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Copyright © Alastair McLoughlin 2015    Revised © Alastair McLoughlin 2019 and 2022

The right of Alastair McLoughlin to be identified as the original Designer, Developer and Author of the Work has been asserted by him in accordance with the Copyright, Design and Patents Act 1998.

All rights reserved. No part of this text may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without the prior written permission of the publisher, nor be otherwise circulated in any form of binding or cover, or reprinted in any physical or electronic manner without the written consent of the author.

The ideas and concepts explored within this text are those of the author. For educational purposes only.

No diagnosis is being offered nor any cure promised by the application of this information.

Alastair McLoughlin cannot be held responsible for any injury arising from the application of this work by the practitioner to any third party however caused.

This work is not a substitute for medical attention. Please seek your physician’s advice if in doubt.
There are TWO applications for this work:

Muscular tension of the adductors, resulting in inward rotation of the thigh when laying supine

Venous congestion of the medial part of the thigh

Both applications are very different in execution.
Extreme care must be taken in Method 2.  


Method 1 – Muscular:

  • Inward rotation of thigh when laying supine
  • Pelvic problems
  • Medial knee problems
  • Gait problems
  • Tenderness or tension of the inner thigh
  • Restricted or reduced thigh abduction

Method 2 – Venous:

  • Lymph or venous congestion of thigh
  • Tenderness or pain on the inner aspect of the knee - sometimes misdiagnosed as medial knee ligament injury
  • Acute tenderness and sensitivity of medial thigh proximal to the knee


Method 1 – Muscular:

The moves should be applied within the tolerance of the client, assessing sensitivity or pain in the region of the application.
You may have to vary your pressure of AoB moves throughout the procedure.

Method 2 – Venous:

Be careful and proceed with caution where vascular problems are evident - such as varicose veins.
Ensure there is no possibility of DVT (Deep Vein Thrombosis) and do not do this work if that has been diagnosed or you suspect it may be an undiagnosed DVT.

Refer for medical diagnosis if you are unsure about any undiagnosed medical condition.

Position of the patient:

The client should lay supine on the treatment table.


Method 1 – Muscular:

Assessment of tight adductors is extremely easy, but also very gentle and subtle.

With the client laying supine, observe the angle at which the feet are resting as shown in segment (a).
Ideally they should rest at an approximate equal angle of 45 degrees, but in our example you can see how inwardly rotated the right leg seems.

If one leg is more inwardly rotated, this could be a visual indicator that the adductors on that leg are restricted in some way and there may be hip tightness or restriction on that side.

Should one leg be more outwardly rotated this could be due to over tightness of the glutes (piriformis) on the same side.
Addressing that issue could rebalance the resting angle of the thigh.

Further assessment (b) includes slight pressure on the medial aspect of each foot - near to the great toe.
You are seeking to determine if there is greater resistance on either side.

Remember: This assessment is very subtle.
Hardly any pressure is being applied.
You will NOT be able to accurately assess resistance or restriction in the thigh if you use too much pressure.

Any resistance felt may indicate hip problem or restrictions.

If you find a left hip restriction (for example) but the client insists their problems are all on the opposite (right) side - do not be fooled by this.
They will be experiencing referred pain from the seemingly unaffected side. However our assessment reveals the true problem side.

Method 2 – Venous:

Venous congestion of the inner thigh can be experienced by extreme sensitivity to touch.
Even the slightest touch creates pain.

There may also be pain, oedema, inflammation and sensitivity on the medial aspect of the knee.
This can be misdiagnosed as medial ligament injury.
Palpation of the knee, more proximally, should also reveal sensitivity if a vein problem is the cause.

With the client supine, flex their knee and place the foot on the treatment table as shown in segment (c).  

Gently palpate the affected area.
This will probably be sore or sensitive.
That is a certain indication for using this second adductor technique.

Venous congestion can often be a problem with overweight people, or those whose work entails long hours of standing or sitting.   

Application of the AoB procedure:

Method 1 – Muscular:

With the client supine, flex their knee and place the foot on the couch.

