Tibial External Rotator: Release and Lengthening

This course describes tibial external rotator release and lengthening, commonly referred to as tibial external rotator foam rolling, tibial external rotator foam rolling, tibial external rotator release with ball, tibial external rotator stretching, or knee mobility techniques. Although terms like muscle tightness, tight hips, tight tibial external rotators, tensor fascia lata (TFL) tightness, a tight biceps femoris (hamstring) muscle, etc., are commonly used, it may be more accurate to label these muscles as prone to over-activity (e.g. hypertonic, phasic). Performing tibial external rotator release and lengthening techniques to increase mobility prior to activation, integration, and strengthening techniques may significantly enhance rehabilitation and performance programs. In practice, the release of the tensor fascia latae (TFL), vastus lateralis, biceps femoris, and lateral gastrocnemius (calf), mobilizing the knee joint, and integrating a kneeling hip flexor stretch (TFL stretch), and modified calf stretch (gastrocnemius) is likely to improve knee mobility and improve the effectiveness of exercises like terminal knee extensions (TKE's), deadlift touchdowns, isolated tibial internal rotator activation, etc. Tibial external rotator over-activity has been correlated with altered lower extremity alignment, pronation distortion syndrome, knee bow in (knee valgus or functional valgus), an asymmetrical weight shift, loss of tibial internal rotator strength, and loss of vastus medialis obliquus (VMO), semitendinosus, and semimembranosus strength. Further, tibial external rotator over-activity has been correlated with knee pain, ankle pain, increased risk of future injury, and a loss of sports performance. Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) should consider adding these exercises to their repertoire to improve the outcomes of their integrated exercise programs and therapeutic (rehabilitation) interventions.

Release Techniques

• Tensor Fascia Latae Static Release
• Biceps Femoris Static Release
• Vastus Lateralis Static Release
• Vastus Lateralis Dynamic Release (Pin and Stretch)
• Lateral Gastrocnemius Static Release
• Lateral Gastrocnemius Dynamic Release

Joint Mobilization Techniques

Following release techniques, but before lengthening techniques, it may be beneficial to perform Self-administered Joint Mobilization Techniques: Lower Body

• Knee Mobilization

Lengthening Techniques

• Hip Flexor Static Stretch
• Slant Board Stretch (Lateral Gastrocnemius Stretch)
• Biceps Femoris Active Stretch

Caption: A vastus lateralis (pin and stretch) release technique with a foam roller