I have noticed a trend with my clients who have very similar backgrounds.
I have four clients over the age of 30, all female, all with two children each (age 3-14), and all of them have experinced the same problem on the four sign screen which is stop them progressing onto stabilise.
I have managed to pass all other screens (nerve, pelvis and spine) however on the right side of these cleints pelvis, the screens are all positive. They are all doing similar actions aswell, as when i screen i can see the left side of the hip almost pulling across.
I was just wondering if anyone else had experienced this, and if so how they dealt with it??
The problem seems to be 4-sign on the right side. The results just dont seem to change at all.. after given 4-sign as an exercise, the left seems to become a negative however the right seems to stay positive regardless of what do and the distance the knee is from the coach just doesnt seem to change. On a couple of clients this is the only factor holding me back to progressing onto stabilise/functionalise..
OK, so what factors can stop someone passing the 4-sign and how long should you leave it before progressing on to stabilise whether they pass 4-sign or not?? the answer to these questions were covered on the course, let me know what you think.
I think the two main factors are muscle spasm in the piriformis muscle and also the glute muscles. I would also say from previous experience this could also be the inner thigh muscles such as gracilis?
I would say leave 6 weeks before moving onto stabilise. At this point 6 weeks of anti-spasm would have taken place, so then i would move onto stretching glutes, piriformis and gracilis.. then strengthen antagnoist and then conditioning. Is this correct?
Im actually going to but a new post about moving on to stabilise, in the stabilise section. WOuld be interesting to see other peoples thoughts.
Yes you're quite right. rememebr the test is to estabilsh pelvic dysfunction, not sspecifically piriformis or other muscle spasm, although it may be an indicator. rememebr also that hip joint immobility can cause a false positive, so if it continues to be posiitve think about referal for therapist to see if there is any major joint restriction like arthitits.
