Bursitis of the hip causes heaps of pain in the region.  A Bursa is a sac of Synovial Fluid that acts to reduce friction between surfaces, and this is where the problems originate.  The amount of fluid in the bursa increases and thickens, restricting movement and causing masses of inflammation.

The major bursae are found around and near the large joints including the shoulders and hips as well as the elbows and the knees.  An inflamed bursa is known as “Bursitis.”
Bursitis is not a young person’s problem and it is more common in women. Anti-inflammatory medication may… ease the pain, but this doesn’t treat the cause.

So what’s going on?
Around the hip, there are several bursae that will cause stiffness and pain around the hip joint, groin as well as in and around the Glutes.

The Trochanteric Bursa is located on the side of the hip.  It’s usually the one to become inflamed and is separated from the actual hip joint by tissue matter and bone.   Once it becomes inflamed, it’s the cause of pain around the bony projection on the side of the hip.  This is the one that will give you the most grief.

As well as local pain in this region, Trochanteric Bursitis will be the cause of pain down the outer thigh along the Iliotibial Band (aka ITB), the bum, and even into the groin.

The Ischial Bursa is located in the Gluteal region or the bum.   It can cause dull pain in this area that is most noticeable ascending stairs.  Pain often appears after sitting on hard surfaces for a while.

Another Bursa found in the hip is the Iliopsoas Bursa.  This Bursa will cause pain to the thigh and groin areas as well.

Symptoms of Trochanteric Bursitis.

Trochanteric Bursitis and causes extreme tenderness on the outer hip.  The pain will make it difficult to sleep on the affected side.

There will also be a burning painful sensation on the outer part of the thigh and into the groin.

Walking and going up stairs will tend to exacerbate the condition as will trying to perform squats.  The area will suddenly go weak also.

Sitting cross legged is difficult and applying pressure to the Trochanteric Bursa causes pain.

Hip Bursitis is sometimes referred to as Frozen Hip, and is is a condition that sneaks up on you over a period of time.  You’ll notice, for instance, that as you walk, you’ve begun to feel a slight pain in the hip.  This pain will get worse over time.  It can be the result of an injury like a fall, so a long time ago you probably don’t even remember it.

The stiffness in the region is an overreaction of the hip joint to counteract the inflammation.  Once established, this inflammation spreads into other soft-tissues and causes swelling in other bursae.

Cortisone injections are often tried.  It is usual to have up to four injections.  These may give brief periods of pain relief, but mostly, they seem to give only a few days or weeks of symbolic respite.  Cortisone, which is a steroid, is a crystalline substance and is injected into the joint capsule.  The best remedy for Hip Bursitis is Drug Free!

A massage based treatment works.

The body and the brain is tricked into healing itself by addressing the two main components of the problem … pain and stiffness. Initially the aim is to significantly reduce the pain by treating the swelling around various  tendons.

Following this, the technique moves on to rapidly ‘thaw’ and improve the range of  motion by stimulating a unique sequence of reflexes hidden within the muscles.  One reflex is triggered against another in sequence and the hip is not forced.  Instead it’s kept still whilst applying the pressure.

Patients treated in this massage based technique will notice a definite improvement with each treatment session.  These should be twice a week for twenty to thirty minutes a session and complete relief should be within twelve weeks.

Hip Bursitis can be overcome without drugs or surgery.

When dealing with patients, as Therapists,we need to view the body as a whole. Our perspective should be modified to incorporate a complete picture from head to toe including an appreciation of its component parts.

By becoming aware of our own posture, and of ways to correct it, we are often able to give advice to all those who are open to receive it.

Posture’ means simply position or alignment of body-parts.  It means:

• Body-alignment that favours function.
• Position that requires the least muscular work to maintain, and which puts the least strain on muscles, ligaments and bones.
• Keeping the body’s center of gravity over its base.

Good posture in standing position, for example, means head and chest held high, chin, abdomen and buttocks pulled in, knees bent slightly and feet planted firmly on the ground slightly apart.

Thanks to gravity, the only way the body can be kept upright is through muscles exerting a continuous pull on the bones in the opposite direction to gravity.

The muscles are able to do that thanks to their property of tonicity.

Tonicity or muscle-tone refers to the constant readiness of the muscles to react.  Our muscles are never completely at rest.  They can lose their tone through illness, old age, accident and lack of exercise, and become flabby.

Massage is an excellent way to restore muscle-tone.

Effects of Bad Posture:

• Poor posture throws more work on the muscles to counteract the pull of gravity and therefore hastens fatigue.
• It puts more strain on ligaments… more abnormal strain on bones… and could lead to deformities (e.g. spinal misalignments).
• Bad posture interferes with respiration and heart action.  It can even diminish the feeling of self-confidence.  You’ll probably start feeling like a dag and your quality of life heads south.

Ideal Plumb Alignment:

If we were to drop a line down the side of the body and line it up with the Lateral Malleolus (aka ankle bone), on the way up, it should pass slightly to the front of the midline of the knee.
Progressing higher, it should pass through the centre of the hip joint… higher and through the shoulder joint and through the lobe of the ear.
Slightly posterior to the apex of the normal surface.

