01/04/2015
The Pectineus muscle is a short strong muscle sandwiched between the Psoas major and the Adductor Longus. It is a powerful adductor of the hip joint, but it also helps to flex the hip. It is an ‘easy to forget’ muscle but it’s trigger points may be a major source of persistent “internal” groin pain. It may present as groin strain, hip pain, post hip replacement pain during rehabilitation, post hip fracture pain, hip pregnancy pain, postpartum groin pain, pain during sexual in*******se/ hip adduction exercises (gym) and osteoarthritis of the hip.
CAUSES: Leg splint/cast, foot/ankle problems, sudden overload due to gymnastics, football/ice skating, soccer, horse riding, skiing, cross-legged sitting.
The good news is that Pectineus lends itself readily to trigger point therapy. Because it is a short lever, the technique we suggest is NAT supine. With the hip in flexion and abduction, identify the taut band by getting the patient to adduct the hip against resistance. Locate the trigger point in the middle of the taut band and then ask the patient to relax. Using your elbow, gently press on the trigger point and build up pressure until you find the heart or ‘sweet spot’. Compress and hold until you feel the trigger point yield (this may take unto several minutes). Don’t come away to soon, gently come away but keep some of that (hard one) wound-up fascia and move your elbow in a clockwise direction. This allows you to approach the trigger point from a different angle, often enlivening a different part of the trigger point map. Go around the clock face pausing on the trigger point until the point is fully disabled. Follow this with a gentle stretch into abduction.