0:00 This is Brent, coming at you with another one of our manual stretching 0:02 videos. In this video we're going to go over both the internal rotators of the 0:06 glenohumeral joint, as well as the latissimus dorsi. I think when I show you 0:09 these two techniques you'll understand why I paired them both together in this 0:13 video. I'm going to have my friend, Yvette, come out and help me demonstrate this 0:16 exercise. Now, first things first, we talked about body position, notice here 0:23 Yvette's right up next to my hips so that I don't have to lean over the table. 0:26 Since I'm stretching muscles around her glenohumeral joint, I want to 0:31 make sure that the table is stabilizing her scapula, that the glenohumeral joint 0:35 is just slightly hanging off the table so I have free movement of that joint. 0:39 The first manual concept, or manual technique, we're going to have to learn 0:43 for these two stretches is how to stabilize the scapula, keep it from 0:48 upwardly rotating. So the first thing we need to do is we need to palpate and 0:52 find the inferior angle of the scapula. This is not too terribly difficult. We're 0:57 then going to try to find a way to cup the inferior angle right here, and all we 1:02 have to do is kind of hold our hand like this, slide our fingers underneath the 1:07 patient or client, and then actually, Yvette's body weight is doing a really good 1:12 job of holding my hand in place. I don't need to push or shove. All I need to do 1:17 is keep my hand hooked like this, Yvette's body weight is pushing against my 1:21 fingers, and I have her inferior angle right in the palm of my hand. I'm then 1:26 going to go ahead and grab her arm right around her humeral condyles. That gives 1:29 me good control of both her forearm, as well as her humerus, and then I'm going 1:35 to pull her back into flexion and external rotation here. Now, I can feel a 1:42 little bit of pressure up against the palm of my left hand, I can feel a good 1:45 stretch happening here on her arm, and where do you feel this Yvette? Your armpit? 1:52 So, this, everybody calls a lat stretch, and the truth of the matter is 1:57 is this is not a very good lat stretch. It is a wonderful internal rotator 2:01 stretch. Where Yvette is feeling it is in her armpit right around her 2:04 subscapularis and teres major. So, an important stretch, but if I'm trying to 2:10 affect the latissimus dorsi I'm going to need to start 2:12 here, make sure that I get a good stretch out of these limiting structures, but 2:17 then I'm actually going to need another technique for my latissimus dorsi. For 2:22 the latissimus dorsi, what I'm going to do is, I'm going to bring Yvette into 2:26 this hook lying position, I'm going to posteriorly tilt her pelvis, that'll help 2:31 lengthen her lats on this side, I'm then going to take this hand and go back to 2:36 that lumbrical grip you saw me use in the pectoralis major stretch, 2:39 that's going to go over her humeral head, because one of the things that happens 2:43 when we pull the arm back this way is the humeral head tends to want to pop up 2:47 this way. I'm going to go over her humeral head, I'm going to make sure I 2:50 have good control of her achromion shelf and the lateral third of her clavicle, 2:54 and I'm going to keep that humeral head down, while pushing the scapula back into 3:01 a posterior tilt, I'm going to pull her arm into flexion, a little bit of traction or 3:07 distraction here and external rotation, and now if I take it to the first 3:13 resistance barrier, now where do you feel this? Notice she feels it a lot lower. She 3:18 actually feels it below her scapula. This is a lat stretch. Now, why would I want 3:25 to stretch the lats and not the internal rotators of the shoulder? Which is 3:30 definitely a fair question. If she had upper body dysfunction chances are I'm 3:34 going to have to stretch both. This is part of that upper body dysfunction. 3:38 We have both latissimus dorsi tightness, as well as subscapularis and teres 3:42 major. So, it would probably start with the subscapularis and teres major stretch, 3:46 get those limiting structures out of the way, and then move to the bigger 3:50 latissimus dorsi stretch. But, if Yvette was somebody who had, let's say, an 3:54 anterior pelvic tilt, the latissimus dorsi are contributing to 3:59 lumbar extension, not her glenohumeral internal rotators. So even though they 4:04 also may be tight, if my focus is here initially, I'm going to want to do this 4:10 latissimus dorsi stretch and be very specific to a structure that is 4:13 going to help improve the dysfunction I'm working on. So let's go over these 4:18 two techniques one more time. The first one was 4:23 legs in neutral position, I'm going to cup the inferior angle of the scapula and 4:28 let her body weight push my fingers down. I'm going to grip the humeral condyles 4:33 and pull her back into flexion and a little bit of external rotation. She 4:39 probably will feel this right in her armpit. This is subscapularis and teres 4:44 major. Now if I want to stretch the lats I'm going to put the legs into a hook 4:49 lying position, posteriorly tilt the pelvis, that's going to help lengthen the 4:54 lats down here, I want the scapula to upwardly rotate and 4:58 posteriarly tilt, and I want to protect the humeral head from shifting anteriorly, so 5:04 I'm going to use this lumbrical grip up here, let the scapula move up into my 5:10 hand, but push it back into the table, as well as the humeral head, and then pull 5:15 into flexion, distraction, retraction, and external rotation to the first 5:19 resistance there. I hope you enjoy these stretches. I think as your technique will 5:24 get better, you'll get bigger and bigger results from your clients. Use a little 5:28 bit of functional anatomy knowledge to refine which structures you're going after. 5:32 I'll talk with you again soon.
