0:00 This is Brent, coming at you with another one of our manual stretching videos. In 0:03 this video we're going to go after the adductor complex, those inner thigh muscles 0:06 that have a tendency to get short and overactive in those individuals with 0:10 both lower leg dysfunction, so that's feet turn out and often knees 0:13 cave-in or knees bow out, as well as our lumbo-pelvic hip dysfunction, so that's 0:17 those individuals who have an anterior pelvic tilt, posterior pelvic tilt, or 0:21 have an asymmetrical weight shift. Now, I'm going to have my friend Yvette come out and 0:25 help me demonstrate this exercise. The biggest mistake I see on this 0:30 manual stretch is professionals making it very hard on themselves, rather than 0:35 taking advantage of some kinesiology to make it very easy on themselves to get 0:39 this stretch accomplished. So, first things first, I usually see people do 0:43 this, take on the whole weight of the leg. Now, that might be fine if there's a size 0:49 difference like there is between Yvette and I, where I'm much larger, but if 0:54 Yvette was a professional athlete that was twice my size, to take the entire leg 0:58 and try to stabilize it for the amount of time I'm going to need to stabilize 1:02 for a static stretch could be problematic, especially if I have many 1:05 clients, many athletes, many patients, one after the other. So I need to find an 1:10 easier way to do this. Easiest thing to do, and I'll explain the kinesiology as 1:14 I'm doing this, is actually just let the leg drop off the table. I have her in 1:20 abduction, this is an adductor stretch, all I have to do is have her adjust her 1:25 pelvis either right or left to get the amount of abduction I need to ensure 1:30 that this is a good stretch, and all I did by bending the knee was take the 1:34 gracilis out of the picture. The gracilis is an internal rotator of the tibia. It 1:39 is not common for the internal rotators of the tibia to become short and 1:43 overactive. It's much more common that we get that feet turn out, and the external 1:47 rotators of the tibia overactive. So this is fine, there's no problem here, I can 1:52 then take it a step further. For the most part it's the anterior adductors that get 1:57 tight, it's the anterior adductors that get overactive. Those are the flexors and 2:01 internal rotators of the femur. We think about an anterior pelvic tilt being more 2:05 common, knees duck in is more common than knees duck out. I can force her into a bit 2:10 of a posterior pelvic tilt to improve this stretch by simply taking her other 2:15 leg and pulling her as far into flexion as I can, and then adjusting her pelvis a 2:22 little bit so that she's now just slightly tucked under. You feel a stretch? 2:26 I haven't done anything, I don't have to use any of my own muscular power, I can 2:32 just use gravity and a little bit of kinesiology to get a nice adductor 2:36 stretch. If from here I want to dial it in, I want to refine it a little bit, I now 2:40 have both my hands free to either stabilize at either ASIS, or maybe 2:45 stabilize at the femur as we did in the hip flexor video, and then I can use my 2:49 other hand or even my opposite leg to add a little bit of force this way. So 2:55 for those of you guys who are using some of your PNF protocols where you're doing 3:00 contract-relax, or if you're doing 3 sets of 20 seconds where you're getting 3:04 a release and pushing a little further, all you have to do is either use your 3:07 leg or your hand and you can take her out just a little further, wait you're 30 3:12 seconds to 2 minutes, a little further etc. So a really easy stretch technique as 3:17 opposed to the one we saw before, not to mention much more specific to the adductor 3:22 complex, that pectineus brevis and possibly longus that are actually 3:26 short and overactive in those compensation patterns we talked about. 3:29 Now, in some individuals we have a propensity for not the anterior adductors 3:35 to get tight, but the posterior adductors. These are those individuals who have 3:40 knees bow out, or in an asymmetrical weight shift if somebody has SI joint 3:45 dysfunction, they're going to be tight on the side of the SI joint dysfunction in 3:50 their posterior adductor magnus. Now the adductor magnus has a propensity to 3:56 extend or it extends the hip rather than flexes the hip. So we're going to have to 4:00 use different mechanics than the stretch we just used. The easiest way to go about 4:04 doing this that I have found, is we're going to take Yvette up into flexion 4:08 here and