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Static Manual Release: Hip External Rotators (for Lumbo Pelvic Hip Complex Dysfunction): Audio

Manual release techniques for the commonly overactive muscles of the external rotators of the hip. Soft tissues release techniques for the adductor magnus, biceps femoris, piriformis, and deep rotators of the femur. Advanced soft tissue, massage, trigger point palpation, and mobilization techniques to inhibit antagonists. The reliability and validity of manual release techniques for knees bow out, hip pain, knee pain, asymmetrical weight shift, SIJ (sacroiliac joint) dysfunction and lumbopelvic hip complex dysfunction.

Static Manual Release: Hip External Rotators (for Lumbo Pelvic Hip Complex Dysfunction):

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Brookbush Institute

I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

Brookbush is the most efficient Personal Training Certification I have ever come across. All the lessons are well thought out and very straight to the point.

I am getting my Master's degree in Kinesiology, and I would like to say that I have benefited greatly from the rich, comprehensive, well-documented scientific content of Brookbush Institute that links theory to practical applications. Proudly I've got my CPT certificate, and I am on my way to get my HMS certificate.

Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

Totally loving the convenience and affordability of this program with my crazy lifestyle! I feel like I am getting a quality education without a massive cost! My favorite part is the videos I can watch in the courses. I learn so much better that way. Once I really spent more time on the site, I figured out how to maneuver around a lot better! I enjoy the sense of humor, as well as the easy explanation, and short tests. And if I am really tired, I can have the computer read me the lessons. 😁

Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

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Integrated Manual Therapist

This course describes static manual release techniques for hip external rotator muscles that are commonly assessed as over-active and prone to trigger point development. Unfortunately, it is easy to be confused by a large number of synonyms for these terms. For example, the techniques described in this course could be considered refinements of massage therapy techniques, deep tissue massage, sports massage, medical massage, trigger point therapy, static compression techniques, soft tissue mobilization, muscle inhibitory techniques, and manual therapy techniques. Even the term trigger point is referred to by a variety of synonyms including muscle knots, nodules, adhesions, over-active muscle fibers, hypertonic fascicles, spasms, and acute points of hyper-contractility, and the trigger point phenomenon is likely part of every reference to short muscles, tight muscles, "locked" muscles, muscle strains, muscle spasm, etc. Part of the reason there are so many synonyms is the rich history of scientific inquiry, from multiple disciplines and cultures, that have contributed to our understanding of these techniques and the information in this course.

This course includes techniques for the adductor magnus, biceps femoris, piriformis, and deep rotators of the hip. Release techniques for these muscles are commonly included in an integrated program designed to address chronic lower back pain, sacroiliac joint dysfunction, anterior hip joint pain, or leg pain (groin or lateral thigh). These techniques may also aid in addressing movement impairments correlated with lumbopelvic hip complex and lower extremity dysfunction including an asymmetrical weight shift, knee varus (knees bow out), an inadequate forward lean, a loss of hip mobility (restricted hip rotation), and/or hip flexor over-activity.

The techniques in this course are recommended for all clinical human movement professionals (physical therapists, physical therapy assistants, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) with the intent of developing an evidence-based, systematic, integrated, patient-centered, and outcome-driven approach.

Piriformis and Deep Rotators Manual Static Release

Static Manual Release: Upper Trapezius, Levator Scapulae and Splenii

Static Manual Release: Suboccipitals, Sternocleidomastoid (SCM), Scalenes and Cervical Extensors

Static Manual Release: Hip Internal Rotators

Static Manual Release: Hip External Rotators

Static Manual Release: Tibia External Rotators

For a review of muscle fiber dysfunction and trigger point etiology:

Muscle Fiber Dysfunction and Trigger Points

Course Description: Hip External Rotators Static Manual Release

For a complete review of muscle fiber dysfunction, trigger point etiology, assessment and intervention, please check out:

Signs of over-activity and/or a maladaptive decrease in length:

