What’s your go-to strategy for a QL release? We’ve got a guy with a high hammy strain and upslip on the same side.
The quickest fix for an upslip is a leg pull manip.
Have him hold on to the table, try a diaphragmatic breath, let it out, and almost at the end of exhale, then you do a quick yank on the leg downward. You can try some distal joint play to see where/if there is a stronger direction of resistance.The pull must be quick like a cobra. Not trying to sound silly, but do it almost when they are not expecting it.
It can be scary to try this when it’s acute, but that’s when manipulations work the best according to the literature.
Otherwise I would go pillows on the opposite side in side lying and look for the trigger lateral to the TVerse processes of L1 to L4. It can be anywhere in there, but you’ll know you’re on it id the referral is to the sacrum, high hamstring (is it really a high hamstring strain?), or same side pelvic rim or greater trochanter.
Follow this with a length with breath technique of keeping the pillow in there, let the top leg drape backwards and breathe. Or you can let the top leg drape forward and let it hang. Use the myofascial position that feels better or allows for a perfect breath.
While this isn’t directly-related to this post, it got me wondering about what types of suggestions you’d make to your patients/clients/athletes in terms of selecting an optimal sleeping surface and position for their needs. Perhaps at some point int he future if you have the time and the desire to do so you can throw out any pertinent suggestions you might make on these fronts.
Given that many hours are spent in bed, this seems like one of those stealth areas that can make or break an effective treatment process (or at least greatly throw a wrench into the works if the person is essentially undercutting himself during these hours).