Vastus Lateralis Static Manual Release

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Learn the proper technique for vastus lateralis static manual release (a.k.a. soft tissue mobilization, ischemic compression, trigger point release) in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides detailed guidance on assessment, positioning, tissue differentiation, and pressure application to release vastus lateralis trigger points, reduce muscle over-activity, alleviate hip and thigh discomfort, and improve lower extremity function. Perfect for clinicians and movement professionals, including physical therapists, massage therapists, athletic trainers, and chiropractors, seeking to enhance their manual therapy skills for hip and knee rehabilitation, performance, and pain management.

Differentiation

The vastus lateralis is a superficial muscle that encompasses the entire lateral portion of the thigh, distal to the greater trochanter.
The biceps femoris may also be palpated laterally. To ensure your palpation has not drifted too far posterior, you may test your palpation using resisted knee flexion to initiate contraction of the biceps femoris , or resisted knee extension to initiate contraction of the vastus lateralis .

Potentially Sensitive Tissues

The lateral femoral cutaneous nerve may be compressed or stretched during this technique. Generally, this would result in a burning, tingling, or searing pain. The nerve is fairly small and a slight adjustment in hand position either anterior or posterior should be sufficient to avoid continued pressure on the nerve.

Trigger Points

The common trigger point for the vastus lateralis is either a few inches from the knee, or close to the middle of the length of the muscle.

Release Technique

Position 1 (Side-lying):
1. This technique is likely easiest to perform with the patient/client in side-lying, with hip and knee slightly flexed for comfort and stability.
2. The practitioner should be behind the patient, adjacent to the thigh.
3. Passively extend the patient's hip and flex the patient knee so that their foot rests against your ASIS.
4. Leaning into the patient's foot may be used to increase hip extension, knee flexion, and tension in the vastus lateralis .
Position 2 (Cross-body):
1. Start with the patient in supine, standing on the side opposite of the affected leg.
2. Passively flex, adduct, and internally rotate the patient's affected leg, pulling it across their body.
3. Block the client's leg from returning to that position using your ASIS (see video above).
  1. Note: Although this position is the preferred technique, not all patients tolerate the position well. If the patient does not tolerate this position, use position 1.
4. Leaning into the patient's leg, increasing adduction, internal rotation, and flexion can be used to increase tension.

Release

Use a "thumb over thumb" or "thumb in thenar crease" hand position to palpate the fascicles the vertically oriented fibers of the vastus lateralis from posterior to anterior to identify taut bands. The vastus lateralis is a thick muscle, so several strokes may be required to explore fascicles at various tissue depths.
Once a taut band is located, the length of the band is explored for a dense nodule and consistent pressure is applied.
Generally, compressive force is sufficient to pin dense nodules; however, a slight posterior to anterior force may be added.
Consistent pressure is held until the nodule softens under the practitioner's fingers, or tissue density/sensitivity is significantly reduced (generally 30 - 120 seconds).

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