ProActionClinic

ProActionClinic a mené plusieurs années de recherches et de synthèse de nombreux travaux scientifiques et a mis au point le coussin extensit.

Extensit est la bases d’une nouvelle stratégie d’approche des troubles posturaux et des maux de dos qui y sont probablement liés.

 


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LOW BACK, HIP, GROIN, KNEE PAIN AND ILIOPSOAS       MUSCLES : WHAT DO WE KNOW ?

 

« Although  ipsilateral psoas activity is consistent with the psoas being a hip flexor, contralateral activity is not. The most simplest explanation of the pattern found is that the psoas is bilaterally recruited to stabilize the lumbar spine, probably in the frontal plane. » ([1])

« The 2 anatomically different muscles of the iliopsoas complex were shown to have individual and task-specific activation patterns depending on the particular demands for stability and movement at the lumbar spine, pelvis and hip. »([2])

« Low back pain (LBP)  is a common complaint among sport practice. Symptoms ultimately can resolved when some are treated for internal  snapping hip syndrome which is a painful lesion of the iliopsoas and other findings  suggest that individuals with a primary complaint of LBP  but with hip impairments may benefit from treating vertebral column to reduce hip impairments. » ([3])([4])

« For patients presenting to a spine surgeon's clinic for LBP, up to 25% of patients may have significant pain contribution from the hip or SI joints. Clinicians should consider evaluating for unilateral asymmetry in range of motion in the hip in patients with low back pain. The presence of such asymmetry in patients with low back pain may help identify those with sacroiliac joint dysfunction. » ([5])([6])([7])

« Current physiotherapy practice is often based on localized spine stabilizing muscle exercises; most attention has been focused on transversus abdominus and multifidus with relatively little on psoas. The evidence of coexisting atrophy of psoas and multifidus suggests that a future area for study should be selective exercise training of psoas, which is less commonly used in clinical practice. »([8])

Other articles show influence of iliopsoas muscles on  hip and groin pain([9])([10]) ; also, knee and hip ranges of motion related to iliopsoas muscles and hamstring have been put into an evidence : knee flexum is correlated with shortening of hamstring and simultaneous iliopsoas shortening as well.([11])

For these reasons we suggest treatment of low back, hip, groin and knee pain to be combined with iliopsoas stretching.

Unfortunately, stretching  iliopsoas muscles is not easy ; proposed exercises show often no benefit or are unperfectly executed and, indeed, maintaining stretching position for an adequate  time is often uncomfortable and consequently have no efficacy.

The Extensit pad induces a posture allowing a gradual, gentle, painless stretching and with programmable duration.
The patient may remain clothed, removing the belt. Supine, the sacrum is maintained by the nose of the pad, the column is extended, so the two hip bones and the coxofemoral joints gently go down : the iliopsoas muscles stretch slowly.
And especially : this stretching is bilateral.

Extensit pad can be used in complement with  other medical treatment : see scientific studies and  speak to your therapist !

 


[1] Hu H1Meijer OGvan Dieën JHHodges PWBruijn SMStrijers RLNanayakkara PWvan Royen BJWu WHXia C. Is the psoas a hip flexor in the active straight leg raise? Eur Spine J. 2011 May;20(5):759-65. doi: 10.1007/s00586-010-1508-5.

[2] Andersson E1Oddsson LGrundström HThorstensson AThe role of the psoas and iliacus muscles for stability and movement of the lumbar spine, pelvis and hip. Scand J Med Sci Sports. 1995 Feb;5(1):10-6.

[3]Little TL, Mansoor J. Low back pain associated with internal snapping hip syndrome in a competitive cyclist.. Br J Sports Med. 2008 Apr;42(4):308-9; discussion 309.

[4] Burns SA, Mintken PE, Austin GPClinical decision making in a patient with secondary hip-spine syndrome. Physiother Theory Pract. 2011 Jul;27(5):384-97. doi: 10.3109/09593985.2010.509382.

[5]Sembrano JN, Polly DW Jr.How often is low back pain not coming from the back? Spine (Phila Pa 1976). 2009 Jan 1;34(1):E27-32. doi: 10.1097/BRS.0b013e31818b8882.

[6] Cibulka MT, Sinacore DR, Cromer GS, Delitto A.Unilateral hip rotation range of motion asymmetry in patients with sacroiliac joint regional pain. Spine (Phila Pa 1976). 1998 May 1;23(9):1009-15.

[7] Cibulka MT.Low back pain and its relation to the hip and foot. J Orthop Sports Phys Ther. 1999 Oct;29(10):595-601.

[8] Barker KL1Shamley DRJackson D. Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability. Spine (Phila Pa 1976). 2004 Nov 15;29(22):E515-9.

[9] Janzen DL, Partridge E, Logan PM, Connell DG, Duncan CP. The snapping hip: clinical and imaging findings in transient subluxation of the iliopsoas tendon. Can Assoc Radiol J. 1996 Jun;47(3):202-8.

Shabshin N, Rosenberg ZS, Cavalcanti CF. MR imaging of iliopsoas musculotendinous injuries. Magn Reson Imaging Clin N Am. 2005 Nov;13(4):705-16.

Blankenbaker DG, Tuite MJ The painful hip: new concepts. Skeletal Radiol. 2006 Jun;35(6):352-70.

Blankenbaker DG, Tuite MJ. Iliopsoas musculotendinous unit. Semin Musculoskelet Radiol. 2008 Mar;12(1):13-27.

[10] Taylor GR1Clarke NM. Surgical release of the 'snapping iliopsoas tendon'. J Bone Joint Surg Br. 1995 Nov;77(6):881-3.

[11] Rhie TY1, Sung KHPark MSLee KMChung CY. Hamstring and psoas length of crouch gait in cerebral palsy: a comparison with induced crouch gait in age- and sex-matched controls J Neuroeng Rehabil. 2013 Jan 30;10:10. doi: 10.1186/1743-0003-10-10.

 

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