Muscle Role In Posture:

Mans basic instinct is to prevent himself falling forward, consequently his muscle maintain the original stance.

The muscles that hold man erect against gravity are called postural muscles.
These muscles have a majority of slow twitch (red) muscle fibres, which can hold a contraction for a long time before fatiguing. If posture is not balanced, postural muscles are required to function more like ligaments and bones. Postural muscles tend to shorten and become hypertonic when under strain.

In contrast the phasic muscles, which have a majority of fast, twitch (white) muscle fibres and will tire out fast. It is more common to find muscular tendinous junction problems in phasic muscles. The four most common problems are micro tearing of the bursitis. Phasic muscles will weaken in response to postural muscle shortening. Phasic muscle can become hypertonic. This almost always results from some sort of repetitive behaviour and is a common problem in athletes.

Imbalance between these muscles leads to postural abnormalities, which need to be corrected by an exercise program that stretchs thePpostural muscles and strengthens the Phasic muscles.

Military Type Posture:

Many people try to solve their slouching problem by telling themselves to “Stand Up Straight!” … and if they didn’t correct themselves, their parents or teachers did.  These people take on a military-style posture. But in reality, military-style posture causes just as many problems as slouching.

The phasic muscles are purposely being used to maintain the military-style posture and these muscles will fatigue quickly. This is why when most slouchers try to correct their posture they can only maintain the “correct” posture for a few minutes and then they collapse back into their comfortable slouch.

In this ‘military type’ position, the chest is elevated and the pelvis is tilted forward putting the rectus abdominis in a somewhat elongated position. The lower back and the hip flexor muscles are in a shortened position. Due to the anterior pelvic tilt, the hamstrings are in a slightly longer position than in ideal alignment.

Although this posture is not one of the four main types of postural alignment, the Military type posture can occasionally be observed.

With  this “military type” position, the chest is elevated and the pelvis is tilted forward putting the rectus abdominis in a somewhat elongated position. The lower back and the hip flexor muscles are in a shortened position.

It is characterised by an increased curve in the lumbar spine of lower back and an anterior pelvic tilt.

The client shows a posture in which the chest is pushed forward.

Kyphosis Posture:

This image shows the typical posture of someone with an increased Thorax (Kyphosis) and an hyper extended lower back (Lordosis).

This position places stretch on the anterior hip joint ligaments, the one-joint hip flexor muscles and the external oblique abdominal muscles. These muscle groups usually show stretch – weakness. The lower back and hamstring muscles are likely to be strong and somewhat short. In the upper trunk, the opposite conditions prevail. The upper back muscles show stretch ‘96 weakness and the upper abdominals are likely to be strong.

Kyphosis is usually associated with an increase curve of the thoracic spine. Along with this, a slightly posterior pelvic tilt is seen along with a reduced lumber curve and a forward head position. The client will show a hunched over posture with a depressed chest.

Lordosis:
We speak of Lordosis when there is an increased curve in the lumbar spine of lower back. Often there is also an increased pelvic tilt. This posture shows the stomach and head are pushed forward.

Lordosis is defined as an excessive inward curve of the spine. It differs from the spine’s normal curves at the Cervical, Thoracic, and lumbar regions, which are, to a degree, either Kyphotic (near the neck) or Lordotic (closer to the low back).

The spine’s natural curves position the head over the pelvis and work as shock absorbers to distribute mechanical stress during movement.

Lordosis is found in all age groups. It primarily affects the lumbar spine, but can occur in the neck (cervical). When found in the lumbar spine, the patient may appear swayback, with the buttocks more prominent, and in general an exaggerated posture. Lumbar Lordosis can be painful, too, sometimes affecting movement.
Not every Lordosis requires medical treatment. However, when the curve is rigid (fixed), medical evaluation is warranted.

Flat Back Posture:

The term ‘flat-back’ describes a faulty posture where the spine appears straight.  It doesn’t have the normal curves of a healthy spine. A ‘flat-back’ posture has a forward head, or excessive extension of the cervical spine. He has increased flexion of the upper portion of the thoracic spine while the lower portion of the thoracic spine is straight. His lumbar spine is flexed. As a result, his pelvis is tilted backward and his hip joints are extended. His knees may be extended as well.

People who have flat-back posture often have strong abdominal muscles, though the positioning of the pelvis indicates that the hip flexors are weak. The hamstrings will be tight also, pulling the pelvis into a backward or posterior tilt. Weak neck flexors and tight neck extensors contribute to a forward head.

In flat low back posture, generally the hamstring muscles are tight, which brings the back side of the pelvis closer to the thigh. As the pelvis moves forward, it has a straightening effect on the curve of the lower spine.

Along with tight hamstrings, the flat low back posture will also show strong lower abs, back muscles and weak quadriceps muscles.

While it is good for your back to have strong abdominal muscles, a flat low back posture is a deviation from ideal alignment, and affects posture and balance.

Occasionally due to the position of the hip it can be difficult to fully straighten the knees when standing.

Sway Back Posture:

A Sway back posture can be seen with a neutral or posterior pelvic tilt with the hip almost rolled upward to the front. The client shows a relaxed posture, leaning backwards with the upper body.

A Sway-Back posture has several characteristics.

