Discussing sleep position with patients is an important component of care. The way someone sleeps is rarely the cause of someone’s problem, but it can be one of the many factors that don’t allow their body to recover like it should. If the goal is to provide fast, long lasting relief than all factors need to be considered and sleep position can be a big one. Here is a general rule:
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When dealing with any type of knee problem we need to understand the relationship that the knee has with the other joints in the body, particularly the hip and the foot. It can be said that the knee is caught between the foot and the hip, and as such the foot, knee, and hip make up what is known as a kinetic chain. In fact, many of the muscles that act at the knee also cross either the hip or ankle joint. As a result of this relationship, with any knee problem both the foot and hip must always be closely examined as an abnormality in either area will greatly influence problems at the knee.
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The hip consists of a “ball-and-socket” joint that is formed between the Femoral Head and the Acetabulum, a part of the Pelvic Bone. As a result of its shape the hip joint is capable of a wide range of motion in all directions – forward and backwards, side-to-side, and rotation inwards and outwards. In addition to this large range of motion it is important to understand that because the hip joint joins the leg to the trunk there is a tremendous amount of force that must pass through this region with daily activities. Due to the high amount of force, combined with the large range of motion, the hip must rely on a complex system of muscles to control and protect the area.
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Piriformis syndrome is a condition in which the piriformis muscle becomes tight or spasms and causes pain. This muscle can also irritate the nearby sciatic nerve which can cause pain and numbness and tingling along the back of the leg.
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The sciatic nerve is a large nerve that travels from the lower back through the hip and down the leg and into the foot. It supplies both skin and muscles. Symptoms can include pain, numbness and tingling, and in some cases weakness. Although some cases can be complicated, most are treated conservatively and never return.
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When discussing any type of back problem we also need to review the relationship that the back has with the other joints in the body, particularly the hip. Recall that the spine is designed to be flexible, but that excessive stress will lead to problems. The hip is unique in that is it designed to be a mobile joint but also depends on muscles to provide stability when needed. Hip stability is crucial when we put weight on a single leg, such as when we walk or run. Excessive stress on the spinal joints will result in low back pain, but as you can see, the problem at the hip may the underlying cause. Continue reading “The Hip and Back Relationship” »