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Vastus Lateralis Static Manual Release

Eliminate tightness in your hip muscles with step-by-step video instructions for a Static Manual Release of the Vastus Lateralis. Learn from a physical therapist and gain strength in your hips.

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Transcript

00:04 - 00:07This is Brent of the Brookbush Institute, and in this video going over static manual
00:07 - 00:11release for the vastus lateralis. Now if you're watching this video I'm assuming
00:11 - 00:14you're watching it for educational purposes, and that you are a licensed
00:14 - 00:19manual therapists, or your scope of practice in your state allows you to
00:19 - 00:23perform static manual release techniques. Physical therapists, athletic trainers,
00:23 - 00:27massage therapists, chiropractors, osteopaths you're likely all in the clear.
00:27 - 00:32Personal trainers this probably does not fall within your scope. I'm going to have
00:32 - 00:37my friend Brian come out, he's going to help me demonstrate this technique. Now
00:37 - 00:43all of our manual release techniques they follow similar principles. We have
00:43 - 00:47to know how to palpate the muscle, and in this case the vastus lateralis is huge
00:47 - 00:52and fairly easy to palpate being on the side of our leg. We get bonus points for
00:52 - 00:56knowing where our trigger points are because that will help direct our hands,
00:56 - 00:59and I got the trigger points marked off here on Brian. I don't know if you can
00:59 - 01:02see in this view, but when we go to a close-up you will be able to see those
01:02 - 01:08trigger points marked out. You should be aware if there's any contraindications
01:08 - 01:12to this technique, there's anything that could be damaged by compression. In the
01:12 - 01:17case of the vastus lateralis we don't have any major concerns, and the last
01:17 - 01:21thing is we need to know what the best position for release technique is, and
01:21 - 01:24that's usually based on what's comfortable for the therapist, as well as
01:24 - 01:28being able to put a little tension in that muscle. So as you go to press down
01:28 - 01:33on these trigger points, these little balls of overactivity, you don't start
01:33 - 01:38playing the trying to put your finger on a marble game. Now there's two positions
01:38 - 01:45we use for vastus lateralis release, and one of them in particular makes very
01:45 - 01:50little sense, that I think you guys will find in both techniques that moving the
01:50 - 01:56hip actually contributes to increase in tension in the vastus lateralis, which
01:56 - 02:00doesn't make a whole lot of sense if we think back to our basic anatomy courses.
02:00 - 02:05But if we take things up a notch we learned that the vastus lateralis
02:05 - 02:10actually does invest into the iliotibial band and putting tension in the
02:10 - 02:16iliotibial band, whether we go into extension and the TFL pulls a
02:16 - 02:21little tighter. Or we go into flexion and the glute max pulls a little tighter on
02:21 - 02:25the iliotibial band, that's also going to have an effect on those vastus lateralis
02:25 - 02:30fibers. The first position i'm going to show you guys is it's probably the one
02:30 - 02:35that's most obvious, or makes the most sense. I'm going to go ahead and take him
02:35 - 02:41into some knee flexion. I'm going to use my body to block knee flexion. I'm going
02:41 - 02:44to be pushing down on his vastus lateralis so i'm going to go ahead and
02:44 - 02:47take this leg, make them a little bit more comfortable and stable by bending
02:47 - 02:53it, and then i'm going to be careful to actually put his medial gastroc
02:53 - 03:01underneath his vastus medialis. So that when i press down i get meat on meat and
03:01 - 03:05I don't do one of these like knee cap on ankle bone things, because if i press
03:05 - 03:12down there it's going to hurt. So we go here. I'm going to do my palpation
03:12 - 03:19posterior to anterior to feel for the most overactive or the densest fascicles,
03:19 - 03:26and then once i found them i generally know that trigger points in the vastus
03:26 - 03:31lateralis usually happen pretty close to the knee, or right dead center
03:31 - 03:36between greater trochanter and me. So you guys notice even when I put my hand down,
03:36 - 03:40I put my hand down pretty close to the center of his thigh, because i'm hoping
03:40 - 03:47to get kind of lucky here and not only put my hand down on overactive fascicles,
03:47 - 03:55but be pretty close to a nice tight nodule, a trigger point without having to
03:55 - 04:02do too much searching moving from distal to proximal, or proximal to distal.