The head is forward. There is increased flexion in the upper back.

• The ribs are positioned behind the hips.
• The pelvis is tilted back, yet it sways forward from the feet. Both hip knee joints are hyperextended and the ankle joint is usually neutral.
• The consequence is someone whose trunk seems to be behind the rest of the body. The chest seems to be depressed, and the hips seem to thrust forward.
• Pregnant women tend to have this posture, and some continue to stand this way when carrying their children after birth, to offset baby’s weight and have their arms free to do chores.
• Someone with sway-back posture may complain of back pain.

A person that has the sway-back posture has weak hip flexors and external obliques. The muscles that extend the back are weak also. The forward head position makes for weak neck flexors, and the low back can be very tight, requiring stretching. The hamstrings and internal obliques may also be tight.

Scoliosis:

With this condition, we have a lateral or sideways curve in the spine that is apparent when viewing the spine from behind. It can be genetic or due to abnormalities or diseases of bone, muscle or nerves. A mild degree of Scoliosis is common, occurring in up to 50 per cent of the population.

Scoliosis generally does not require any specific treatment. However, severe scoliosis does indeed need treatment. Scoliosis occurs mainly in the thoracic and thoraco-lumbar regions.

Between the ages of about nine and fourteen, children bones grow rapidly and can in some children form excessive bony deposits in spots of the skeletal structure. At this time the backbone or spine may show signs of developing Scoliosis.

There are two basic types of Scoliosis.

Structural and Functional.

In the structural Scoliosis the mechanics of the curve are such that rotation of the vertebrae occurs in combination with lateral curvature, and this usually produces a protruberance of one side of the rib cage, seen best when a person bends forward. This is the worst type of scoliosis, and it can be progressive.

In the functional Scoliosis, fixed rotation does not occur, and the curvature is usually non-progressive. This type of Scoliosis is classified into postural, and most commonly due to a short leg.

The Sciatic Nerve is quite large, in fact, it is the largest and longest peripheral nerve found in the body, and is as thick as a finger where it leaves in the lower spine. It extends from your lower back through your hip and under your buttock, and continues down your leg where it splits into two at the knee.

Each leg has its own Sciatic Nerve.

‘Sciatica’ simply means the Sciatic Nerve is is inflamed. The Sciatic Nerve provides information about leg movements, and transmits that information about sensations up to the brain.

Like most other nerves, the Sciatic Nerve performs two important roles.  It sends messages to the muscles of the leg from the brain, and it collects sensory information from the legs and sends it back to the brain.

Conditions such as Sciatica that affect the nerve will change these normal functions. This usually appears as either weakness of these leg muscles… pain in the legs and thighs… or both.

Symptoms of Sciatica.

• A cramping or burning sensation in the thigh.

• Shooting pains from the buttock, down the leg

• Tingling, or pins-and-needles sensations in the legs and thighs

Some with Sciatica may notice a worsening of their symptoms with actions such as squatting or coughing. These actions can increase pressure around the nerve and escalate the symptoms of Sciatica.

The pain from Sciatica is felt along the Sciatic Nerve and can be felt deep in the buttock, with pain that travels down the back of the leg, sometimes as far as the foot. There may also be tingling, ‘pins and needles’, or loss of feeling, and sometimes, weakness in the leg.

Usually, Sciatica effects one leg at a time. Occasionally, a feeling like an electric shock may be occur. The pain can range from a mild ache to severe pain.

Sciatica pain is often felt when you sneeze, cough, or when you’re sitting, and lower back pain may be present as well.

What is the cause of the pain?

A Tight Piriformis is the most common cause.

Sciatica and Piriformis Syndrome are one and the same condition.  The medical community is starting to call the condition by the muscle (Piriformis) that is involved instead of calling it by the name of the associated nerve.  So now you have a choice… a syndrome or a condition.

The Piriformis is a muscle that lies deep underneath the Gluteal muscles of the buttocks. The function of the Piriformis muscle is to externally rotate and stabilise the hip. The Sciatic Nerve passes directly underneath the Piriformis and with some people, it actually passes through it.

Sciatica (aka Piriformis Syndrome) occurs when the Piriformis muscle becomes tight, goes into spasm, or swells. When this happens it compresses the Sciatic Nerve.

Pregnancy can be a cause of pressure on the Sciatic Nerve.

Treatment:
Stretching is a good start, and Deep tissue massage is  also hard to beat in treating Sciatica (aka Piriformis Syndrome).  The best  technique is without a doubt, a darn good active release. It’s a very precise technique that’s used to remove any adhesions that might have formed within the Piriformis or between it and the Sciatic Nerve. A deep tissue massage can help if the masseur is familiar with the anatomy of the Deep Gluteal Muscles.

If you’re experiencing the pain we’ve talked about in this article, call and make an appointment today.  A Remedial Massage could be all you need to relieve the condition.

Iliotibial Band Syndrome is sometimes referred to as Runners Knee and Iliotibial Band Friction Syndrome.

The Iliotibial Band is a band of thick, fibrous tissue which attaches to both the Iliac Crest of the Pelvis (aka hip bone) and the Tensor Fascia Latae muscle. It then runs down the outside of the thigh and inserts into the outside surface of the Tibia (aka shin bone). Its function is to extend or straighten the knee joint as well as abducting the hip or moving it out sideways.