Abduct their thigh by about 30 to 45 degrees and support it using your body.
This enables the client to relax the limb by resting it upon you.

The adductor muscles should be very relaxed and you should feel the weight of their thigh against you.
If the muscles are not relaxed, or there is no weight against your body, then the client is still holding the thigh in tension.
This means the adductor is being held in contraction and you will see the muscles ‘rise’ to the surface.
You can easily palpate and see the muscle in its contracted state.
Encourage the client to fully relax the thigh.

When full relaxation occurs the adductor will ‘drop’ and become loose.

In the video presentation you see me palpating the adductor and identifying the anterior and posterior borders of it with the two first fingers of each hand.

My right thumb then ‘drops’ into the space just anterior of the adductor, and ‚rolls‘ over the muscle, posteriorly.
The left thumb opens up the space adjacent to the muscle.
No ‘rolling’ motion is felt with this movement.

Commencing at the proximal attachments of the gracilis and adductor magnus, ‘open’ or ‘unfasten’ these adductors, using anterior and posterior moves as shown in the video presentation.  

Alternate the moves medially and laterally and progress down the inside of the thigh until you reach the medial aspect of the knee.
You may turn your left hand part way through the moves, as shown, and complete the moves with your fingers.  

The work should then be complete and you can reassess.

Method 2 – Venous:

***Use great care when applying with these moves. You are working directly on a blood vessel.***

With the client supine, flex their knee and place the foot on the couch.

(We have already gently palpated the affected area.
If this area is sore or sensitive then that is the perfect indication for using this second adductor application.)

In this method we use a gentle pressure of 2 out of 10 pressure (where 1 out of 10 is literally just touching the skin very lightly).
We are literally making ‘micro’ AoB moves on the skin of the affected area.
The video tutorial shows these moves are just perhaps one or two millimetres in length.

Work down the affected area gently and slowly, moving distally (from the client’s perspective) from half way down the thigh, towards the medial aspect of knee.
The client will tell you if your pressure is too great as they cannot tolerate more than the lightest of pressure at this time.

You can repeat the AoB moves and then wait 2 minutes.


Go back and reassess the changes in the resistance in the adductors as shown in the video presentation.
The angle of the feet should be more equal if you have used Method 1 - for the adductors.

If you have used Method 2 there should also be an almost immediate change in the pain and sensitivity of the area of the vein and it will almost certainly decrease by around 80%.

You can repeat the AoB moves if necessary and then wait another 2 minutes.

You may also need to apply this work to both left and right side adductors.

That should conclude the session and no further work in that area should be needed.

You may need to repeat the work as part of a regular ‘tune-up’ for the client, especially if they have varicose veins or are overweight.

Help the client to a seated position:

Pause and check the client experiences no dizziness or light-headedness.

(a) If they are dizzy or light headed then wait for a minute or two to allow that feeling to clear itself.
Only then may the client step down from the couch placing BOTH feet on the floor at the same time to allow even weight-bearing into both hips to occur.

(b) If the client continues to be dizzy after waiting two minutes then lay them in a foetal position, cover them with a blanket and wait for the dizziness to pass.

Return them to a seated position and check any dizziness has subsided.
Ask them to stand - placing BOTH feet on the floor at the same time to allow even weight-bearing into both knees and hips to occur.

The client may need to sit for a few moments before dressing and leaving your office.

How it works:

Method 1 – Muscular:

The ‘opening’ or ‘unzipping’ effect of these AoB moves increases lymph drainage through the thigh, creating an effective relaxation of the tissue.
The alternating moves also have a slight ‘roll’ over the tissues which also produces a relaxing effect.

Method 2 – Venous:

Congestion of the tissue causes pressure fluid build up.
The Great Saphenous vein is reasonably near to the surface at the knee and half way up the thigh.
It then navigates more deeply into the thigh - which is why the moves are only important from the mid point of the thigh and down towards the knee.

It is quite amazing but the AoB movements we apply rapidly release the pressure on the vein, creating an almost immediate drop in pressure, pain and sensitivity.

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