“Opening” a joint is quite the buzzword! Each time you "open" a joint in one direction, however, you are simultaneously "closing" it in another direction. True opening, if you will, occurs when a joint is pulled apart via traction. Don’t get me wrong: I love moving joints fully in specific directions. But I suggest we need to comprehend what we’re actually doing. Using fancy terms is fine, but it can perpetuate or create the wrong idea.
The seated butterfly stretch/position, for instance, does not “open” your hip. It opens the anteromedial (front middle) aspect of your hip to an extent, but it also closes the posterolateral (back outside) aspect to an extent at the same time. Examples abound.
It’s worth considering, as well, that if you open in one direction and then do an opener in the opposite direction, the two may cancel each other out in certain circumstances. By no means does that apply to every case, but if you’re hoping to achieve something measurable, you need to see if this counteracting effect is occurring and thwarting your progress. -- Laura
A prescription for someone's hip pain may be: single leg stane on a BOSU with hip abduction, core stabilization on a physioball, soft tissue release of the psoas, Turkish get-ups, hip long axis traction, hip extensor strengthening, IT band foam rolling. My prescription for this patient may be: loaded hip extension. This is not an exaggeration. This is a representative example of what a patient might get for his complaint of hip pain with other clinicians and what I often give patients with a complaint of hip pain.
The logical question is why does this happen? The answer lies in the fact that I look at the neuromusculoskeletal system differently than other clinicians. Compared to 10 years ago, I evaluate differently and diagnose differently now. Ergo, I prescribe different treatment plans. I find that most orthopedic disorders are joints not moving well and therefore the treatment is specifically directed at getting them to move normally again.
Is there a scenario in which I would prescribe all those things in the first example? Maybe, but I can’t imagine that case. I know those things exist if I need them, though, because I used to employ them.
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