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This is Brent of the Brookbush
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Institute, and in this video we're going over
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static manual release of the adductor
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magnus. If you're watching this video, I'm
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assuming you're watching it for
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educational purposes and that you are a
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licensed manual therapist. That is, a
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physical therapist, an athletic
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trainer, a chiropractor, a massage
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therapist, or an osteopath, and the laws in your
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state cover your scope of practice to
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perform manual release techniques. If you
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are unsure please look those laws up.
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Personal trainers, this video probably
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does not apply to you. I'm going to have
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my friend, Melissa, come out. She's going
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to help me demonstrate. Now, all of these
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static manual release techniques follow
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very similar protocols. We have to know
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how to palpate the muscle we're
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targeting. We get bonus points for
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knowing the trigger points, because that
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will definitely narrow down our search.
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We need to know if there's any tissues
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that, perhaps, we should be watching out
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for that don't like compression. In the
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case of the adductors, we do have to be
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aware of the femoral artery. The femoral
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artery isn't huge underneath our fingers.
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Remember that arteries aren't going to
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be any thicker than your pinkie. So if you
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do happen to feel a pulse while doing
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this, don't freak out, just move up or
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down or side to side and you should be
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able to find a way to the targeted
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tissues without compressing that artery.
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And, of course, we need to know what
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position we're going to put Melissa in
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so that I'm comfortable and can apply this
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pressure for a long, sustained period of
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time being 30 seconds to 2 minutes
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without fatiguing, and that Melissa is
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comfortable, and I'm not putting in her in a
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position of pain. We need to be adding
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some tension to this muscle so that we
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pin down those nodules, or points of
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hyperactivity and don't start playing the
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"put your finger on top of a marble" game,
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or that marble will just keep slipping out.
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Now, in the case of the adductor magnus, I
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use the same position that I use for the
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adductor magnus stretch. So, I
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put her foot up on my ASIS. Now I have
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total control of how much tension is in
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her adductor magnus, because
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I can just move back and forth this way.
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If this is way too much of a stretch for her,
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I can back off this way. If this isn't
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enough tension, I can take a step forward.
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And, of course, if I get my table up nice
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and high, I can get my arms out straight
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with my elbows nearly locked, and I'll just
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be applying pressure by leaning forward
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and using my bodyweight instead of
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trying to use my hands, which is
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eventually going to wear me out. Now,
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finding your adductor magnus isn't
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particularly difficult. It is the most
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posterior of the adductor muscles, so if
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I kind of attack the adductors from the
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posterior side going this way, I'll be on
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the adductor magnus. The only thing I
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have to differentiate is where is my
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adductor magnus versus where is my
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hamstrings. In an athletic population, you
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might see their hamstrings popping out
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just by looking down. In Melissa's case, I
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can actually see a nice little bump
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where her developed hamstrings are
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sticking out, and I know if I put my
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fingers right above that bump, I'm on adductor
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magnus. If you can't see that bump, if
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you can't get a good visual
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indication of where the adductor magnus
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starts, use one hand and kind of use like
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a nice, broad area to kind of grab the back
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and inside of their thigh. Use your other
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hand against the back of their
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heel and have them flex their knee.
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Remember, your adductor magnus doesn't
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cross the knee, but your hamstrings do, so
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you'll feel an increase in tissue
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density- you'll feel their hamstrings
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contract, but their adductors won't. All
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you have to do is go just above that
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contracting tissue. Go ahead and relax
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for me. Alright, now I mentioned I get
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bonus points for knowing where those
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trigger points are. In the adductor
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magnus, we have one that's like basically
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right in the middle of the thigh and
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then one that's very close to the
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ischial tuberosity, so way up close
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to the origin of the
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adductor magnus. Now, I'm going to use these
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posterior to anterior kind of swiping
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motions to find the most dense, most
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tight fascicles, and then once I find
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them, I can start moving a little bit
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more proximal. In this case, I started
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just a little distal of the midpoint of
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her thigh, and I find a nice tender point
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right there. Once I find the tender point
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in this position, I'm going to use a
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thumb over thumb technique. Alright, I'm
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going to kind of lock out my elbows here,
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and then I'm just going to lean. I'm only
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going to lean enough to get some good
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pressure on those dense fascicles. Now,
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remember, I said good pressure is kind of
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where you push until you start feeling a
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little give back but you don't get that
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huge increase and give back, that huge
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increase in resistance. Because at that
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point, you're probably getting guarding.
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You're probably going to get some pain,
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and it's actually going to be harder to
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get a release. We want to go just up to
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the point where we start getting an
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increase in tissue resistance, or an
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increase and push back on our fingers.