The Tensor Fascia Latae (aka TFL) muscle is a muscle that works over your hip joint. If you put your hands on your hips as if you had your hands in your trouser pockets, your palms should be sitting over the TFL.

As the Iliotibial Band (aka ITB) passes over the lateral epicondyle (a bony part of the femur of the outside of the knee) it is subject to friction. At an angle between 20˚ and 30˚ the Iliotibial Band flicks across the lateral epicondyle. When the knee is being extended or straightened, it flicks in front of the epicondyle and when it is bent, it ducks back in behind.

Iliotibial Band syndrome is frequent in runners because 20-30˚ is about  the angle the knee is at when the foot strikes the ground when running. In people who run regularly this may lead to aggravation of the ITB commonly known as Iliotibial Band Friction Syndrome.

What causes IT Band Syndrome?

Certain factors may make you more susceptible to developing Iliotibial Band syndrome:

• A naturally tight or wide IT band.

• Weak hip muscles such. as Gluteus Medius.

• 

  Trigger points within the IT band and Glute muscles.

• Over-pronation (foot rolls inward)

• Overuse.

• Excessive hill running.

• Running on an uneven surface.

• Different leg lengths.

Symptoms of Iliotibial Band Syndrome:

• There will be pain on the outside of the knee (at or around the lateral epicondyle of the femur).
• A tightness in the Iliotibial Band (ITB)
• Pain normally aggravated by running, especially running downhill.
• Pain during flexing or extending the knee, worsened by pressing in at the side of the knee over the sore area.
• Tender trigger points in the Butt region may also be present.
• Weakness in hip abduction.

What can the athlete do to prevent Runners knee?

• Rest.
• Avoid painful activities like downhill running.
• Use ice to reduce any inflammation.
• Always stretch the ITB after training.
• Massage can also be very helpful in correcting excessive ITB tightness.

Therapy:

Massage that involves specific stretching is a good start and frequent Iliotibial Band stretches should be maintained even after symptoms have ceased.

If you haven’t tried Remedial Massage and you’re experiencing pain in your Iliotinial Band… make a call today.  Arrange an appointment and experience the many benefits that Remedial Massage has to offer.

The shoulder girdle consists of  a whole bunch of bony joints and muscles that connect the upper limbs to the rest of the skeleton and provide an impressive range of movement.
The three bones which form the Shoulder Girdle are the Scapula, the Clavicle, and the Humerus, and the most important feature of the shoulder is the large range of movement that it allows, which is of prime importance to daily life.

Trapezius.

The Trapezius Muscle has many functions:

• Moving the shoulder blade in toward the spine.
• Moving the shoulder blade up and down.
• Bringing the head and neck in a backward direction.
• To rotate and side bend the neck.
• Assists in breathing.
• Rotates the shoulder blade so that the upper-most part of the upper arm faces up.

The Effects on the Neck:

Because the Trapezius Muscle works to move the neck in several directions, its degree of tightness or looseness affects neck flexibility.

For people who work at desks and computers, or who spend many hours driving, the Upper Trapezius is that muscle above your shoulder that becomes very sore and painful.

The Trapezius Muscle is in four parts:

The upper fibres of the cervical vertebrae is the weakest part of the muscle and only provides minor elevation of the clavicle.

• The area commonly known as’ Upper Traps’ is a strong elevator, rotator and retractor of the Scapula.
• The mid-portion of the Trapzius is mainly responsible for scapula retraction.
• The lower fibres of Trapezius assists in retraction and rotation.

Working together they have the effect of simultaneously lifting and retracting the Scapulae. The Trapezius is used most commonly to fix the Scapula to allow the Deltoid to move the Humerus.

Action:

• Laterally rotates, elevates and retracts Scapula. If Scapula is fixed, extends and laterally flexes neck.

Typical uses:

• Shrugging shoulders.
• Overhead movements.

Levator Scapulae.

Shrugging the shoulders (scapula elevation) involves the use of Levator Scapulae and Trapezius.

Fixation of the scapula by other muscles, allows the Levator Scapulae muscles to work together to aid cervical extension, or independently to laterally flex (side bend) the neck towards the side of the working muscle.

Action:

• Elevates the scapula and gives lateral flexion of the cervical spine (each side independently)
• Also responsible for the extension of the cervical spine (each side independently).

Typical use.

• Shrugging shoulders.
• Carrying a heavy shopping bag.

Rhomboids.

There are two rhomboid muscles – Rhomboid Major and Rhomboid Minor.

Rhomboid Major is larger and positioned below Rhomboid Minor.  Chins and dips are excellent activities for developing these muscles.

Action:

• Retracts Scapula (bringing the shoulder blades together). Rotates Scapula downwards to rest position.

Typical use.

• Pulling a draw open.

Pectoralis Minor.

The Pectoralis Minor muscle is the smallest of the two pectoral (chest) muscles.

It works together with the Serratus Anterior  which protracts and rotates the Scapulae upwards.

When the two work together, pure protraction (without rotation) is produced.