Hip Internal Rotation Goniometry in Prone

Hip Internal Rotation Goniometry in Supine

Gluteus Maximus Manual Muscle Testing (MMT)

 - Weak or With Compensation (Lumbar extension and/or knee flexion)

Gluteus Medius Manual Muscle Testing (MMT)

 - Weak or With Compensation (Lumbar lateral flexion and/or hip flexion)

It is advised that additional mobility techniques, as well as 

 and integration techniques, follow release techniques. The over-activity of muscles in this course may be associated with under-activity of the following muscles:

Introduction

Adductor Magnus

Biceps Femoris

Piriformis and Deep Rotators

Research Corner

Adductor Magnus Manual Static Release

Biceps Femoris Manual Static Release

Piriformis Manual Static Release

Videos

Florence Peterson Kendall, Elizabeth Kendall McCreary, Patricia Geise Provance, Mary McIntyre Rodgers, William Anthony Romani

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Stratton, P., Khachikyan, I., Sinaii, N., Ortiz, R., & Shah, J. (2015). Association of chronic pelvic pain and endometriosis with signs of sensitization and myofascial pain.

Fuentes-Márquez, P., Valenza, M. C., Cabrera-Martos, I., Ríos-Sánchez, A., & Ocón-Hernández, O. (2017). Trigger points, pressure pain hyperalgesia, and mechanosensitivity of neural tissue in women with chronic pelvic pain.

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Yentür, E. A., Okçu, G., & Yegül, I. B. (2003). The role of trigger point therapy in knee osteoarthritis.

Cotchett, M. P., Munteanu, S. E., & Landorf, K. B. (2014). Effectiveness of trigger point dry needling for plantar heel pain: a randomized controlled trial.

Brennan, K. L., Allen, B. C., & Maldonado, Y. M. (2017). Dry needling versus cortisone injection in the treatment of greater trochanteric pain syndrome: a noninferiority randomized clinical trial.

 journal of orthopaedic & sports physical therapy 

Jayaseelan, D. J., Moats, N., & Ricardo, C. R. (2014). Rehabilitation of proximal hamstring tendinopathy utilizing eccentric training, lumbopelvic stabilization, and trigger point dry needling: 2 case reports

journal of orthopaedic & sports physical therapy

Chu, J., Takehara, I., Li, T. C., & Schwartz, I. (2004). Electrical twitch obtaining intramuscular stimulation (ETOIMS) for myofascial pain syndrome in a football player.

Mosler, A. B., Blanch, P. D., & Hiskins, B. C. (2006). The effect of manual therapy on hip joint range of motion, pain and eggbeater kick performance in water polo players.

Robb, A., & Pajaczkowski, J. (2011). Immediate effect on pain thresholds using active release technique on adductor strains: pilot study.

 Journal of bodywork and movement therapies 

Weiss, J. M. (2001). Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome.

Padua, D. A., Bell, D. R., & Clark, M. A. (2012). Neuromuscular characteristics of individuals displaying excessive medial knee displacement.

Nourbakhsh, M. R., & Arab, A. M. (2002). Relationship between mechanical factors and incidence of low back pain.

 Journal of Orthopaedic & Sports Physical Therapy 

Tateuchi, H., Taniguchi, M., Mori, N., Ichihashi, N. Balance of hip and trunk muscle activity is associated with increased anterior pelvic tilt during prone hip extension (2013)

 Journal of Electromyography and Kinesiology 

Hungerford, B., Gilleard, W., Hodges, P. (2003) Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine 28(14), 1593-1600

Jung, H., Kang, S., Park, J., Cynn, H., & Jeon, H., (2015). EMG activity and force during prone hip extension in individuals with lumbar segmental instability.

Botter, A., Oprandi, G., Lanfranco, F., Allasia, S., Maffiuletti, N. A., & Minetto, M. A. (2011). Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning.

Alburquerque-García, A., Rodrigues-de-Souza, D. P., Fernández-de-las-Peñas, C., & Alburquerque-Sendín, F. (2015). Association between muscle trigger points, ongoing pain, function, and sleep quality in elderly women with bilateral painful knee osteoarthritis.

