Hip position

[mike]

Hi,
Regarding hip position.
I have read somewhere that in no other place in the body is the general tension of the nervous system affected more than in the hip. Isn’t the majority of the hip muscles located posterior of the hip, meaning that the action should bee external rotation instead of internal. What is the explanation for that the sympathetic response will show us internal rotation of the hip rather than external rotation?
Patients with cerebral palsy have there hips in internal rotation due to lack of central control but this is not the case with an intact nervous sytem. Is there references to that a sympathic response will internal rotate the hips?

What are you thoughts?

Mike

[Barrett Dorko]

One feeds off the other. Startling (sensorymotor activity) may strongly internally rotate the hips and internal rotation of the hip pulls the nervous tissue tautly, leading to greater sympathetic tone. It's also difficult to allow the diaphragm to move freely when the hips are held in internal rotation, thus enhancing sympathetic-like behavior.

In my experience, many bits of discomfort and areas of perceived tightness are made worse by simply holding the feet together.

This is the paradox: A culture that claims it wants comfort and ease for us also strongly encourages postures that approximate "attention" (feet close together) and a "flat stomach" (persistent elevation of the diaphragm) - looks good, feels awful.

[Diane]

I've wondered about this too.

I've seen and treated lots of patients who are the other way, have neural tension that pulls them into external rotation. Now I see that likely these ER ones are probably less "central" (don't seem to have any precipitating startle issue) and more "peripheral". Usually they respond well to treatment of dorsal cutaneous, cluneal, lateral cutaneous, tibial, fibular, and plantar nerves, and narrowtrail walking. Of course, they are subject to all the same cultural overlay about appearance, and to the same detriment.

[Jason Silvernail]

This is such an important thing to look at - I've had people climb off the table after ER'ing their hips and diaphragmatically breathing who felt a LOT better with just that.

I think you can draw on Patrick Wall's 3 stages of pain and the "protection/guarding" phase here, too.

[emad]

Most of what I encountered are E.rotations positions , which might put less load/stress over the nerve ( I begin to negate peripheral and central clssifications ) . Personally , I have not noted internal rotations in pain . As for cerebral palsies , in severe spastic children yes some are internal rotations .
cheers
Emad

[nari]

It's just occurred to me that if someone feels defensive, unsafe, submissive, what happens to the feet? They turn in. Cartoonists make good use of this especially during pre-elections.

Nari

[mike]

I’m still a little bit confused about this as I also clinically often have experience that the hip is held in ER. Especially those with acute LBP, which seems logical as the nervous system wants to keep the load of the nervous tissue, the hip end up with an antalgic posture i.e. ER.
I guess I have to look at this more.

Mike