Actions:

• Elevates ribs if scapula fixed, protracts scapula (assists Serratus Anterior).
• Rotation of the scapula downwards.

Typical use.

• Pushing a door open.

Serratus Anterior.

The Serratus Anterior muscle is used in activities which draw the scapula forwards.

It is used strongly in push-ups and bench presses. Winged Scapulae are an indication of a weak Serratus Anterior.

Actions:

• Laterally rotates and protracts Scapula.

Typical use.

• Reaching up to open a high window.

Sternocleidomastoid.

Sternocleidomastoid can clearly be seen when you turn your head to one side, on the opposite side of the neck.

Actions:

• Flexes and laterally rotates cervical spine. Protracts head when acting together . Extends neck when neck already partially extended

• Contraction on one side only: Laterally flexes (side bends) to the same side and rotates to the other.

Typical use:

• Looking at the floor.
• Looking over your shoulder.
• Holding the phone between your ear and shoulder.
• Generally being a sticky beak.

They can also be named for their origin and insertion point, like the Semispinalis Thoracis which has its origin on the transverse process of the Thoracic Vertebrae and inserts on the spinous process of the Thoracic Vertebrae.  The Quadratus Lumborum covers the area of your kidneys, and is involved in side bending.
Those on the front of the body are collectively known as the abs.  Actually there are a few different abdominal muscles that work together.  The Rectus Abdominis is known as the “six pack”.  It flexes the trunk so that the rib cage moves toward the pelvis, and covers the Transverse Abdominis, which is responsible for keeping your internal organs just that… internal.

Rectus Abdominus.

The Rectus Abdominus is the most superficial of the abdominal muscles. It is this muscle which forms the six-pack shape!
It is a key postural muscle and is responsible for flexing the lumbar spine, as when doing a “crunch”.  The Rectus Abdominis assists with breathing and plays an important role in respiration.

It runs vertically on each side of the anterior wall of the abdomen and controls the tilt of the pelvis and curvature of the lower spine.

Action:

• It flexes trunk and lumbar spine, aids forced expiration and raise intra-abdominal pressure.

• It also tilts pelvis forward improving the mechanical positioning of the Erector Spinae.

Typical use:

• Moving from lying to sitting.

External Obliques.

Your External Obliques run diagonally down from your lower eight ribs, attaching to the top half of your hip and your Rectus Abdominis.

The External Obliques, along with the Internal Obliques, are the rotators among the muscles that make up your abdominal muscle anatomy. They twist your body at the waist and straighten your body when you bend to the side.

Action:

• Supports abdominal wall, assists forced expiration, aids raising intra-abdominal pressure and, with muscles of opposite side, abducts and rotates trunk.

• Contraction of one side alone laterally bends the trunk to that side and rotates the trunk to the other side. It also compresses the abdomen and supports the abdominal organs.

Typical use:

• Raking leaves.

• Mopping the floor.

Internal Obliques.

The Internal Obliques are under the External Obliques and run diagonally in the opposite direction.  The Internal Obliques work with the externals to rotate the trunk. They will also compress the abdomen when both sides contract.

It’s the same with the External Obliques, but unlike the External Obliques, they are not visible when fully developed.

Action:

• Supports abdominal wall, assists forced respiration, aids raising intra-abdominal pressure and, with muscles of other side , abducts and rotates trunk. Conjoint tendon supports posterior wall of inguinal canal.

• Contraction of one side alone laterally bends the trunk to that side and rotates the trunk to the other side. It also compresses the abdomen and supports the abdominal organs.

Typical use:

• Raking leaves.

• Mopping the floor.

Transversus Abdominus.

Of the four muscles of the abdominal muscle group, the Transverse Abdominis is the one that does not cause trunk movement.  When you “suck it in,” it’s muscle that pulls the ab wall in.  It is located deep in your abdomen, underneath your obliques. It holds your organs in place and forces expiration when contracted.

This muscle is often mistakenly overlooked, because with training, it can pull your stomach in, giving you a slender appearance.

Action:

• Supports abdominal wall and organs, aids forced expiration and raising intra-abdominal pressure. The conjoint tendon supports posterior wall of inguinal canal.

Typical use:

• Maintaining good posture.

Quadratus Lumborum.

The Quadratus Lumborum is a muscle with many functions.  It laterally flexes (sidebends) the trunk, and elevates the hip. It also helps to stabilise the low back, and is usually involved when low back pain is present.

It has fibers that run vertically and in two diagonals.

The Quadratus Lumborum act as guy ropes for the thoraco lumbar junction and lower ribs to the pelvis.  Due to abnormal stress patterns, mainly through poor posture, one or both of these will be chronically or acutely contracted, tender to touch and a common cause of lower grade back pain.  Pain is felt mainly locally and stimulates pain coming from the kidneys.

Action:

• Fixes 12th rib during respiration and lateral flexes (side-bends) trunk.

Typical use:

• Bending sideways to pick something up.

Erector Spinae.

The Erector Spinae is often described as a group of different muscles called Iliocostalis, Longissimus and Spinalis.

Erector Spinae consists of lots of small fibres which are situated very close to the spine.
They are the chief flexors of the vertebral column. They straighten the flexed column and can also bend it posteriorly. They also release during its flexion so that the movement is slow and controlled.

