The Association Between Femoral Nerve Tension and Hip Flexor Length Femoral Nerve Tension and Hip Flexor Length
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Abstract
Background: Femoral nerve tension and hip flexor muscle length are critical factors in musculoskeletal health. Their relationship is particularly important in diagnosing and managing conditions like low back pain, often associated with tight hip flexors.
Objective: This study aimed to explore the association between femoral nerve tension and hip flexor muscle length in individuals with acute low back pain compared to healthy controls.
Methods: A correlational study was conducted with 68 participants (34 healthy controls and 34 acute low back pain patients). Data were collected using self-administered questionnaires and clinical tests, including the Prone Knee Bend Test and Modified Thomas Test. Femoral nerve tension and hip flexor length were measured using a goniometer. Data were analyzed using Pearson correlation and linear regression in SPSS version 25.
Results: The Thomas Test showed a statistically significant negative correlation between femoral nerve tension and hip flexor length in Group B (-0.096, p=0.042). In the Prone Knee Bend Test, a minimal positive correlation was observed (0.007, p>0.05). Cross-tabulation highlighted a significant association between test results in the control group (p=0.025).
Conclusion: A significant relationship exists between femoral nerve tension and hip flexor length in individuals with acute low back pain. These findings suggest the need for targeted interventions focusing on neural and muscular components.
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References
References:
Turl SE, George KP. Adverse neural tension: a factor in repetitive hamstring strain? The Journal of orthopaedic and sports physical therapy. 1998;27(1):16-21.
Nischal P, Agarwal S, Kumar D. Effect of Hip Flexor Muscles Strengthening and Femoral Nerve Sliding on Lumber Lordosis and Low Back Pain.
Anloague P, Chorny W, Childs K, Frankovich M, Graham C. The Relationship between Femoral Nerve Tension and Hip Flexor Muscle Length. J Nov Physiother. 2015;5(244):2.
Refai NA, Black AC, Tadi P. Anatomy, Bony Pelvis and Lower Limb: Thigh Femoral Nerve. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Asa Black declares no relevant financial relationships with ineligible companies. Disclosure: Prasanna Tadi declares no relevant financial relationships with ineligible companies.: StatPearls Publishing Copyright © 2023, StatPearls Publishing LLC.; 2023.
Chhabra A, Faridian-Aragh N. High-resolution 3-T MR neurography of femoral neuropathy. AJR American journal of roentgenology. 2012;198(1):3-10.
Park JA, Lee SH, Koh KS, Song WC. Femoral nerve split with variant iliacus muscle: a potential source of femoral nerve entrapment. Surgical and radiologic anatomy : SRA. 2020;42(10):1255-7.
Vázquez MT, Murillo J, Maranillo E, Parkin IG, Sanudo J. Femoral nerve entrapment: a new insight. Clinical anatomy (New York, NY). 2007;20(2):175-9.
Spratt JD, Logan BM, Abrahams PH. Variant slips of psoas and iliacus muscles, with splitting of the femoral nerve. Clinical anatomy (New York, NY). 1996;9(6):401-4.
Livingstone JP, Tamate TM, Richardson AK, Harpstrite JK. A Cadaveric Study Measuring Femoral Nerve Tension During Anterior Total Hip Arthroplasty Approach. Hawai'i journal of health & social welfare. 2022;81(3 Suppl 1):30-6.
Kim GM, Ha SM. Reliability of the modified Thomas test using a lumbo-plevic stabilization. Journal of physical therapy science. 2015;27(2):447-9. Case reports in orthopedics.
González-de-la-Flor Á, García-Pérez-de-Sevilla G, Domínguez-Balmaseda D, Del-Blanco-Muñiz J. Validity and reliability of a new hip flexor muscles flexibility assessment tool: The reactive hip flexor (RHF) test. Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine. 2023;64:41-7.
Kumar S, Pflueger G. Delayed Femoral Nerve Palsy Associated with Iliopsoas Hematoma after Primary Total Hip Arthroplasty. 2016;2016:6963542.
Gibelli F, Ricci G, Sirignano A, Bailo P, De Leo D. Iatrogenic femoral nerve injuries: Analysis of medico-legal issues through a scoping review approach. Annals of medicine and surgery (2012). 2021;72:103055.
Thorborg K, Bandholm T, Zebis M, Andersen LL, Jensen J, Hölmich P. Large strengthening effect of a hip-flexor training programme: a randomized controlled trial. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2016;24(7):2346-52.
Jiroumaru T, Kurihara T, Isaka T. Measurement of muscle length-related electromyography activity of the hip flexor muscles to determine individual muscle contributions to the hip flexion torque. SpringerPlus. 2014;3:624.
Peshin S, Karakulova Y, Kuchumov AG. Finite Element Modeling of the Fingers and Wrist Flexion/Extension Effect on Median Nerve Compression. Applied Sciences. 2023 Jan 16;13(2):1219.
Shahid A, Kashif F, Asghar F, Islam F, Raza A. Hip Flexors Shortening among Patients with Low Back Pain. American Journal of Health, Medicine and Nursing Practice. 2023 Oct 1;9(2):22-31.
