Long Axis Traction Through Manual Therapy and HipTrac

Long Axis Traction Through Manual Therapy and HipTrac


Long axis traction. When people come in and you’re trying to figure out, do they have back pain? Is it an extra-articular problem,
is it an intra-articular problem? If they have OA? Can you guys see that okay? You can make that go at any level. You can go, you know, start at more flexion if you wanted to be a little
more looser or a little bit more comfortable. Chase them down to extension. But when you’re in that evaluation and you’re pulling their leg – how many people in this room have heard that in their career, where you pull and they’re like, “Oh gosh, keep doing that, please keep doing that. Don’t stop! That’s the best, my husband is too lazy. He won’t do it. And my wife, you know, she won’t do it.” So then I – And they intuitively know that they want distraction,
they want that pulled on. We know long axis traction, not curing cancer here. It’s not
going to fix anything. But when someone comes in really acute and in a lot of pain and you
can’t touch them and they don’t have that steroid injection, that’s that one thing that
you usually can do. Especially if it’s OA or FAI. Now, if it’s that nineteen year old with hypermobile ballet, dancer who has a labral tear, she or he may like some traction but
they don’t want heavy traction. They’re not going to like that like somebody with moderate OA. They just want to be unloaded. So they do well with a superband just to
kind of, unload them a little bit after training or after a long day at the office or whatever.
But someone with OA, the super band is just not going to be enough. It feels good, you can
take it on the road with you and it’s a great tool but it’s just not going to be enough.
Which we’ll get to HipTrac here in a moment. That long axis traction, besides kind of unlocking that pain, it’s going to cause relaxation. It’s going to create glute medius and glute
minimus relaxation. It’s going to decrease hypertenacity of psoas. You’re going to see this natural relaxation that occurs and it happens anywhere in the body. If we took everybody in this room and said, “How many have neck pain?” Let’s say twenty of you said they don’t have neck pain. And I laid you down up here and we did a little soft tissue work, I did
some traction and I said, “How are you feeling?” “Oh my gosh I didn’t realize how much pain I was in.” There’s a natural phenomenon, even if you don’t have hip problems. So there’s
PGA tour golfers, there’s athletes on the ATP, you know, the tennis tour, they get long axis traction and they don’t have any pathology at all. They just want to recover from really intense training. And the athletic trainers do that. When I played basketball at Oregon State, I’m twenty two years old and they’re doing some of these osteopathic things to me and I’m like, I don’t really know why they’re doing it but it feels good. So it’s not just for people
with disease either. All right. And then HipTrac. So HipTrac is a device here that basically replicates what we do in the clinic. You can do it on your bed. You can do it on the floor. It can
replicate any degree of extension, abduction, IR, ER and up to thirty degrees of flexion.
And so most people, when they have hip OA or capsular pattern, you know, they lose favors, they loose I-R, extension, abduction, they can’t abduct, flex, internally rotate, you know, they lose all that stuff. You’ve got to get them moving again. And so you start in that loose pack position maybe. So the goal is to chase them into closed pack. That’s the goal of any mobilization right? Try to get them into closed pack. People say, “Well you don’t mobilize in closed pack.” And you’re like, “You’re right. If I can get to
closed pack then there is no need to mobilize. I already won. So we’re done.” But if you’re
always mobilizing in loose pack position you’re not chasing that restriction. So, just
like anywhere else, but in the beginning, on that first and second visit, you’d like to see
them for a third visit. So you want to be boring a little bit, get them used to grabbing them or pushing on their ankle skin, or their hip or whatever. You’re sort of kind of trying to charm them a little bit. But then you’ve got to kind of get into it. You’ve got to
ramp it up a little bit. You’ve got to kind of chase that closed pack. The important thing here is the four hundred to a thousand Newtons. So we know that in the literature that four
hundred Newtons – give or take a couple of fifty Newtons is what it takes to distract the human hip. But then we have studies that show that when you get close to eight hundred Newtons and it’s even better for outcome for mobility and pain. But again we need a lot more research around this. But that’s important here, based on the Newtons, because this will produce up past that eight hundred to a thousand Newtons. The super band will not. So super bands great; when you don’t have this, travelling, hypermobile or not that stiff. But if you got a stiff
hip, you want this thing.

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