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The Adductor Minimis head of Adductor Magnus muscle is a seldom-discussed head that needs more clinical attention.
内收小肌头(Adductor Minimis Head)是内收大肌(Adductor Magus)中非常少被讨论但需要更多临床关注的肌肉
This week, my business partner, master trainer Joe Boffi, was noticing a limitation in his right hip external rotation. He felt it lock up as he tried to squeeze the glutes and press a kettlebell overhead. 这一周, 我的事业伙伴- 个人训练大师Joe Boffi发现他的右髋关节在外转时受限他的髋关节在收缩臀肌以及将壶铃上举时有锁死的感觉
He pointed to a round sore spot that had created a palpable swelling, inferior to the greater trochanter of the femur. 他指出了一个圆形的酸痛点,并且有明显的肿胀 就在股骨大转子(Greater Trochanter)之下
This ball of tissue was inserting on the gluteal tuberosity, where 25% of the Gluteus Maximus attaches.This ball of tissue was a concentrically loaded (locked short) Adductor Minimus. 这个球状组织连接在股骨臀肌粗隆(Gluteal Tuberosity) , 25%的臀大肌连接于此处这个球状组织是内收小肌锁死在向心收缩(locked short)的现象
The Adductor Minimus is a powerful internal rotator of the femur, due to its perfect positioning between the ischial tuberosity (sit bone) and the gluteal tuberosity (posterolateral hip). 由于位置完美的介于坐骨粗隆(Ischial Tuberosity)与股骨臀肌粗隆(髋后外侧)之间，内收小肌是一条非常强壮的股骨内转肌
This third head of the Adductor Magnus muscle can be recruited easily, as Adductor Magnus is dominating hip extension in an internally rotated position. 而因为内收大肌在髋内转的姿势下控制了髋伸展动作，这条内收大肌的第三头可以轻易的被征召活化
For Joe, the dysfunction was being driven by the labored ability to supinate his right foot, due to a fibular fracture in his history. 在Joe的案例中失能来自于右足旋后困难, 与他曾经有过腓骨骨折相关
Without the cue from the foot to supinate, the Gluteus Maximus recruitment was down-regulated.缺乏了来自足部旋后(Supinate)的回馈,臀大肌的征召能力会下降
Adductor Magnus then acts like a hero, trying to step in as a hip extensor in the pronated foot. 这时内收大肌就像英雄一般现身,在足旋前(Pronated foot)状态出面帮助髋伸肌
This can’t go well, since Adductor Magnus is already loaded in the sagittal plane. The Adductor Minimus can become very painful, as an attempt to stretch into external rotation goes uncued by the foot. 但这个过程不会太顺利, 由于内收大肌已经在矢状面上工作, 内收小肌在要被伸展至外转却又缺乏足部旋后的情况下可能会非常疼痛
广告
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The Gluteus Maximus needs foot supination and hip external rotation to shorten, and Adductor Minimus needs both of those movements to fully stretch. 臀大肌需要足部旋后以及髋外转去缩短而内收小肌需要这两个动作去伸长
We broke the vicious cycle by first mobilizing and encouraging supination in his right foot. After that was complete, Adductor Minimus had permission to relax, allowing Gluteus Maximus to externally rotate the hip. 回到Joe的案例, 我们先增加右足的活动以及促进旋后来打破这个失能循环完成之后, 内收小肌才得以放松
After treatment, we got creative and gave Joe a corrective that supplies all those treatment features. 使臀大肌可以执行外转的动作在治疗后, 我们给予Joe一个包含这些动作元素的矫正性运动
His press immediately improved, as did his comfort level at the hip. We could see and feel an absolute improvement in his foot supination and hip external rotation.他的壶铃上举马上得到进步, 而且髋部的异常感觉也有所降低我们也马上看到足旋后与髋外转的显著改善
If your client is having trouble accessing supination and/or hip external rotation, assessing Adductor Minimus is a must. 如果你的患者对足旋后或者髋外转有障碍,那绝对需要评估内收小肌
Remember that it is an adductor and internal rotator, a direct opposer to Gluteus Maximus on those planes. 记住这是一条内收与内转的肌肉, 与臀大肌恰恰相反
The other two heads to Adductor Magnus are powerful hip extensors, so Adductor Minimus can act as a compensator in an already loaded Adductor Magnus.内收大肌的其他两头是强力的髋伸肌, 所以内收小肌会是内收大肌中的代偿者
Check the pictures to learn the location for palpation of Adductor Minimus.可以参照下面的图并且学习内收小肌的位置以及如何触诊
By:Dr. Kathy Dooley
