Lower Back Pain – Thigh Abduction

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By Jennifer Chu

Patients with lower back pain often secondary to irritation of the L5 and S1 nerve roots will have difficulty not only due to the pain but due to weakness of the hip abductor muscles. The most powerful hip abductor is the gluteus medius. It is supplied by the superior gluteal nerve (L4, L5 and S1). The L5 nerve root has the strongest representation in this muscle. The other hip abductors are the other muscles are tensor fascia latae and gluteus minimus which are also supplied by the superior gluteal nerve.

Hip abduction can be tested with the patient supine with the thighs spread apart. The examiner then pushes the thigh inward to the midline. The hip abductors can also be tested with the patient lying on his side with the tested side uppermost. The patient then lifts the thigh up against gravity.

The most functional way of testing for hip abduction is to have the patient stand on one limb. If he is standing on his right leg and if he has weakness in his right hip abductor muscles his opposite hip will drop. This testing is called the Trendelenburg testing. To prevent the left hip from dropping in the case of a right hip abductor weakness, the patient may lean over to the right. This is also an indicator of weakness of the hip abductors on the right side.

Jennifer Chu, M.D., founder of eToims Soft Tissue Comfort Center® is also President and CEO of eToims Medical Technology LLC, a medical device company with training programs in eToims® Twitch Relief Method. She is an Emeritus Associate Professor in the Department of Physical Medicine and Rehabilitation at the University of Pennsylvania, where has been on faculty for more than 30 years.

Jennifer Chu, M.D. emeritus professor of Physical Medicine and Rehabilitation, School of Medicine, University of Pennsylvania, pioneered eToims Twitch Relief Method that utilizes surface electrical stimulation to locate motor points (trigger points). The motor points are then stimulated to induce strong local muscle contractions, termed twitches. This results in reduced muscle pain and discomfort in the areas that were stimulated. The involved pain/discomfort-relieving mechanism is thought to include local muscle exercise and stretch effects.

eToims Soft Tissue Comfort Center® specializes in diagnosis and treatment which ends muscle discomfort and pain.

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