Manual therapy + movement for the masses

Pain in the Nethers-Conversation About DTM and Pelvic Pain

Pain in the Nethers-Conversation About DTM and Pelvic Pain
April 30, 2018 Phillip Snell

This is a live discussion between Dr. Dean and Dr. Snell discussion DTM treatment options for coccydynia, some pelvic pain, upper hamstring, buttock and very high adductor symptoms. This video includes several personal case studies that challenge you to think outside of the box.

Key concepts

1) Pudendal nerve only partially innervates areas of the external genitalia. Pudendal branch of the Posterior Femoral Cutaneous Nerve is also an important consideration.

2) Inferior Cluneal Cutaneous Nerves should be considered in gluteal pain and coccydynia. They are branches of the PFCN.

3) The Lateral Fiberous Expansion is an important manual therapy location when assessing all said cutaneous nerves. DTM is this location can be highly effective!!!;)

 

Stecco practitioners will recognize this as the Retro-Pelvic point.

4) Cutaneous Nerves (gluteal cleft) should be considered when assessing someone for hamstring complaints!!! Think sprinters!!!!!

5) The purpose of this video to to give therapist options for pelvic pain, coccydynia, hamstring pain and buttock pain. Sciatica and flexion intolerant discogenic low back pain should be cleared with an orthopedic and neurodynamic exam! Don’t go too far down the rabbit hole!!!!

Check out previous DermalTractionMethod blog discussing the Posterior Femoral Cutaneous Nerve with Hamstring pain.

Chronic Hamstring Pain and the Posterior Femoral Cutaneous Nerve

 

References:

1)  Ploteau, S., Salaud, C., Hamel, A., & Robert, R. (2017). Entrapment of the posterior femoral cutaneous nerve and its inferior cluneal branches: Anatomical basis of surgery for inferior cluneal neuralgia. Surgical and Radiologic Anatomy,39(8), 859-863. doi:10.1007/s00276-017-1825-z
2)Ploteau, S., Salaud, C., Hamel, A., & Robert, R. (2017). Entrapment of the posterior femoral cutaneous nerve and its inferior cluneal branches: Anatomical basis of surgery for inferior cluneal neuralgia. Surgical and Radiologic Anatomy, 39(8), 859-863. doi:10.1007/s00276-017-1825-z
3) Tubbs, R. S., Miller, J., Loukas, M., Shoja, M. M., Shokouhi, G., & Cohen-Gadol, A. A. (2009). Surgical and anatomical landmarks for the perineal branch of the posterior femoral cutaneous nerve: Implications in perineal pain syndromes. Journal of Neurosurgery, 111(2), 332-335. doi:10.3171/2008.11.jns081248

 

Comments (0)

Leave a reply

Your email address will not be published.

*