0:00 This is Brent coming at you with our very first manual stretching video. In 0:03 this video we're going to go after the hip flexor complex, using a very common 0:07 testing position which is the Thomas test position. I think you guys will find 0:10 that stretching the hip flexors using the Thomas test position is both very 0:14 comfortable for you, as well as your patient or client. I think you'll also 0:18 find that with some good body positioning, you can use both hands to 0:22 specifically target the hip flexor that you're trying to get extensibility out 0:27 of. I'm going to have my friend Leanne come out, she's going to help me demonstrate this 0:31 exercise. Now, first things first, if I want to stretch Leanne's hip flexors I 0:36 need to be able to pull her femur into extension, which means it's got to be off 0:40 the table, none of this can be up on the table. So I'm going to queue Leanne to sit on 0:46 her tailbone, no lower, and then from there I'm going to have her grab her 0:50 opposite leg. She's going to pull her opposite leg into her torso, this is 0:54 going to posteriorly tilt her pelvis. As she posteriorly tilts her pelvis 0:58 that'll give me a little bit of lumbar flexion, which will help me protect her 1:03 from going into excessive lumbar extension as she goes back. I think what you 1:08 will find is a lot of the people who need good hip flexor stretching, are the 1:11 same people who have a history of low back pain, and we don't want to do 1:15 anything to reignite or exacerbate low back pain, that can definitely be a 1:19 problem moving forward in our routines. From here, I'm going to go ahead and throw a 1:23 towel over her foot, that's just so I don't get foot prints on my shirt, and 1:26 then I'm going to go ahead and use my torso to stabilize this leg. If I use my torso 1:32 to stabilize this leg two things happen: number one, Leanne can relax, she no longer 1:37 has to pull on this leg which is going to make it easier for me to get autogenic 1:40 inhibition or those releases I'm looking for on the opposite leg. Second, by using 1:45 my torso I have both hands free to make sure I can dial into the hip flexor, or 1:51 dial in to great technique for this stretch. First things first, I'm going to use 1:56 this hand to control her pelvis through this leg. She's at her end range, so if I 2:02 feel her tilting this way, I can actually get her to tilt back by just pushing 2:06 this way. If I think she's going into an anterior pelvic tilt, I can lean a little 2:10 bit with my torso and force her back into a posterior pelvic tilt. So I 2:14 can do a lot to control her pelvis and make sure she stays neutral here, just by 2:19 controlling this knee, and controlling this foot with my torso. Now, let's talk 2:24 about all of the different things we can do with this part of the stretch, the 2:28 actual stretch part of the stretch, to let it dial in to the specific hip 2:33 flexor I'm looking for. Now, if you have iliacus and psoas tightness, that's 2:37 what you've assessed to be tight, probably the best bet is to posteriorly 2:42 tilt as far as you can, making sure that lumbar spine is actually flat, 2:46 that'll pull the psoas longer, and then I'm going to go femur in neutral, that 2:53 way I know there's no compensation happening, and then I'm going to push down 2:57 into extension until just past that first resistance barrier, and hold until 3:01 I get a release. So psoas iliacus, we're going to go posterior pelvic 3:07 tilt, neutral position of the femur. Now, if I want to turn this into a TFL 3:12 stretch, the TFL does internal rotation of the femur, as well as a little bit of 3:17 abduction, and external rotation of the tibia. So I can pull her foot in, that's 3:24 internal rotation of the tibia, I can pull her tibia this way, which is 3:29 external rotation of the femur, and then use my hand and my leg a little bit to 3:34 pull her into just a little bit of abduction, and she should go from feeling 3:38 this stretch more in the lower ab, or just just inside her ASIS, to now just passed her 3:44 ASIS on the side here where her TFL lies. Do you feel that? -Yes. Good. So we went from psoas 3:50 to TFL just by turning her in a little bit, and pushing her in a little bit. Now, 3:54 if I had assessed that her pectineus was tight, your pectineus as an adductor 3:59 muscle is a little different in the sense that it has an innervation from the 4:02 femoral nerve, that femoral nerve is the same nerve that innervates all of our 4:05 hip flexors, so it has a tendency to get tight with the hip flexors. If I wanted 4:10 to make this a little bit more of a pectineus stretch, I'd actually go in the 4:12 opposite direction of my TFL. So now I'm just going to push her into a little bit 4:18 of abduction, and extension. So we've got psoas, TFL and pectineus. 4:28 And then, of course, the last one, which I see abused a little bit, to get rectus 4:34 femoris all I really need to do is get her back into neutral, and kick that leg 4:38 to just past 90. The reason I say this gets abused a little bit is I see people, 4:43 number one, take this stretch a little too far. 4:46 Instead of that mild discomfort they go for darn near pain, and they try to pull 4:51 this leg up towards the table. One thing I can definitely tell you is more 4:56 is not better. The harder you stretch somebody, the more muscle spindle 5:00 activity you'll get, and the more their muscle is going to fight back against you. 5:04 That's not going to help you get autogenic inhibition, that's not going to help you get 5:08 a release, that's going to lead to an increase in extensibility and soft 5:13 tissue adaptation. So all we need is a little mild stretch here, and just using 5:17 my leg to pull it back just past 90, use my hand, once again I'm going to correct her 5:23 pelvic position. You can kind of see me adjusting here to make sure her foots on 5:27 the right place on my torso, I'm using this hand, I'll push her just a little bit past 5:32 the first resistance barrier, and I'm going to hold until she lets go. So there you 5:37 have it, we've got psoas with straight on with a posterior pelvic tilt, 5:42 TFL is adduction, turning her leg in, turning her foot and tibial internal 5:48 rotation, we've got pectineus which was pushing 5:53 into abduction a little bit, and rectus femoris was taking a leg under. And 5:58 then of course, you're going to hold with mild discomfort until you get a release 6:03 to happen, and you can wait for two to three releases as you push further 6:07 and further into that resistance barrier. Now, be very careful, as you get somebody 6:11 out of this position, just like we were careful to get Leanne into this position, 6:14 we don't want to drop this leg and let her pelvis pull her into an anterior 6:19 pelvic tilt, hyperextension of lumbar spine and 6:22 then she's having low back pain again. So what I'm going to have Leanne do is go ahead 6:25 and grab this leg again, both hands, once she has this leg I'm going to 6:31 go ahead and get out of the way of this leg, because we're going to have her 6:33 step down on this leg, and I'm going to help her 6:37 pull up, and then she can just slide off the table, onto that leg that 6:41 we just stretched, no low back pain. I hope you enjoy this manual stretch. 6:46 If you haven't done manual stretching before I suggest you practice on a few 6:50 people before you actually practice on a client or patient. For my trainers out 6:54 there you can practice on a few of your personal trainer buddies. 6:57 Everybody loves to be stretched! So I hope you get a huge increase in 7:01 extensibility from this stretch, I hope you are working on your technique, 7:04 I'll talk to you soon.