abduction, I'm then going to rest her shoe, and you can use a 4:13 towel if you want to make sure you keep somebody shoes off your pants, but I'm 4:16 going to rest that on my ASIS, I'm going to use my other hand to palpate 4:21 her ASIS on the opposite side, and then I have this hand to stabilize her knee. 4:27 Actually Yvette, let me get you just a little closer to me on the table. Alright, 4:34 so I'm just watching my mechanics there, I was reaching over the table. I'm going 4:37 to stabilize this ASIS, stabilize this knee, now I can control the amount of 4:42 flexion by just scooting forward until I feel that first resistance barrier, and I 4:47 can use this hand to either support, to make sure she's not guarding, or to give 4:51 a little bit of over pressure to further stretch her adductor magnus. Once again 4:55 I'm going to hold for 30 seconds to 2 minutes. I can then go further into the 4:59 stretch. If I want to use my PNF contract relax antagonist, contract protocols, I 5:04 can do all that from this position, I'm in a very strong stable position so she 5:08 can extend back into my ASIS, she can push up into my hand, whatever I need her 5:13 to do. How does that feel? Good. Now, the last stretch I'm going to show you 5:18 is for a particular problem that we sometimes face with adductor 5:24 stretching. This is not going to be something that you use for everyone 5:27 necessarily, and there are some other techniques that can you can use to get 5:30 around this technique, but every once in a while you'll pull somebody into 5:34 an adductor stretch, and you'll go okay where do you feel it, and rather than say 5:40 inner thigh, which is obviously where we want this stretch felt, they say, "I feel a 5:44 pinch here." Well that's a problem. Pinching is not going to help 5:49 our stretch, in fact, it's probably going to start stimulating some of those 5:52 nociceptors, get us guarding, we're never going to get that release that 5:56 we're looking for. So there's a trick we can use to make sure that this doesn't 6:00 happen. I'm going to have Yvette come to the other side of the table, she's then going to 6:08 lay on her side facing away from me, back herself all the way up into my hip 6:13 because I want her nice and close to me to save my mechanics once again, 6:16 you can just use a hip to make sure they're blocked out and don't back 6:19 themselves up off the table. I'm then going to have her bend this bottom leg so 6:23 that she's stabilized. Now, the reason why we're getting pinching up on this side 6:28 of the hip, partly anyway, is that we had inferior capsule 6:32 tightness. So what we need to find a way to do, is to depress the femoral head. So what 6:39 I'm going to do is I'm going to grab Yvette's leg like so, so I'm nice 6:42 and cradled, and then that way right when I stand up this will be on stretch, I'm 6:48 then going to use this hand right over her greater trochanter, I'm actually 6:52 going to use this space in here, and I'm going to create a little bit of pressure 6:56 that way towards this heel. So I'm going to go pressure towards that 7:01 heel, stand up, and how does that feel Yvette? Alright, so now I've taken that 7:07 femoral head, pressed it down making sure I stretch that inferior capsule, I no 7:13 longer get the pinching on the side of the hip, and this is a pretty good 7:16 stretch. Now, the disadvantage of this stretch over the two stretches that we 7:21 just did is this does take a lot more work from me. It is not easy to lift the 7:26 weight of somebody's leg. So, once again, just a quick review, we had the 7:31 anterior adductors. 7:37 It was leg hanging off, and then this, the contralateral leg, was up, forcing 7:43 somebody into a posterior pelvic tilt, you can then add as much force 7:46 as you need. We had the adductor magnus stretch, that's for individuals with 7:51 knees bow out, or that asymmetrical weight shift caused by SI joint 7:55 dysfunction. That was here. So I'm pulling into flexion and abduction. And then the 8:01 last technique we went through was for those individuals who feel pinching, 8:05 is going to be side-lying, bottom leg nice and stable, you're going to 8:12 stabilize the greater trochanter, cradle the leg, stand up, and use a little 8:17 inferior glide to make sure that pinching goes away and we get a little 8:20 bit of an inferior capsule stretch. I hope you keep working on your 8:24 manual stretching technique, I think you'll find that the better your 8:26 technique is, the better results your clients, patients, and athletes get. I look 8:31 forward to talking to you again soon.
