Forward Hip Rotation and Consequent Lower Limb Backline and Plantar Fascia Tightness, Pain and Injury
"He did squeal loudly stretching the hip flexors. They were tight, very tight."
Few medical practitioners link tightness through the back line musculature of the lower limbs with Sacro-Iliac Joint (SIJ) dysfunction...it is not taught in scientific curriculums; the explanation for the phenomenon is based on the traditional Chinese philosophy of energy flow. Energy they call Chi that cannot be measured by instruments or felt by the uninitiated. A gifted few do have an innate awareness of Chi. More typically, individuals develop the ability undertaking the discipline and rigour of meditation and oriental martial training.
In Chinese medical philosophy, when circulation of Chi is blocked, pain and tightness results. My first awareness of this came to me resolving an RSI condition which disabled both arms to the point where I could no longer work. The next instance was treating a fit elderly gentleman afflicted with severe plantar fasciaitis causing pain and tightness in the sole of the foot.
This gentleman's chronic condition had caused considerable pain over many years. He had been examined by medical practitioners in both Melbourne and London and underwent a surgical procedure to release the fascial tightness to no avail. Extensive massage treatment to the lower limb over a 12 month period proved ineffective too. Finally, extending my awareness further, I noted the SIJ pain he experienced only as a backgound discomfort not worth mentioning. Balancing his hip posture by applying an intense hip flexor stretch relieved the SIJ's. He did squeal loudly stretching the hip flexors. They were tight, very tight. One week later the Plantar Fasciaitis condition no longer afflicted him.
I now recognise a common cause for tightness along the back line from hips to the bottom of the feet is chronic forward hip rotation. There may or may not be noticeable pain or discomfort at the SIJ, yet dysfunction from this postural abnormality blocks energy flow to the back of the lower limb. This is typically present on one side only, unilateral forward hip rotation being the most frequent presentation.
Generally, this condition presents as a background discomfort or ache in the lower back and tightness in Gluteals, Hamstrings and/or Calves. One muscle group may be affected more than the others due to individual postural and gait habits.
In some cases, the patient is not aware of any discomfort in the lower back or dysfunction at the SIJ, but examination reveals forward hip rotation and palpation of the SIJ illicits pain. More acute cases experience sharp pains in the SIJ they are only too aware of.
Regardless of the intensity, tightness in the lower limb is only partially relieved by massage while the hip posture abnormality/SIJ dysfunction remains and returns quickly after treatment. Full recovery from tightness, pain and injury to the back line of the lower limb and plantar fascia can only be achieved after correcting the hip posture.