 Journal of manipulative and physiological therapeutics 

Itoh, K., & Kitakoji, H. (2010). Effects of acupuncture to treat fibromyalgia: a preliminary randomised controlled trial.

Geist, K., Bradley, C., Hofman, A., Koester, R., Roche, F., Shields, A., … & Johanson, M. (2017). Clinical effects of dry needling among asymptomatic individuals with hamstring tightness: a randomized controlled trial.

Grieve, R. (2006). Proximal hamstring rupture, restoration of function without surgical intervention: a case study on myofascial trigger point pressure release.

 Journal of Bodywork and Movement Therapies 

Dembowski, S. C., Westrick, R. B., Zylstra, E., & Johnson, M. R. (2013). Treatment of hamstring strain in a collegiate pole‐vaulter integrating dry needling with an eccentric training program: a resident's case report.

 International journal of sports physical therapy 

Mason, J. S., Crowell, M., Dolbeer, J., Morris, J., Terry, A., Koppenhaver, S., & Goss, D. L. (2016). The effectiveness of dry needling and stretching vs. stretching alone on hamstring flexibility in patients with knee pain: a randomized controlled trial.

Trampas, A., Kitsios, A., Sykaras, E., Symeonidis, S., & Lazarou, L. (2010). Clinical massage and modified Proprioceptive Neuromuscular Facilitation stretching in males with latent myofascial trigger points.

Sullivan, K.M., Silvey, D.B.J., Button, D.C., Behm, D.G. (2013). Roller-massager application to the

increases sit-and-reach range of motion within five to ten seconds without performance impairments.

 International Journal of Sports Physical Therapy 

Morales‐Artacho, A. J., Lacourpaille, L., & Guilhem, G. (2017). Effects of warm‐up on hamstring muscles stiffness: Cycling vs foam rolling.

 Scandinavian journal of medicine & science in sports 

Peacock, C. A., Krein, D. D., Silver, T. A., Sanders, G. J., & Von Carlowitz, K. P. A. (2014). An acute bout of self-myofascial release in the form of foam rolling improves performance testing.

 International journal of exercise science 

Giphart, J. E., Stull, J. D., LaPrade, R. F., Wahoff, M. S., & Philippon, M. J. (2012). Recruitment and activity of the pectineus and piriformis muscles during hip rehabilitation exercises: an electromyography study.

 The American journal of sports medicine 

Snijders, C. J., Hermans, P. F., & Kleinrensink, G. J. (2006). Functional aspects of cross-legged sitting with special attention to piriformis muscles and sacroiliac joints.

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Alonso-Blanco, C., Fernandez-de-las-Penas, C., Morales-Cabezas, M., Zarco-Moreno, P., Ge, H. Y., & Florez-Garcia, M. (2011). Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity.

Bassaly, R., Tidwell, N., Bertolino, S., Hoyte, L., Downes, K., & Hart, S. (2011). Myofascial pain and pelvic floor dysfunction in patients with interstitial cystitis.

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Avrahami, D. (2012). Conservative management for a distance runner with a suspected case of quadratus femoris myofascial pain: a case report.

 International Journal of Therapies and Rehabilitation Research 

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 Cardiovascular and interventional radiology 

Kim, S. H., Kim, D. H., Yoon, D. M., & Yoon, K. B. (2015). Clinical effectiveness of the obturator externus muscle injection in chronic pelvic pain patients.

Fanucci, E., Masala, S., Sodani, G., Varrucciu, V., Romagnoli, A., Squillaci, E., & Simonetti, G. (2001). CT-guided injection of botulinic toxin for percutaneous therapy of piriformis muscle syndrome with preliminary MRI results about denervative process.

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 Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy 

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Cuthbert, S. C., & Rosner, A. L. (2012). Conservative chiropractic management of urinary incontinence using applied kinesiology: a retrospective case-series report.

Bibliography

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