The thigh contains some of the strongest muscles in the body and can be very influential in postural problems. It is also the site of many sports injuries, and although not a very common presenting site of symptoms in most osteopathic practices, may well be involved in hip, knee and lower back problems.
Although it is possible to work on most of the muscles with conventional structural stretching and cross-fibre techniques, muscle energy and inhibitory pressure are often useful here.
Special precautions include the obvious one of the necessity to work sometimes in sensitive areas near the groin, but with suitable choice of technique position, and care in handling, this should not present too much of a problem. There is also the chance of interfering with an organizing haematoma, and the possibility of myositis ossificans, particularly in gracillis and to a lesser extent in the quadriceps, must be considered.
30.1 • Kneading anterior thigh supine From the opposite or same side of the table the operator can apply a cross-fibre kneading to the quadriceps by concentrating either on the hand pushing away from himself, the hand pulling towards himself, or a bit of both according to the needs of the tissue. The more the work is shared by both hands, the less the amplitude of movement with each hand, and therefore the less discomfort for the patient.
Tips: Most useful where the muscles are not very well developed as it is possible to get into the belly of the muscle well. Least useful with large strong muscles and very tight fascia. Extra considerations: Deep and slow produces the best result as the muscle has time to relax, and fluid interchange takes place.
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