Actions:

• Extension of the spine.

• Lateral flexion (side-bending) of the spine.

• Maintains correct curvature of the spine.

Typical use:

• Maintaining good posture.

Splenius.

Splenius is often divided into two muscles, Splenius Capitus which insert on the skull, and Splenius Cervicis that inserts onto the cervical transverse processes of the spine.
The two flat muscles extend from the upper vertebrae to the base of the skull and help to rotate, flex or extend the head and neck.

Actions:

• Extension of the head and neck.

• Contraction of one side laterally flexes and rotates the neck to the same side.

Typical use:

• Looking up at the stars.

• Looking over your shoulder.

Multifidus.

Multifidus is a series of small muscles which travel up the length of the spine. It is an important muscle in the rehabilitation of lower back pain and can have an extraordinary impact on your body.
Although the Multifidus muscle is very thin, it’s a “powerful” muscle that provides support to the spine.  Multifidus muscle is a series of muscles that are attached to the spinal column.

The Multifidus muscles help to take pressure off the vertebral discs so that our body weight can be well distributed along the spine.  It also keeps our spine straight while the deep muscle group contributes significantly to the spines stability. These two groups of multifidus muscles are recruited during many actions in our daily living, which includes bending backward, sideways and even turning our body to the sides.

Studies have shown that the multifidus muscles get activated before any action is carried out so to protect our spine from injury.  When you are about to carry an object… even before moving your arm, the Mutifidus muscles will start contracting before to the actual movement of the body and the arm to prepare the spine for the movement and prevent it injury.

Actions:

• Extension, lateral flexion and rotation of the spine.

Typical use:

• Maintaining good posture of the spine.

The shoulder joint is one of the body’s most flexible and allows the arm to be positioned and moved in just about any direction.

The Shoulder Joint also allows the arm to be rotated inward (internal rotation) or outward (external rotation) to help put the bent forearm in a favorable position to perform a required task.

The head of the Humerus is almost spherical in shape and rotates freely in the glenoid fossa of the Scapula.
The shoulder joint’s flexible ligaments, the Rotator Cuff, and the other muscles that cross this joint all add to the shoulder’s stability and its incredibly amazing range of movement.

Deltoid.

The Deltoid muscle is used in all side lifting movements and any movement of the humerus on the Scapula. It is divided into three portions, anterior, middle and posterior, with the fibres having different roles due to their orientation.

Actions:
• Anterior portion – Shoulder flexion and internal rotation.
• Posterior portion – Shoulder extension and external rotation.
• All fibres – Shoulder abduction.

Typical Use:
• Lifting.

Supraspinatus.

The Supraspinatus muscle is one of the four muscles which make up the rotator cuff. Its main function is to stabilise the upper arm by holding the head of the humerus in position.
It is important in throwing motions to control any forward motion of the head of humerus.

Actions:
• Abduction .
• Stabilisation of the humerus and shoulder joint.

Typical use:
• Holding shopping bags away from the body

Infraspinatus.

The Infraspinatus muscle assists the lifting of the arm while turning the arm outward (external rotation). It is the main external rotator of the shoulder joint.

It is one of the four rotator cuff muscles crossing the shoulder joint and is commonly injured.

Actions:
• Shoulder abduction.
• External rotation.
• Stabilises the shoulder joint

Typical use:
• Brushing hair.

Teres Major.

The Teres Major is only functional when the Rhomboids fix the scapula. This muscle mainly helps the Latissimus Dorsi.

Action:

• Medially rotates and adducts arm.
• Stabilises the shoulder joint.

Typical use:
• Tucking your shirt into the back of your jeans.

Teres Minor.

The Teres Minor is one of the four rotator cuff muscles surrounding the shoulder. Its main action, along with the Infraspinatus  is to externally rotate the shoulder joint. It assists the lifting of the arm during outward turning (external rotation) of the arm.

There are two Teres muscles, the other being Teres Major.
The other muscles whose tendons form the rotator cuff are:
•    The infraspinatus muscle, which (like the teres minor) helps in the outward turning (external rotation) of the arm.
•    The supraspinatus muscle which is responsible for elevating the arm and moving it away from the body; and
•    The subscapularis muscle, which moves the arm by turning it inward (internal rotation).

Actions:
•    External rotation.
•    Shoulder abduction and stabilises shoulder joint.

Typical use:
•    Brushing hair.

Subscapularis.

The Subscapularis moves the arm by turning it inward (internal rotation).

The Subscapularis is one of the four rotator cuff muscles which cross the shoulder joint. The muscle also acts to hold the head of the humerus in position and prevents it moving forwards. It is shown here with a couple of ribs cut away at the front.

“Subscapularis” means under (sub) the scapula (the wingbone). The subscapularis muscle originates there, beneath the scapula.

Actions:
• Internal rotation.
• Adduction.
• Stabilises shoulder joint.

Typical use:
• Tucking your shirt into the back of your jeans.

Latissimus Dorsi.

The Latissimus Dorsi muscle is one of the largest in the body.

It is a powerful extensor muscle of the arm and is used extensively in chinning and climbing and its basic function is to pull the shoulders downward and towards the back.

