetic spasm and involuntary tightness in all the hip extensors and abductors. The spasm deep into the SI and lumbar joint capsules . This is associate with hip and back muscles. Which become inflamed and are subjected to increased accumulations of waste products at the injured site.

Hence , The brain continues to cover the area with spasmodic tissue to protect sensitive nerve structures. This process only serves to further shorten the lumbopelvic connective tissues which often creating tissue micro-tearing and increased inflammation.

The brain attempts to prevent excessive movement by forming

[restrict]dense collagen adhesions or knots that encase and “cast” the muscle. Because the brain fears the muscle itself may be damaged, it tries to protect it…much like a doctor would when casting a broken arm.

How this impact on clinical practice ?

After reading this post . You must have many thoughts for this diagnosis but we provide the guideline so you can impliment in your clinical practice.

Running is a frequent cause of pain in the lower extremity. To treat pain related to running therapist should consider what can be done to change amount of stress being loaded on affected tissue. Another way to change the recruitment pattern of muscles and this post will help you to find your answer.

Release the tight muscles as per your assessment and activate in proper recruitment pattern . Finally , When you find tight hamstring think for gluteus . Depending on pain perception therapist should find exact cause of pathology.

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