My Pesky Pectineus

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I have a story not unlike many of us yoga practitioners and athletes. We all have a story. I survived two very serious auto accidents within two years of each other. Long story—short; beside multiple, head, chest, and knee injuries, I had fractured my spine, breached the left hip socket which leaked synovial fluid out of the joint, resulting in four hip surgeries within three years. Three total hip replacements. The last one was 2 ½ years ago on my right hip. I’m almost 62 years old and complete healing, in my experience (for my standards of joyful yoga function) continues for over 2-3 years.

I underwent an anterior approach hip arthroscopy. There is a 4½ inch incision at the anterior, lateral portion of my pelvis, inferior to my ASIS. With this approach no muscles are cut, but a lot of fascia is! Muscles are separated, then retracted out of the way to expose the joint capsule, allowing space to disarticulate and amputate the head and neck of the femur. A titanium cup and plastic sleeve are positioned into the acetabulum, and a prosthetic head with long post placed within eviscerated femur bone.

Then they send you on your merry way with minimal weight bearing for 8 weeks. As a long time athlete, dancer and yoga practitioner, I commenced my PT exercises with gusto. Immediately I noticed (yes it was disarming and alarming!) I could no longer flex my hip to lift my leg off the floor in a supine position. I also had no ability to abduct & if I manually would get it out there, away from the other leg there was NO way, on God’s little green acre, I could get my legs back together by adducting my thigh. After about 4 months I could lift it (with much effort), and the abductors turned back on. The ability to achieve those movements gave me hope.

I saw my ortho and complained about the adductor issue, he calmly said “oh it’s still asleep”. It felt comatose to me! I was also having a lot of pelvic floor issues. I love using my Yoga Tune Up® therapy ball for pelvic floor release.

Fast forward, my strength improved and I am back to my practice. I feel very blessed to have found Jill Miller and Yoga Tune Up®. I am E-RYT, have 30 years’ experience in teaching and practice, and I couldn’t wait to become a certified YTU teacher, because of the inherent value it holds for everyone, not only yogis. There are nuances in Yoga Tune Up® which make traditional postures deeper, yet more effective, and precise. Targeting areas and tiny muscle groups laying close to the joint that are untouched by many traditional modalities.

Pectineus and anterior muscles of the hip

Pectineus and anterior muscles of the hip

I still periodically experience pain in my groin and inner thigh. I’ve been analyzing what exactly is my problem? The precise area I experience residual discomfort is deep within the inner thigh, groin, and pain the fold where the leg joins the body. This led me to examine the musculature contributing to both these locales.

With experimentation, examination, investigation, and scrutinizing, I determined the pectineus muscle is participating in my issue. This is why.

The pectineus originates along the pectineal line, at the ramus of the pubis, it inserts inferior to the lesser trochanter on the posterior surface of the femur. In short, it connects the pubic bone to the top of your thigh bone. The pectineus assists with moving your thigh inward toward the body (adduction), medially rotating, and bringing your thigh forward (flexion). The pectineus helps us achieve things akin to kicking a football, or crossing the legs. Similar to the actions I could not achieve for the longest time, lift my leg off the floor & especially adduct my hip!! The entire area sustained trauma. Here are some activities that can cause pectineus muscle pain and symptoms; sitting for long periods with legs crossed, a slip or catching yourself in a mis-step, and power walking when the stride is forcefully longer than one’s usual stride.

Now that we’ve discussed the ins an outs of the pectineus, join me on Friday for an adventure in self-exploration!

Enjoyed this article? Read Strengthen Your Pectineus!

