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Best wishes to everyone, and best wishes for the New Year. Love from Liv, Kit, and Nathan, our tech guru! ×
Best wishes to everyone, and best wishes for the New Year. Love from Liv, Kit, and Nathan, our tech guru!

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Posted

Hi forum members,

What would be causing the femur to be held excessively forward.  When standing with feet together the left knee is visibly more forward than the other leg which has presumably caused glute/hamstring pain.

In this scenario is it more a matter of activating psoas, etc, or loosening muscles that may be holding the femur forward.

Posted

When you say visibly forward, do you mean the left knee isn't fully extended compared the the right knee? (Is one leg 'straighter' than the other?) Could I see a picture? 

What other positions are you limited in or experiencing asymmetry in?

Posted

Hey danny, thanks for posting.  It's my g/f, if she stands with legs straight/feet together, her left kneecap is more forward than the right knee cap, maybe 1cm or so.  She can deliberately move the leg back to level it but clearly her normal position is with the left knee forward.  She has pain in the glute/ham region which i suspect is an outcome of this forward leg.  I suspect it's a problem with perhaps a weak left side core or psoas that may be allowing the femur to sit too far forward in the hip socket.  

It becomes evident in downward dog to lunge transition whereby she can't get her left foot between her hands during the lunge transition whereas her right foot has no trouble during this same movement.  

It's also evident during a lying straight leg raise (her left leg can't rise to 90 deg before glute/ham tension whereas the right leg easily exceeds 90 deg).

 

Posted

Does she have a leg length discrepancy at all? 

What are her spinal curves like? Does she have a noticeable scoliosis? 

I would first look at some images of the hip and it's anatomy. If the femur in acetabulum itself were drawn forward - if would be a quite an extreme injury. There are layers of ligaments and capsule (and bone). It's fairly secure. Joints (generally speaking) don't get radically misaligned. The tensions in the soft tissues can cause incongruent movement and very small articular issues. But what you might suggest (to make a 1cm change) would be basically a dislocation or serious injury. Of course, I could be wrong (and old professor of mine had a patient who dislocated a hip in their 20's, and 50 years later had a fall which required an x-ray. For 50 years this lady had a 'false socket' where the femoral head was somehow stuck behind glute medius - crazy stuff. 

In a downward dog position is one side of her pelvis higher than the other?

I'd imagine it's tight and weak hip flexors keeping her hip in flexion. How old is she? Does she have any past injuries? 

Sorry for all the questions!

 

 

Posted

Yep I'm quickly learning that there may be a core weakness going on.  She's 30yo, no past injury etc.  

We've been doing some resistance band 'psoas march' which along with ql stretching seems to be improving her downward dog lunge transition.

Her standing toe touch is also restricted due to left leg glute/ham pain as her hand approaches the floor.  Interestingly I had her squeeze a ball between her thighs during the toe touch and the harder she squeezed the pain lessened and she gained range.  Which makes me think there's a core deficiency.  This is the hard part, distinguishing when stretching is the correct approach and when strengthening may be more valid.  And whether there's a muscle inhibiting the function of her core or whether some solid deep core strengthening will resolve this. 

Posted

If that seems to work, try out gray cooks stuff on toe touch: https://www.functionalmovement.com/articles/Screening/747/breaking_down_the_toe_touch_progression

I was at a workshop and Brett Jones did this to some guy in the group. The guy was super shocked and stood there open mouthed after he touched his toes.

 

I've always loathed the term 'core deficiency'. I like to think of the body like an orchestra, if the orchestra isn't playing well - you don't have a 'french horn' or even 'strings' deficiency, you have a problem with the conductor or lack of practice playing together. It's to co-rodination of the players, and not the players themselves, that make orchestras great. Sometimes it's okay to practice solos.

 

Loaded stretching & bodyweight drills are good ways at re-gaining co-ordination and control. Many people look to rolling/hard rolling as a means to being to get everything working in harmony:

 

Hard Roll: 

https://www.youtube.com/watch?v=poawu9InFrQ

Soft Roll:

https://www.youtube.com/watch?v=UNQUivcLKPg

 

Obviously there are a million ways to move towards solving the issue. If you're in Seoul I can help in person!

 

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