It extends from the spine, hip and ribs to the upper arm.

They are commonly known at ‘the lats’.

Actions:
• Extends, adducts and medially rotates arm.
• Helps with deep inspiration and forced expiration

Typical use:
• Pushing down on the arms of a chair when standing up.

Pectoralis Major.

Pectoralis major is the largest and most superficial of the two chest muscles. Pec Major and the anterior fibres of Deltoid work closely together. Pec-fly and push-up exercises are good for the Pectoralis major.

Actions:
• Clavicular head:flexes and adducts arm.
• Sternal head: adducts and medially rotates arm .
• Accessory for inspiration.

Typical use:
• Applying a roll-on deoderant.

I’m not referring to your nagging wife or lazy husband.  This is all about pain in that muscle tucked in behind the Glutes… the Piriformis, and someone in the world of the wise has named it the Piriformis syndrome.

The Piriformis Syndrome effects countless numbers of people daily, and doctors refer to it as neuropathic entrapment.  That means that a muscle deep under the gluteal area called the Piriformis is tight or inflamed which decreases the performance or flow of the largest nerve in the body (the sciatic), which passes behind it.  Sometimes, it goes through the muscle.  Tightness in the Piriformis  will cause pain can be in or around the muscle, and along  the sciatic nerve, usually in the back of the thigh, and possibly all the way down into the foot. Shooting pain along the sciatic nerve distribution is called sciatica.  Pain can also be referred up into the lower back region.

If you have pain walking uphill or up stairs, along with pain after prolonged periods of sitting, it’s quite possible you have a dicky Piriformis.

Where is it?

The origin of the muscle is the front the sacrum.  The sacrum is that triangular shaped bone at the base of the spine between the two hip bones, forming the pelvic girdle. The Piriformis Muscle then goes through the greater sciatic foramen (that’s a hole in the pelvis) before it blends into its tendon and inserts onto the top of the Femur at the Greater Trochanter ( hip bone).

The sciatic nerve travels through the greater sciatic foramen (that hole I told you about) behind the Piriformis Muscle.  In about 15% of the population, the sciatic nerve goes through the Piriformis muscle. It’s no surprise then that those within that 15% would be much more likely to experience Piriformis syndrome. Regardless, a tight and/or inflamedPiriformis will eventually lead to a condition known as Sciatica.

Function?

The function of the Piriformis is to abduct and laterally or externally rotate the femur. Abduction of the thigh means to move the leg out to the side away from the body. Lateral (a.k.a. external) rotation means to rotate the hip such that your toes are pointed out to the side instead of forward.

Runners, cyclists, and weightlifters usually experience the condition. Another cause is sitting for prolonged periods with the hips abducted and externally rotated. This can occur at one’s desk, but it is also very common while driving for long periods of time.

Treatment:

Stretching is good.  Deep tissue massage is  also invaluable in treating Piriformis Syndrome.  Undoubtedly, the best  technique is an active release. It’s a very precise technique that’s used to remove any adhesions that might have formed within the Piriformis or between it and the Sciatic Nerve.

A deep tissue massage can help if the therapist is familiar with the anatomy of the deep gluteal muscles.  If you’re experiencing the symptoms of Piriformis Syndrome or tight Gluteal muscles, make a booking and feel the difference Remedial Massage can make.  With any massage however, it’s advisable to wear comfortable underwear that’s not too tight.

Your muscles make up about half of your body weight and can be divided into three separate groups… skeletal, cardiac and smooth.  These groups can all stretch and contract, but each play very different roles.

Skeletal Muscle:

Skeletal muscles are voluntary muscles positioned between two bones and cause movement of one of these bones by contracting or shortening.  The other bone will be stabilised by its very nature such as the rib cage or sternum or by another muscle such as the Deltoid stabilising the humerus.

Skeletal muscles cover your skeleton, and give your body shape.  They are attached to your skeleton by strong, flexible tendons or are directly connected to rough patches of bone. Skeletal muscles are subject to voluntary control, which means you consciously and deliberately control their actions.

Every move you make, from walking around to scratching your nose, is caused by skeletal muscle contraction.  Your skeletal muscles function almost continuously to maintain your posture. Always on the job, they are constantly making small adjustments to keep your body upright.

Skeletal muscles are also crucial for holding your bones in the right position and prevents your joints from dislocating.  If we didn’t have skeletal muscles, we’d be in an untidy heap on the floor.

Some skeletal muscles in your face are attached to your skin.  The slightest contraction of one of these muscles changes your facial expression and it takes more muscles to frown than it does to smile.  We still see them though… people doing it tough and working hard… at frowning!

Skeletal muscles produce heat as a consequence of muscle activity.  This heat is essential for maintaining your normal body temperature.

Cardiac Muscle:

Your heart is made of cardiac muscle.  This type of muscle only exists in your heart. Other types of muscle get tired, but not this one.   The cardiac muscle never gets tired. It works automatically and 24-7, without rest.  Cardiac muscle contracts to squeeze blood out of your heart, and relaxes to fill your heart with blood only to squeeze it out again.

