Need advice

[Balerie]

I haven't been there yet myself, but I think having her keep her hand there would be a good start. If you tuck the sheet under her hip laterally to pin the outside, then pulled the inside section of sheet under her leg (the leg you're working, of course), I think that would keep the sheet in place while exposing the thigh all the way to the crease and she may not even have to use her hand to hold the sheet.

 

[midnighteden]

Need advice

My prenatal massage instructor taught us a very similar "hold", where the client sets and holds the boundary along that line. We work *outside* the client's hand, and the client feels more secure because she is the one setting the boundary, and is able to maintain it throughout the work on that area. The therapist is more secure that the client isn't worrying about her going "too far", so is able to relax and not worry about whether the client is worrying or not. Win-win! Just one question: have you had training in the inguinal/groin area? Are you familiar with the more delicate anatomy there?

 

[edwardlova101]

Need advice

I work on pro athletes intermittently. For the groin work, it has mainly been on basketball players and tri-athletes.

Personally I don't have the client hold thier jewels, but I think it can be a good idea.

I frogleg supine, do a simple drape, tuck as high as I can, and start working my way up the adductors. As I get closer to where I need to be (attachments), I let them know where I am going, and what I am looking for... tightness, adhesions, etc.... and make sure to ask if it feels like I am working the problem area they are really having an issue with.

When I get to a spastic area in the region of the attachments, I will peg it with my fingers and wait for it to release or at least loosen. This has been my most effective method to date. I have been known to get right at the attachments on the pubic bone in the past when it was necessary, but much of the time, I can peg right below the edge of the bone. Much of my work is by feel - specific to the tightness/restrictions, and not due to a pre-conceived notion regaring specific muscle or tendion I think the problem is coming from.

Depending on the situation with the musculature, I may drop all the way back down to the medial knee and start working my way up again. I may even do this proceedure again and again and again. Or, I may stay high. Usually though, I am moving around a lot. When I work that way (re-doing the proceedure), most times I will find that on the second, third or fourth run, I can work quickly around the medial knee and lower 1/3 of the medial thigh, and will find the restrictions become lessened as I am am working my way up. So, I may end up spending only 10 seconds around the lower 1/3 of the thigh, but still spending a few mins. (between 2 and 7 mins.) at the medial 1/3 of the thigh and a few more mins. (probably about 3-6 mins. - sometimes more, depending on the situation and problem) at the upper 1/3 of the thigh and attachements. In this particular method, I will find that at some point I can peg the attachment and it will eventually release, though it may take 15 mins. to get it to do that, or it may take as much as a half hour + (plus).

A side note, is that I may work all the way up from the foot, with a good portion of my work on the lateral tibia. Deep, with rocking motion of the foot while stretching out that area. It is not necessarily comfortable, and when I do it, I can actually lay the medial portion of the foot on the table if the leg will allow me to stretch it that far, all the while stripping the area along the lateral tibia, within about a two inch span while working the entire length of the tibia. Hope that makes sense.

Sometimes I will also stop in the middle of my adductor session and just give the area a break. If I do that, I'll usually move over to the other leg for a while (not doing the adductor attachments on the other leg unless there is a need).

I definitely work the SI joints at the end of a session like this, with something that is similar to a sheering compression type of work - client prone, forearm to the lateral edge of the sacrum, with deeper pressure, while the drape is in place. In this technique, my drape will not slide around under my forearm.

I hope that helps you formulate a plan. Know the anatomy... is my best advice.

 

[NeSsA]

Need advice

Agreed with Pueppi-- I usually just ask the client to tuck the drape around so I can get right up to the attachment on the pubic bone. Depending on the severity and when the injury occurred, the client may not be comfortable lying in one position too long and you may just have to be prepared to adjust with pillows. I prefer to work the adductors sidelying with the leg I'm going to work either in front of the clients body or behind so I can get the adductors without having to bend over the table. If the injury happened within the last two or three weeks, you should only apply gentle work. Make sure the injury has healed enough before any deeper work. Include the hamstrings, quads, gluts and TFL, usually if you work those muscles first, you'll find the client feels less tenderness when you do get to the adductors.

 

[Lauren]

Need advice

Include the hamstrings, quads, gluts and TFL, usually if you work those muscles first, you'll find the client feels less tenderness when you do get to the adductors.

Thanks, kathryn. I usually work quads and TFL first. I'll add the others in next time and see how it goes. I like this idea for an approach.