This is Brent of the Brookbush Institute and in this video we're going over our
static hip flexor stretch. I'm going to have my friend Adam come out he's going to help
me demonstrate both the wrong way and the right way to do this stretch. Now me
and you have been personal trainers a long time, let's show everybody how we
see this done poorly quite often. Alright and you can see he gets
this nice arch to his back, if he threw his arms back he looks like he should be
on the front of the Titanic. Although this might be pretty like it's
definitely not the greatest way to do this stretch. If we think about how much
hip extension you have, which is just 10 to 15 degrees, we know that this is not
15 degrees, that's more than 45. He has to be getting that mobility from somewhere
else and that should worry you a little bit. We want our stretches to be specific.
You can get out of that position, it even irks me a little bit to see
you in that position right. It's not a great thing to not know what you're
stretching, we want to make sure that we're stretching stuff that's short.
Remember hypermobility is just as dangerous as hypomobility, so if
we're stretching things that aren't short we could be setting somebody up
for some dysfunction, or possibly pain in the future. So how can we make this
specific to just the hip flexors, and the truth is that it's actually easier. The
the stretch I'm going to show you is way easier than the ones you just saw.
So Adam is going to set himself up with these nice 90-degree angles, so
he's going to be 90 degrees with knee right underneath his hip and then leg straight
back, and then he can go ankle right under this knee, and then this knee is
level with this hip, so we get these nice right angles and we get easy lines
to monitor. He's got good straight posture this way, remember your psoas
connects into your lumbar spine so it is important to even watch how much
lordosis you're getting here. Now once he's in this position all you have to do
is go posterior pelvic tilt. Now I don't tell my clients to posterior pelvic tilt
but that's what we're going teach them. What I usually tell my clients to do is
can you tuck your tail, alright it's scared dog,
and if I have to I'll give them a little manual pressure on their PSIS
usually that'll get people to tuck under, good. Squeeze their glutes is
another good way to get them to posterior pelvic tilt, and usually if
you can teach that simple little turn of their pelvis under, can you feel that in
the front of your hip, it's like immediate. It just makes it so easy, you're just going
oh hip flexor stretch got it, got it. It's just that easy, and now we can be pretty
certain because all we've done there with a posterior pelvic tilt is lengthen
out our hip flexors via some hip extension. Now what I can do from here is
add a few little modifications if I wanted to go after specific muscles.
Let's say I've taken my assessment one step further, I went from just doing the
overhead squat assessment and seeing things like anterior pelvic tilt or
excessive forward lean that make me think that my hip flexors are tight, to
now I'm starting to think about well if knees bow in that's femoral internal
rotation; of my hip flexors, my gluteus minimus and my TFL are internal
rotators you following me, how can I make a hip flexor stretch specific to
the TFL and gluteus minimus? It's actually not that hard, I'm going to have
Adam take this leg and turn it, face the camera real quick for me Adam, he's going to
take this this foot, hopefully you can see what I'm seeing, and he's
going to put it behind this ankle. So we don't need a lot of external rotation,
but just a little bit of external rotation because my TFL and glute minimus
are internal rotators, so I'm going to externally rotate to lengthen them. He's
then going to hip hike a little bit, or lean in this way, that's going to adduct his
hip relative to his pelvis, and you don't even have to do that much because we
still want just enough room to do a posterior pelvic tilt. Alright so now
tuck under, and you should feel that more on the lateral side of your hip. How's
that feeling? Good. So now I'm getting real specific, like I felt like
okay he had knees bow in, that functional valgus, I know the internal rotators are
overactive contributing to that knees bow in functional vagus. Maybe I even
did some goniometry and he had a reduction in either internal rotation or
external rotation, that gets a little complicated, but I'm getting specific. Now
what else could I do? Well, let me have you turn around one more time. Alright
I could go rectus femoris, let's say I have Adam as a patient and I noticed
that a lot of his issues seemed more geared around the knee. Now if you
are physical therapists, athletic trainers or chiropractors you could even
goniometric assessment to see if they had enough knee flexion. Maybe
there's somebody who's post-surgical, right we know that the rectus femoris has
just geared way up, lots of overactivity, lots of active trigger points, lots of
shortening and we want to figure out a way to lengthen it. Well, Adam he's
already in the habit of doing this, but if we take the hip flexor
stretch and we go from this plantar flat foot out position to
dorsiflexed, notice that increases the amount of flexion at the knee which is
now going to lengthen the rectus femoris a little bit; and what Adam should have
noticed is when he goes from, so flop your foot all the way out, when he goes
from their, posterior pelvic tilt, good and then tucks his toe in, then all of a
sudden he feels a lot more down the center of his thigh, cool. Alright
so that's great, so that's a little bit more rectus femoris.