04:03 - 04:09How's that feeling? That's a little more tender. Okay so now that I found this
04:09 - 04:14nice hyperactive point, I'm going to go ahead and this is going to be my dummy
04:14 - 04:18hand, I'm just going to let this totally relax. I'm going to take this hand
04:18 - 04:24straighten it out, alright so I'm noW using this hand to apply force. I'm just
04:24 - 04:28going to go ahead and lean over, and I'm going to wait for 30 seconds to 2
04:28 - 04:36minutes until that tissue density starts to decrease. The over activity starts to
04:36 - 04:41decrease, Brian tells me he just can't handle it anymore, which of course you
04:41 - 04:46need to listen to your patients and back off a little bit. Or of course he tells
04:46 - 04:49me that he's not feeling anything at all, the discomfort has subsided, that's
04:49 - 04:57probably a good sign we can move on. Now we can move on to other points right, so
04:57 - 05:00I can go back to, all right we did the one in the middle of his thigh, does he
05:00 - 05:08have anything near his knee. I feel a point right there, go ahead and put down
05:08 - 05:15some pressure. One thing that often gets mistaken with this technique, is once
05:15 - 05:19again I said this is vastus lateralis static manual release. I think a lot of
05:19 - 05:24people would look at me doing this and being like oh its IT band release. You
05:24 - 05:29can't really release your IT band guys. Trigger points are muscular phenomenon.
05:29 - 05:37There are some fascial techniques that might be able to help with gliding of
05:37 - 05:42the iliotibial band over the vastus lateralis, but these static compression
05:42 - 05:48techniques are muscular techniques for a muscular phenomenon, for the most part
05:48 - 05:52being trigger points, and what we're really trying to do is decrease that
05:52 - 05:58over activity. How's that feel?
05:58 - 06:02Good, let's go ahead and have you on your back.
06:02 - 06:08Now the other position that you can do for vastus lateralis manual release is
06:08 - 06:15similar to what is called the Iron Cross stretch, right cross stretch. This
06:15 - 06:19is the weird one where I have them in knee extension, I'm taking it further into
06:19 - 06:26flexion, but somehow the increased tension in the iliotibial band allows me
06:26 - 06:36to have enough tension in my vastus lateralis to still find hyperactive bands,
06:36 - 06:43and of course tight nodules. Which I of course then want to release. Now be
06:43 - 06:48careful with this technique. If you have somebody with low back pain this isn't a
06:48 - 06:53great technique or a great position to put them in. Notice I have a whole lot of
06:53 - 06:58hip adduction, his pelvis is rotated this way, I'm pulling them further into spinal
06:58 - 07:06flexion. Hip or low back this could be a somewhat a compromised position. This
07:06 - 07:09position does come in handy though if you're doing a lot of different
07:09 - 07:12techniques, and you happen to be working on the biceps femoris and then you can
07:12 - 07:18just go on to the vastus lateralis. I do find this an effective position.
