Good for: overuse injuries, chronic pain or tension, bulky muscles. Active Engagement (AE) Techniques integrate movement with other therapeutic techniques to give your therapist deeper access to your muscles.
Active Engagement (AE) techniques are used to increase the intensity of treatment without increasing the pressure. They integrate active movement by the client with therapeutic techniques by the therapist. In addition, these techniques address multiple issues: chronic tension, overuse injuries, and muscles that are difficult to access. The work is performed during concentric and eccentric muscular contractions. Concentric contraction is the shortening of a muscle. In contrast, an eccentric contraction is the lengthening of a muscle. Techniques applied during a concentric contraction aim to decrease muscle tightness and fibrous adhesions. Meanwhile, techniques applied during an eccentric contraction aim is to increase pliability and broaden muscle fibres and myofascial tissue.
Hip pain is potentially one of the most debilitating as it can hinder your patient’s mobility. Although bursitis is a common diagnosis for hip pain it is often caused by hip abductor dysfunction instead. The good news is that when it comes to hip abductor issues massage therapy can be very effective in resolving patient issues. Here are three important considerations when treating hip issues:
- The Possible Causes: The reason bursitis is often blamed for hip pain is that the three hip abductors gluteus medius, gluteus minimus, and the tensor fasciae latae are in close proximity to the hip. The bursa beneath is there to prevent friction. Therefore it is not uncommon for health care practitioners to assume pain is being caused by deterioration of the bursa. However when you consider the three hip abductors they have a very important biomechanical purpose that contributes to pelvic balance, maintaining tension for knee stabilization and the bearing of weight when walking. This is why it is possible there is weakness or atrophy in the hip abductors if they are innervated by the superior gluteal nerve. This could of course result in hip muscle dysfunction. It is important to consider this in the evaluation as well as the possibility that there may be nerve compression of the superior gluteal nerve due to the piriformis muscle resulting in piriformis syndrome. This could also then contribute to hip abductor weakness. With all of these reasons in mind it is important to treat hip abductors in order to assist in the treatment of complaints related to your patient’s pelvis, trunk and the lower extremity.
- Pain Pattern: You can perform your own assessment to determine from where the issue stems. Palpation of a patient’s muscle tissue may reproduce pain which means the muscles are the cause. However tests that stress the sacroiliac joint and reproduce pain indicate joint pathology. Dysfunctional hip abductors will cause pain when walking as well as when the patient lies on their side. Pain referral from the gluteus medius is usually limited to the thigh whereas pain referral from the gluteus minimus will affect the entire length of the leg. This pain is very similar to sciatic nerve pain which can lead to yet another misdiagnosis. Hip abductor dysfunction will reproduce a patient’s pain when you press on the hip abductor muscles and vice versa for sciatica issues. To make matters worse a patient may be suffering from both sciatica and hip abductor dysfunction. To address trochanteric bursitis check patients to see if they have point tenderness directly over the lateral hip region when pressing near the greater trochanter of the femur. If this produces pain it is more than likely trochanteric bursitis. A thorough assessment will allow you to identify what treatment will be required.
- Effective Treatments: Knowing all of these factors coming into play you will want to include the treatment of your patient’s hip abductor muscles for hip, lower leg and pelvic pain. You will need techniques at deeper levels in order to be successful in treatment such as Active engagement (AE) techniques. This will allow you to engage a patient’s muscle actively in a contraction as the density increases your pressure will be effective. It is more effective in muscle treatment and you won’t have to work your self as hard when applying pressure. Consider using compression with active engagement and a pin and stretch technique as they will assist in making the depth of pressure more effective when applied with stroking.
Because of the connection in the hip and pelvis
Other Resource Links
*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis or medical advice, nor do they represent an endorsement of any product, company or specific massage therapy technique, modality or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.