Teichmann J, Burchardt H, Tan R, Healy PD. Hip Mobility and Flexibility for Track and Field Athletes. Advances in Physical Education. 2021 Mar 18;11(2):221-31.
Karen D, Green DS, Jensen GM, Savinar E. A comparison of muscular tightness in runners and nonrunners and the relation of muscular tightness to low back pain in runners. Journal of Orthopaedic & Sports Physical Therapy. 2021 Jun;6(6):315-23.
Butler D, Gifford L. The concept of adverse mechanical tension in the nervous system part 1: testing for “dural tension”. Physiotherapy. 2015 Revised Edition Nov 10;75(11):622-9.
References:
Turl SE, George KP. Adverse neural tension: a factor in repetitive hamstring strain? The Journal of orthopaedic and sports physical therapy. 1998;27(1):16-21.
Nischal P, Agarwal S, Kumar D. Effect of Hip Flexor Muscles Strengthening and Femoral Nerve Sliding on Lumber Lordosis and Low Back Pain.
Anloague P, Chorny W, Childs K, Frankovich M, Graham C. The Relationship between Femoral Nerve Tension and Hip Flexor Muscle Length. J Nov Physiother. 2015;5(244):2.
Refai NA, Black AC, Tadi P. Anatomy, Bony Pelvis and Lower Limb: Thigh Femoral Nerve. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Asa Black declares no relevant financial relationships with ineligible companies. Disclosure: Prasanna Tadi declares no relevant financial relationships with ineligible companies.: StatPearls Publishing Copyright © 2023, StatPearls Publishing LLC.; 2023.
Chhabra A, Faridian-Aragh N. High-resolution 3-T MR neurography of femoral neuropathy. AJR American journal of roentgenology. 2012;198(1):3-10.
Park JA, Lee SH, Koh KS, Song WC. Femoral nerve split with variant iliacus muscle: a potential source of femoral nerve entrapment. Surgical and radiologic anatomy : SRA. 2020;42(10):1255-7.
Vázquez MT, Murillo J, Maranillo E, Parkin IG, Sanudo J. Femoral nerve entrapment: a new insight. Clinical anatomy (New York, NY). 2007;20(2):175-9.
Spratt JD, Logan BM, Abrahams PH. Variant slips of psoas and iliacus muscles, with splitting of the femoral nerve. Clinical anatomy (New York, NY). 1996;9(6):401-4.
Livingstone JP, Tamate TM, Richardson AK, Harpstrite JK. A Cadaveric Study Measuring Femoral Nerve Tension During Anterior Total Hip Arthroplasty Approach. Hawai'i journal of health & social welfare. 2022;81(3 Suppl 1):30-6.
Kim GM, Ha SM. Reliability of the modified Thomas test using a lumbo-plevic stabilization. Journal of physical therapy science. 2015;27(2):447-9. Case reports in orthopedics.
González-de-la-Flor Á, García-Pérez-de-Sevilla G, Domínguez-Balmaseda D, Del-Blanco-Muñiz J. Validity and reliability of a new hip flexor muscles flexibility assessment tool: The reactive hip flexor (RHF) test. Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine. 2023;64:41-7.
Kumar S, Pflueger G. Delayed Femoral Nerve Palsy Associated with Iliopsoas Hematoma after Primary Total Hip Arthroplasty. 2016;2016:6963542.
Gibelli F, Ricci G, Sirignano A, Bailo P, De Leo D. Iatrogenic femoral nerve injuries: Analysis of medico-legal issues through a scoping review approach. Annals of medicine and surgery (2012). 2021;72:103055.
Thorborg K, Bandholm T, Zebis M, Andersen LL, Jensen J, Hölmich P. Large strengthening effect of a hip-flexor training programme: a randomized controlled trial. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2016;24(7):2346-52.
Jiroumaru T, Kurihara T, Isaka T. Measurement of muscle length-related electromyography activity of the hip flexor muscles to determine individual muscle contributions to the hip flexion torque. SpringerPlus. 2014;3:624.
Peshin S, Karakulova Y, Kuchumov AG. Finite Element Modeling of the Fingers and Wrist Flexion/Extension Effect on Median Nerve Compression. Applied Sciences. 2023 Jan 16;13(2):1219.
Shahid A, Kashif F, Asghar F, Islam F, Raza A. Hip Flexors Shortening among Patients with Low Back Pain. American Journal of Health, Medicine and Nursing Practice. 2023 Oct 1;9(2):22-31.
Teichmann J, Burchardt H, Tan R, Healy PD. Hip Mobility and Flexibility for Track and Field Athletes. Advances in Physical Education. 2021 Mar 18;11(2):221-31.
Karen D, Green DS, Jensen GM, Savinar E. A comparison of muscular tightness in runners and nonrunners and the relation of muscular tightness to low back pain in runners. Journal of Orthopaedic & Sports Physical Therapy. 2021 Jun;6(6):315-23.
Butler D, Gifford L. The concept of adverse mechanical tension in the nervous system part 1: testing for “dural tension”. Physiotherapy. 2015 Revised Edition Nov 10;75(11):622-9.