So we have got TFL which was the turn the foot in and lean over a little bit, and
then we have rectus femoris which is throw the the toes in there and get a
little bit more knee flexion, and then you of course have the first
variation we showed you which is probably just more of a good general hip
flexor stretch, maybe would incorporate a little bit more psoas and iliacus
because the TFL and the rectus femoris have a little bit more slack in
them than these other two positions I've showed you. Now let me harp on
a couple of things that I don't like to see. The couch stretch has become incredibly
popular, I want you to keep in mind that if I take this foot throw it up on
something this way, and then jam my body back against my foot, that number one it
is incredibly aggressive, and we have to get out of the habit of if it didn't
work I need more. If it didn't work it might not be the right technique. I've
never seen anybody get additional benefit from the couch stretch that I
couldn't get from a kneeling hip flexor stretch, especially with toes in,
it's just too much. Not to mention the couch stretch is just rectus femoris. You're
shortening the rectus femoris so much at the knee, or lengthening it so much at
the knee, that when you go into a posterior pelvic tilt the limiting
structure is always going to be your rectus femoris, and you are going to miss
TFL glute minimus, psoas and iliacus every time. So if your goal was to fix
something like knees bow in or an anterior pelvic tilt, you're losing.
You're losing because you're leaving a lot behind. Now the other thing that I
don't like to see, is I don't like to see the very fancy hip flexor stretch which
is Adam if you raise your right arm, and then Adam side bends towards
me, good and then he rotates back this way. Now the problem with this stretch is
not that it's not theoretically sound, it is a very theoretically sound stretch.
What we're doing here is we're trying to lengthen the psoas as far as possible,
remembering that our psoas attaches to the vertebral bodies of L1 through L5, so
if I side bend a little bit, I pull my psoas a little longer on that side,
and then if I rotate back it lengthens even further. The problem with
this stretch is as soon as people do this stuff they tend to lose their
posterior pelvic tilt, they tend to arch their
back and then they tend to go into hip hiking, and now what we have is a
theoretically great stretch with bad form; and I have to be honest I've never
seen good form on that stretch ever, especially once left alone. It's one of
those stretches where maybe you can get it set up right in clinic, maybe you can
get it set up right with coaching, but as soon as you give it for a home exercise
program, as soon as you walk away from your patient, as soon as you turn your
back it becomes like this mess of they just look like Al'Dente noodles,
like hey look I'm stretching my hip flexors, and it kind of goes back into
our what we call the Titanic stretch, right, good. Alright last
point I'm going to make harping on the static hip flexor stretch here is
this is not a stability exercise, so feel free to give somebody something to hold
on to. Let them hold on to a wall, like I like to do these stretches right next to
a wall or like a weight rack so I can hold on to, there's nothing wrong with
that, we're trying to stretch, we'll do stability exercises later, and first
steps first, let's go all the way back to can we just do a good static hip flexor
stretch. I know I'm giving you a lot to think about with modifications and maybe
things you shouldn't do, but where we should start is stable position, 90, 90, 90,
90. Can you posteriorly pelvic tilt, hold for
30 to 120 seconds calmly, and get a good release. That's it,
that's where we're going to start. If you have any questions leave them in the
comments box below, thank you Adam.