 

Shari Williams

Shari is a Yogi and a Scientist. It's her passion for the practice of yoga which fuels her desire to teach. She has direct experience of healing and the significant transformation yoga offers & specifically the increase in strength and joint mobility Yoga Tune Up(R) provides. You will be presented with instruction firmly rooted through her education in kinesiology. The study of human movement. as well as her vast athletic, energetic and Yogic understanding. She has 30 years of teachng and practice experience, Shari knows yoga! She has a developed "eye" to see nd enlighten you to your body's blind spots. Being a lover of the human form and compassionate about the nuance of human condition you will find her warm and accessible. she is hands on (yet respectful if this is not your choice) assisting you develop healthful alignment, the foundation to build your postures. She loves life and enjoys being in nature, hiking in the woods, or biking through the forest. Yoga practice with Shari will enhance your life, give you more time in the day through enhanced energy, self esteem and well-being. She is available for private sessions, workshops, and teaches weekly classes at the Golden Mandala Collective in Nevada City, California.

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Katelyn

Wow Shari, thanks for sharing your journey! It was very interesting to read the process of a hip replacement. It gives perspective to how intricate our bodies are. Your experience has given me some insight into my own pains. Post birth I have definite weakness in my adductors and now suspect my pectineus plays a major role in the “tweaks” that I feel. Thanks for shedding some light on this.

Katharina

Thank you Shari for your article. I have the exact same symptoms that you describe in my inner right groin, especially when folding the hips. Just a few days ago, I decided to read articles on the pectineus, as its connection to the pubic bone pretty much meets the point where I locate my pain in hip flexion. Your detailed description of this muscle helps me in further investigating the possible causes of my groin pain. In my case, the cause of trauma lies in performing a large amount of lunges where, when placing the right foot in front and… Read more »

Ben

Very interesting, I’m seeing a hip orthopaedic specialist next month to talk about my hip impingement and useful to read about the surgery you had, Its amazing that you were able to isolate and identify that as the muscle causing your pain.

Nadia

I really enjoyed reading your blog. It’s very informative. Thank you for sharing your journey to recovery. Knowledge is power and your commitment to healing yourself is inspiring.

Grant

Seems like everyday I’m learning about a new muscle in the hips! This post continues to reaffirm my belief that adductors are woefully ignored muscles. I’m definitely going to have to try and feel this muscle next time I do some adductor slide movements.

Kim

Great article! I recently worked with a runner who was having knee pain. It turned out the knee pain was referred pain from her pectineus! Thanks for sharing your story.

Melissa J

Thank you for sharing your story this was so inspiring. I loved the examples of activities that cause pectineus muscle pain and symptoms. I realized that I walk with a bigger stride that I would normally walk when I am in hurry which is happens far too often. Time to take a look! Happy Healing!

Katie Rutterer

Amazing that you were able to pinpoint such a specific muscle as the root!

I like the idea of ‘waking a muscle up’ by using the YTU balls.

Kendra

These types of articles continue to be my favorite! What a great outline of a muscle not commonly known to the general population that can cause some significant dysfunction when not adequately looked after. Anyone experiencing groin pain or a functional limitation with adduction of the hip should definitely consider this as the culprit in their differential diagnosis. The photo was a great addition clearly demonstrating the anatomy in a complex region.

Kelly

I agree that the YTU method is so empowering, allowing us to participate actively in our own health care and wellbeing

Tracey Silverman

Wow, Shari! Thank you so much for sharing your story and the details of your surgery. 3 total hip replacements – holy moly! Your commitment to healing yourself and puzzling through the challenges and pain is inspiring. I had pubic symphysis disorder during my pregnancy and often have interesting inner thigh/pubic bone sensations and really appreciate your description of the anatomy and function of these muscle/fascia connections. I had a lightbulb moment in your other post linking the pectineus with the obturator externus.

Téa

The pectinius is also a muscle that can be strained during pregnancy, I’ve experienced this first hand. Thanks for the enlightening article!

Claudia Jasper

Hi Shari, I really enjoyed reading your post. I completely agree with you, there is a freedom to learning and knowing more about your body and its capabilities, even when it is not at its normal state. I have found through my own injuries, that I struggle with admitting when I need to back off, even when i know once I have healed I can resume normal practice. I think we have developed a culture, especially in the athletic industry, of pushing boundaries, boundaries that normally should not be pushed. That is why I have really enjoyed YTU because it… Read more »

Helen McAvoy

Great article looking forward to the next! I have a student who has similar issues in that area…thank you !