Summary

• Assessment and Initial Treatment of Gluteal Nerve Entrapment (0:03)

◦ Dr. Richard Hazel discusses the patient's history of an auto accident and the resulting nerve entrapment.

◦ Dr. Hazel explains the three main muscles affected by superior gluteal nerve entrapment: TFL, gluteus minimus, and gluteus medius.

◦ He identifies the top of the piriformis and plans to treat the motor points of the affected muscles.

◦ Dr. Hazel mentions that recovery from nerve entrapment is slower compared to other treatments and expects improvement by tonight or tomorrow.

• Detailed Needling and Motor Point Identification (1:59)

◦ Dr. Hazel needles the TFL motor point and the greater trochanter, explaining the expected twitch sensation.

◦ He identifies the iliac crest and the greater sciatic foramen, noting the achy sensation in these areas.

◦ Dr. Hazel discusses the potential for sciatic radiation and the importance of treating the nerve entrapment zone.

◦ He needles the scar area, explaining the need to go through the scar to reach the motor point.

• Neuromodulation and Additional Needling Techniques (14:14)

◦ Dr. Hazel uses electric stimulation to neuromodulate the superior gluteal nerve and its associated muscles.

◦ He explains the importance of treating the TFL, gluteus minimus, and gluteus medius to alleviate nerve entrapment.

◦ Dr. Hazel discusses the connection between gluteus minimus and vastus lateralis and the potential for movement in these muscles.

◦ He needles the iliacus motor point and explains the importance of avoiding the peritoneal cavity during treatment.

• Trigger Point Treatment and Nerve Entrapment (16:05)

◦ Dr. Hazel identifies and treats trigger points in the QL muscle, explaining their role in sciatic radiation and low back pain.

◦ He discusses the importance of palpation in finding trigger points and the need for twitches to release tension.

◦ Dr. Hazel needles the gluteus medius and piriformis muscles, explaining the expected twitch sensations.

◦ He emphasizes the importance of using the correct needle gauge to achieve twitches quickly and efficiently.

• Obturator Nerve Treatment and Adductor Muscles (23:18)

◦ Dr. Hazel demonstrates the treatment of the obturator nerve trunk and its associated muscles: pectineus and obturator externus.

◦ He explains the importance of angling the needle correctly to avoid the femoral vein and achieve the desired effect.

◦ Dr. Hazel discusses the potential for hip impingement and the role of the obturator nerve in mobility issues.

◦ He tests the patient's adductor strength and flexibility, noting any discrepancies and potential areas for further treatment.

• Abdominal Cutaneous Nerve Entrapment (37:19)

◦ Dr. Hazel assesses the patient's abdominal cutaneous nerve entrapment, identifying sensitive areas and potential causes.

◦ He needles the motor points of the external and internal obliques, explaining the importance of freeing up the fascia.

◦ Dr. Hazel discusses the role of the ilioinguinal nerve in abdominal cutaneous nerve entrapment and its impact on core stability.

◦ He uses electric stimulation to neuromodulate the treated areas and explains the expected parasympathetic response.

• Final Adjustments and Patient Feedback (45:10)

◦ Dr. Hazel makes final adjustments to the treatment plan, ensuring all relevant muscles and nerves are addressed.

◦ He discusses the importance of patient feedback and the potential for self-treatment at home.

◦ Dr. Hazel emphasizes the need for consistent treatment to achieve long-term relief from nerve entrapment.

◦ The patient provides positive feedback, noting significant improvement in pain and mobility.