Learn & Go w Dr. Laurie Iliopsoas Part 2 - For Medical Professionals
Welcome to Iliopsoas Part 2, our latest edition of "Learn & Go with Dr. Laurie"! Today, we will delve further into the iliopsoas muscle—a key player in canine locomotion and a frequent source of musculoskeletal issues. This vlog will focus on its anatomy, palpation techniques, and effective stretching methods. You can see Iliopsoas Part 1 here.
Anatomy of the Iliopsoas Muscle
The iliopsoas muscle is composed of two distinct muscles: the iliacus and the psoas major. These muscles originate from the ventral aspect of the lumbar vertebrae and the pelvis, converging to insert on the lesser trochanter of the femur. This deep-seated muscle group is critical for hip flexion and stabilizing the lumbar spine.
Palpation Techniques
Effective palpation of the iliopsoas muscle requires a thorough understanding of its anatomical landmarks:
Positioning the Dog: Have the dog lie in lateral recumbency. Ensure the dog is calm and relaxed to allow for effective palpation. Make sure the hip and lumbar spine are at least moderately flexed.
Locating the Muscle: Begin by palpating the ventral aspect of the lumbar spine and the iliopsoas’ origin. Follow the side muscles (longissimus and iliocostalis) ventrally pushing the intestines, with gravity, toward the floor. Having a hand on the dorsal spinous processes and knowing that the iliopsoas is just lateral to this, allows you to find where this pencil-like muscle is hiding. Firm but gentle pressure is necessary to feel the muscle belly. Once you find it, you can follow it distally towards its insertion on the lesser trochanter of the femur.
Stretching and Shortening: To facilitate palpation, slowly and gently extend and flex the hip joint. Hip extension will stretch the iliopsoas, making it easier to distinguish from surrounding tissues. Conversely, hip flexion will shorten the muscle making it softer. Palpate along the length of the muscle, noting any areas of tension, swelling, or discomfort.
Identifying Pain Points: Any signs of pain or resistance may indicate strain or injury.
Stretching the Iliopsoas Muscle
Stretching is crucial for maintaining muscle flexibility and preventing injury. Here's how to properly stretch the iliopsoas muscle:
Hip Extension Stretch: With the dog in a standing position, gently extend the hind leg backwards. This action elongates the iliopsoas muscle. Then gently and slowly internally rotate and or abduct the limb. This provides a thorough muscle stretch. Hold the stretch for 15-20 seconds before releasing.
Stabilizing the Pelvis: Stabilize the pelvis by holding the tuber ischii. This ensures that the stretch targets the iliopsoas effectively without causing undue movement in the lumbosacral or sacroiliac joints.
Assessment: Observe the dog's reaction to the stretch. If there is significant resistance or discomfort, it may indicate an underlying issue that requires further investigation.
Differential Diagnosis
When extending the hip, if the dog exhibits pain, it is essential to differentiate between iliopsoas strain and other potential sources of discomfort, such as:
Hip Joint Pathology: Pain originating from hip dysplasia or osteoarthritis.
Lumbosacral Disease: Discomfort due to lumbosacral stenosis or spondylosis.
Sacroiliac Joint Dysfunction: Pain related to sacroiliac joint instability or inflammation.
If the exact source of pain is unclear, radiographs may show changes in the lesser trochanter. If you are still not sure, refer the patient to a surgeon or rehabilitation specialist who may perform advanced imaging if necessary to identify the issue.
Conclusion
Understanding the iliopsoas muscle's anatomy and mastering palpation and stretching techniques are vital for diagnosing and treating related issues. In our next session, we will explore advanced therapeutic approaches and rehabilitation exercises tailored for iliopsoas muscle injuries.
Thank you for your commitment to veterinary excellence. As always, feel free to reach out with any questions or for further discussion on this topic.
Warmest regards,
Dr. Laurie McCauley, DVM, DACVSMR, CVC, CVA, CCRT
Optimum Pet Vitality
Empowering People, Optimizing Pets
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