Integrating Japanese Eastern medicine with Western medicine.

For many people, sitting for long periods of time is unavoidable, whether for desk work or housework. In fact, many patients come to our clinic for advice on back pain caused by desk work. In this case, I would like to introduce a patient who worked in the same position for a long time and whose pain did not subside for two weeks afterward.

Patient’s Situation
The patient is a housewife in her 50s. After working on a computer for 3 hours, she had pain at the base of her left leg when she moved her leg. According to the patient, when she was sitting, her left pelvis was forward and she was working while leaning on her right elbow rest. After examining his range of motion, muscle stiffness, and strength, we found that he had hip pain when he lifted his knee by putting pressure on the psoas major muscle of his left hip. In addition, examination of pelvic movement revealed that during the knee lifting motion, she was not able to use her abdominal muscles well to stabilize her pelvis by using her psoas major muscles excessively.

Usual sitting posture

The cause was thought to be an asymmetrical posture, in which the psoas major muscle was stretched for a long time and its ability to move the left leg was temporarily impaired. In the treatment, we first increased the flexibility around the psoas major muscle so that it would not put too much strain on the psoas major muscle when it was moved. The pain was then reduced to about half, but the pain had not yet been completely removed. Next, the pelvis was unstable because the abdominal muscles were not being used properly. Therefore, we practiced stabilizing the pelvis and moving the hip joint. When lifting the knees up in a sitting posture, the pelvis falls slightly backward under normal circumstances. If this movement does not occur, the hip joint will bend excessively and the muscles at the base of the hip joint will be pinched. After practicing the pelvic movement, I asked the patient to perform the knee lifting exercise and the pain went away.

The psoas major muscle connects the femur to the spine and is the muscle that works in the upright posture and when pulling the thighs up.

Normal Pelvis posture (Left), Patient’s case (Right)

After treatment
After improving flexibility around the muscles and practicing pelvic movements, the pain when lifting the knee disappeared. We ended the session with instruction on correct sitting posture and exercises to increase flexibility and stability of the hip and pelvic area. We ended the treatment by agreeing that we would not make an appointment for the next session, but would make an appointment if any pain occurred in the future.