07:18 - 07:23Next a little close-up recap. Alright guys this is your close-up recap, just so
07:23 - 07:28you can see my hands, the position of the leg, how I search for a trigger point. I'm
07:28 - 07:32going to go ahead and pull him into knee flexion. I'm going to use my body to
07:32 - 07:37block his leg, so now I'm not doing any work. I got both my hands-free. I'm going
07:37 - 07:42to go ahead and I'm going to use, I mean since is this vastus lateralis and it's
07:42 - 07:47very thick, very dense, chances are i'm going to use both thumbs to even search
07:47 - 07:52for overactive fascicles. And then you can see here, I happen to know that the
07:52 - 07:55trigger points are closer to the knee, or right in the middle of the muscles. So
07:55 - 07:59i'm going to put my hands pretty close to where i think those are, and then i'm
07:59 - 08:05going to search by finding the most overactive fascicles, and moving either
08:05 - 08:11proximal or distal, there's a nice one right there. Alright once i found that, i'm
08:11 - 08:13going to use my dummy thumb. I'm going to relax
08:13 - 08:16this hand. I'm gonna use the other hand to apply pressure, and when I say use the
08:16 - 08:19other hand to apply pressure i'm actually just pushing through my arm
08:19 - 08:26into my palm, and then making sure that we're meat on meat here, vastus medialis
08:26 - 08:33to gluteus, I'm sorry vastus medialis to medial gastroc. I'm going to go ahead
08:33 - 08:40and push down until I get a nice release, make sure you guys don't do this thing,
08:40 - 08:46because if i push down his kneecap into his ankle that's not going to feel
08:46 - 08:53good at all. To show you guys the other position, go ahead and have Brian move
08:53 - 08:57away from me a little bit, and then he's going to go into this kind of Iron Cross
08:57 - 09:02stretch. Now the trigger points would be in the same places on this other leg
09:02 - 09:05closer to the knee, or right in the middle of the muscle. And generally
09:05 - 09:09speaking I'm moving my hands in this direction, with this one alright. So I am
09:09 - 09:13applying a little bit of a distal to proximal force. I'm going to find those
09:13 - 09:17tight fascicles, that's a nice tight fascicle there. Let's see if I can find a
09:17 - 09:24nodule within that tight fascicle. A little marble, well there we go once i
09:24 - 09:29find that, again just apply a little pressure and lean in, and i am leaning
09:29 - 09:36this way guys, so I'm not pushing straight down per se. This position can
09:36 - 09:40be a little problematic for those individuals with low back or hip pain. So
09:40 - 09:45keep both these techniques in your repertoire, that first technique is
09:45 - 09:50probably your go-to. I think you guys will find this technique sometimes
09:50 - 09:54convenient if you were combining it with a bunch of other release techniques. I
09:54 - 09:59hope you guys enjoyed static manual release of the vastus lateralis. Remember
09:59 - 10:02if we have somebody up on the table, we're about to perform the manual
10:02 - 10:06release, we want to be eighty percent sure that's what they need based on our
10:06 - 10:10movement assessment. If we're talking about the vastus lateralis, things get a
10:10 - 10:14little complicated in the sense that we have to include the vastus lateralis in
10:14 - 10:21the tensor fasciae latae, iliotibial band, vastus lateralis complex, and then we
10:21 - 10:25start to see that the vastus lateralis gets included
10:25 - 10:30whenever the TFL does, on things like our overhead squat assessment. So that would
10:30 - 10:36be signs like feet turns out, knees bow in, excessive forward lean, anterior
10:36 - 10:42pelvic tilt. If I was doing goniometric assessment while the vastus lateralis is
10:42 - 10:46a knee extensor, so if I saw a limitation in knee flexion that might
10:46 - 10:52give me an indication in a limitation in hip extension, as well as hip internal
10:52 - 10:59rotation, may also be indications of vastus lateralis over activity. Once
10:59 - 11:04again please mind your scope of practice. if manual release techniques do not fall
11:04 - 11:09within your scope do not attempt this. If you can find individuals to practice on
11:09 - 11:14before you actually attempt this on patients, that would be beneficial. There
11:14 - 11:21is no substitution to having a mentor or taking a manual therapy course, but even
11:21 - 11:26just practicing on your colleagues will be very beneficial. Being able to talk to
11:26 - 11:32another manual therapists about hand position, and what things felt like, and
11:32 - 11:36body position, and whose pressures felt the best is invaluable information. I
11:36 - 11:41hope you guys enjoyed this video. I look forward to talking to you soon.
11:47 - 11:49

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