This is Brent coming at you with our very first manual stretching video. In
this video we're going to go after the hip flexor complex, using a very common
testing position which is the Thomas test position. I think you guys will find
that stretching the hip flexors using the Thomas test position is both very
comfortable for you, as well as your patient or client. I think you'll also
find that with some good body positioning, you can use both hands to
specifically target the hip flexor that you're trying to get extensibility out
of. I'm going to have my friend Leanne come out, she's going to help me demonstrate this
exercise. Now, first things first, if I want to stretch Leanne's hip flexors I
need to be able to pull her femur into extension, which means it's got to be off
the table, none of this can be up on the table. So I'm going to queue Leanne to sit on
her tailbone, no lower, and then from there I'm going to have her grab her
opposite leg. She's going to pull her opposite leg into her torso, this is
going to posteriorly tilt her pelvis. As she posteriorly tilts her pelvis
that'll give me a little bit of lumbar flexion, which will help me protect her
from going into excessive lumbar extension as she goes back. I think what you
will find is a lot of the people who need good hip flexor stretching, are the
same people who have a history of low back pain, and we don't want to do
anything to reignite or exacerbate low back pain, that can definitely be a
problem moving forward in our routines. From here, I'm going to go ahead and throw a
towel over her foot, that's just so I don't get foot prints on my shirt, and
then I'm going to go ahead and use my torso to stabilize this leg. If I use my torso
to stabilize this leg two things happen: number one, Leanne can relax, she no longer
has to pull on this leg which is going to make it easier for me to get autogenic
inhibition or those releases I'm looking for on the opposite leg. Second, by using
my torso I have both hands free to make sure I can dial into the hip flexor, or
dial in to great technique for this stretch. First things first, I'm going to use
this hand to control her pelvis through this leg. She's at her end range, so if I
feel her tilting this way, I can actually get her to tilt back by just pushing
this way. If I think she's going into an anterior pelvic tilt, I can lean a little
bit with my torso and force her back into a posterior pelvic tilt. So I
can do a lot to control her pelvis and make sure she stays neutral here, just by
controlling this knee, and controlling this foot with my torso. Now, let's talk
about all of the different things we can do with this part of the stretch, the
actual stretch part of the stretch, to let it dial in to the specific hip
flexor I'm looking for. Now, if you have iliacus and psoas tightness, that's
what you've assessed to be tight, probably the best bet is to posteriorly
tilt as far as you can, making sure that lumbar spine is actually flat,
that'll pull the psoas longer, and then I'm going to go femur in neutral, that
way I know there's no compensation happening, and then I'm going to push down
into extension until just past that first resistance barrier, and hold until
I get a release. So psoas iliacus, we're going to go posterior pelvic
tilt, neutral position of the femur. Now, if I want to turn this into a TFL
stretch, the TFL does internal rotation of the femur, as well as a little bit of
abduction, and external rotation of the tibia. So I can pull her foot in, that's
internal rotation of the tibia, I can pull her tibia this way, which is
external rotation of the femur, and then use my hand and my leg a little bit to
pull her into just a little bit of abduction, and she should go from feeling
this stretch more in the lower ab, or just just inside her ASIS, to now just passed her
ASIS on the side here where her TFL lies. Do you feel that? -Yes. Good. So we went from psoas
to TFL just by turning her in a little bit, and pushing her in a little bit. Now,
if I had assessed that her pectineus was tight, your pectineus as an adductor
muscle is a little different in the sense that it has an innervation from the
femoral nerve, that femoral nerve is the same nerve that innervates all of our
hip flexors, so it has a tendency to get tight with the hip flexors. If I wanted
to make this a little bit more of a pectineus stretch, I'd actually go in the
opposite direction of my TFL. So now I'm just going to push her into a little bit
of abduction, and extension. So we've got psoas, TFL and pectineus.
And then, of course, the last one, which I see abused a little bit, to get rectus
femoris all I really need to do is get her back into neutral, and kick that leg
to just past 90. The reason I say this gets abused a little bit is I see people,
number one, take this stretch a little too far.
Instead of that mild discomfort they go for darn near pain, and they try to pull
this leg up towards the table. One thing I can definitely tell you is more
is not better. The harder you stretch somebody, the more muscle spindle
activity you'll get, and the more their muscle is going to fight back against you.
That's not going to help you get autogenic inhibition, that's not going to help you get
a release, that's going to lead to an increase in extensibility and soft
tissue adaptation. So all we need is a little mild stretch here, and just using
my leg to pull it back just past 90, use my hand, once again I'm going to correct her
pelvic position. You can kind of see me adjusting here to make sure her foots on
the right place on my torso, I'm using this hand, I'll push her just a little bit past
the first resistance barrier, and I'm going to hold until she lets go. So there you
have it, we've got psoas with straight on with a posterior pelvic tilt,
TFL is adduction, turning her leg in, turning her foot and tibial internal
rotation, we've got pectineus which was pushing
into abduction a little bit, and rectus femoris was taking a leg under. And
then of course, you're going to hold with mild discomfort until you get a release
to happen, and you can wait for two to three releases as you push further
and further into that resistance barrier. Now, be very careful, as you get somebody
out of this position, just like we were careful to get Leanne into this position,
we don't want to drop this leg and let her pelvis pull her into an anterior
pelvic tilt, hyperextension of lumbar spine and
then she's having low back pain again. So what I'm going to have Leanne do is go ahead
and grab this leg again, both hands, once she has this leg I'm going to
go ahead and get out of the way of this leg, because we're going to have her
step down on this leg, and I'm going to help her
pull up, and then she can just slide off the table, onto that leg that
we just stretched, no low back pain. I hope you enjoy this manual stretch.
If you haven't done manual stretching before I suggest you practice on a few
people before you actually practice on a client or patient. For my trainers out
there you can practice on a few of your personal trainer buddies.
Everybody loves to be stretched! So I hope you get a huge increase in
extensibility from this stretch, I hope you are working on your technique,
I'll talk to you soon.