Smooth Muscle:

Found in the walls of hollow organs like your stomach and intestines, they work without you being aware of them.  The muscular walls of your intestines contract to push food through your body.  Muscles in your bladder wall contract to expel urine from your body. Smooth muscles in a woman’s womb help to push babies out of the body during childbirth.  The pupillary sphincter muscle in your eye is a smooth muscle that shrinks the size of your pupil.

Iliopsoas

The Iliopsoas is sometimes classified as two muscles, Iliacus and Psoas major, with Iliacus arising from the Ilium and Psoas from the vertebrae.

Action:
Flexes and laterally rotates hip as well as flexing the  torso when the legs are fixed (e.g. laying to sitting).

Typical use:
•    Climbing a step.

Sartorius

The Sartorius is a two joint muscle and so is weak when the knee is flexed and the hip is flexed at the same time. It works better during single movements.

Action:
Flexes, abducts, laterally rotates thigh at hip. Flexes, medially rotates leg at knee. Abducts the hip and externally rotates the hip as it flexes the hip and knee.

Typical use:
•    Sitting in a cross-legged position.

Rectus Femoris

The Rectus Femoris muscle is part of the Quadriceps muscle group.

It is the only muscle of the group which crosses the hip joint and is a powerful knee extensor when the hip is extended, but is weak when the hip is flexed.

Action:
Extends leg at knee. Flexes thigh at hip.

Typical use:
•    Kicking a football.

Gluteus Medius

The Gluteus Medius is an important muscle in controlling the level of the hips.

Weaknesses in gluteus medius often result in a trendelenburg sign, an abnormal gait cycle where the hip of the swinging leg drops down, rather than raises up.

This results in increased degrees of knee flexion in order to clear the ground.

Action:
Abducts and medially rotates hip. Tilts pelvis on walking.
The posterior fibres externally rotate the hip.
The anterior fibres internally rotate the hip.

Typical use:
•    Stepping sideways out of the bath.

Gluteus Minimus

This is the smallest of the three gluteal muscles and sits underneath the gluteus medius.

Action:
Abducts and medially rotates hip. Tilts pelvis on walking.

Typical use:
•    Getting out of a car.

Gluteus Maximus

The Gluteus Maximus is the largest and most superficial of the three gluteal muscles which forms the rounded shape of the buttocks.

Action:
Extends and laterally rotates hip and keeps the knee extended via iliotibial tract

Typical use:
•    Extension phase of walking upstairs.

Piriformis

The Piriformis muscle is an important muscle. The sciatic nerve passes underneath this muscle on its route down to the posterior thigh.

In some individuals the nerve can actually pass right through the muscle. This can lead to sciatica symptoms due to a condition known as piriformis syndrome

Action:
Laterally rotates, abducts and stabilises the hip.

Typical use:
•    Taking the first leg out of the car.

Biceps Femoris

The Biceps Femoris is one of the three muscles which form the hamstring group forming the back of the thigh.

The muscle is often described as having a long head (the attachment from the ischium) and a short head (attached to the femur).

Action:
Flexes and laterally rotates knee and laterally rotates the hip when the knee is flexed. The long head extends hip.

Typical use:
•    Bending the knee to step over something.

Semitendinosus

When running the hamstrings act eccentrically to slow down the knee extension motion.

Hamstring strains are common in individuals with chronically tight hamstrings or who do not warm-up thoroughly.

Action:
Flexes and medially rotates knee, and extends the hip.

Typical use:
•    Bending the knee to step over something.

Semimembranosus

The Semimembranosus is the most medial of the three hamstring muscles.

Chronically tight hamstrings are often a contributary factor to lower back pain and knee pain.

Action:
Flexes and medially rotates knee, and extendsthe  hip.

Typical use:
•    Bending the knee to step over something.

Pectineus

The Pectineus is positioned between the Iliopsoas and Adductor Longus muscles and is part of the short adductor group with adductors brevis and longus.

Action:
Flexes, adducts and medially rotates the hip.

Typical use:
•    Kicking a football.

Adductor Brevis

The Adductor Brevis is the smallest and shortest (hence the name brevis, meaning short in latin) of the three short adductor muscles.

Groin strains are common injuries to the adductor muscles, which occur without a thorough warm-up or in individuals with chronically tight or weak adductor muscles.

Action:
Adducts and flexes the hip.

Typical use:
•    Bringing your second leg into the car.

Adductor Longus

The Adductor Longus is the middle of the three short adductor muscles.

Groin strains are common injuries to the adductor muscles, which occur without a thorough warm-up or in individuals with chronically tight or weak adductor muscles.

Action:

Adducts, flexes and medially rotates hip.

Typical use:
•    Bringing your second leg into the car.

Adductor Magnus

The Adductor Magnus is the largest groin muscle and is one of the two long adductor muscles (gracilis is the other).

It is usually decribed as having two parts, hamstring and adductor parts.

Action:
Adductor portion: adducts, flexes and medially rotates hip. Hamstring portion: extends hip.

Typical use:
•    Bringing your second leg into the car.

Gracilis

The Gracilis is another muscle which works in conjunction with the groin muscles, or adductors.

Action:
Adducts hip. Flexes knee and medially rotates the hip when the knee is flexed.

Typical use:
•    Sitting with the knees pressed together.