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We're going to hold this for 30 seconds
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to 2 minutes, or until we
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feel a release, likely closer to 30
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seconds once you get good at this. Once
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they get a release, I can move on to the
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next trigger point. Now, I've said this in
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many videos, before you put your hands on
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somebody, you should be 80% sure that
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that muscle is involved. You don't use
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manual techniques as assessments, at
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least initially. Of course, everything we
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do is an assessment, but you should have
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a good reason for putting your hands
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there. This is especially true of the
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adductor magnus trigger point at the
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ischial tuberosity. Your hands are going
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to be very close to somebody's groin.
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This is something that you're going to
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want to explain to your client. Build
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rapport. Don't just put your hands
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somewhere and not give your client a
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good indication why.
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You also are going to want to probably
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have a post-test. So, I had an
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assessment, I think this might help, and I'm
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going to do this post-test to show you
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why I put my hands there. If you guys just
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put your hands where I'm about to put my
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hands and have no explanation, you
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could get yourself into trouble. So, the
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adductor magnus's origin is all the way
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at her ischial tuberosity, which is
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essentially what's holding her up on
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this table right now. Those are the
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bones deep in your backside. So, if I come
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down closer to her backside and feel these
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same tissues, I can feel a trigger point
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right here. Same thing- notice, guys, I kind
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of have my hands turned this way, right, I
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don't want my hands over somebody's
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If you needed to, if somebody felt more
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comfortable, you could have them place
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their hand over their groin, or use a
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towel, or have them place a towel and
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their hand over their groin so that they
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feel safe. And, again, I'm going to go
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ahead and hold for 30 seconds to 2
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minutes until I get a release. How does
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that feel? Starting to relax? Good deal.
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And then, at that point I'd probably be
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like, "Okay, why don't you get up and do a
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squat?" Maybe that was where she was
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feeling this pain. In the next segment,
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we're going to do our close-up recap. Alright,
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guys, for your close-up recap I'm
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going to take her thigh into flexion and
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abduction, just like I would for an
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adductor magnus stretch. I'm going to
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put her foot on my ASIS so that I can
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control how much tension is within her
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adductor magnus just by leaning forward
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or leaning back. Now, we know that her
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adductor magnus is the most posterior of
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the adductor muscles, so we just have to
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differentiate between the adductor
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magnus and hamstrings.
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Melissa has some pretty
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well-developed hamstrings, but to show
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you guys how I would differentiate on
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somebody who, maybe, wasn't quite as
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athletic or quite as well-developed, I'd
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use a nice, broad part of my hand, so
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that I could feel all of the inner thigh
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and all of the posterior thigh. I add a
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little pressure there so I know I'm
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feeling through any adipose tissue. I'd
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use my other hand to block the ankle,
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and then have them flex their knee and
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"boom" their hamstrings pop right out.
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Remember, your adductor magnus doesn't
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cross the knee and is not responsible
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for knee flexion. So, if I go right above
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those now contracted dense fibers of our
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hamstring, I know I'm on adductor magnus.
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Now, you guys can actually see this on
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camera. If I just have Melissa go ahead
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and flex her knee, being that she's
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athletic and has these well-developed
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hamstrings- go ahead and relax and flex
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again. you can see her hamstrings just
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pop out, and if I go right above those
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hamstrings, I know I'm right on adductor
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Good. Go ahead and relax for me. Now, with
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the adductor magnus, I know her trigger
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points are going to be right about the
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mid portion or middle of the length of
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her thigh. Right around here.
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And then there's another trigger point
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that's pretty close to the origin of
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this muscle near her ischial tuberosity.
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So, I'm going to go ahead and take these
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posterior to anterior strokes, making
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sure I stay off the femoral artery, but I
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look for the densest fascicles. Once I
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find them, I can then start moving a
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little bit more proximally here since I
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started a little distal to the midpoint
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of her thigh. Once I find that point, I'm
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just going to go thumb over thumb, lock
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out my elbows, and apply some pressure
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until I get a little kickback from
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that tissue. I'm going to try to hold as
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still as I can ensure that Melissa is
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fairly relaxed here. Hold 30 seconds to
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120 seconds, and then hopefully I get a
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Now, the other trigger point we have is
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very close to her ischial tuberosity
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and close to her groin. I mentioned that you
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could drape this area. You could have
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your patient or client cover their
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groin, so that you don't risk bumping
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into it. Melissa is going to go ahead and
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uncover herself, so that you guys can see
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my hands for this particular technique.
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Her ischial tuberosity are
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essentially the bones that are holding
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her up on the table. Those are
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those that pelvis bones that are deep in
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your gluteal area. But, if I kind of
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start there around the origin of this
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you will notice that there's some
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tightness, some density, these hyperactive
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local points just two or three inches
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distal from that origin. And then, again,
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I'm going to go ahead and use my thumb
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over thumb technique here. I'll hold for 30
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seconds to 120 seconds. As I mentioned
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before, guys, this is an important time for
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you to have assessed and have a very
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good reason for your hands to be here.
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This might be one of those
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techniques where I test right after I do
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the technique to go, "Alright, this is
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why we did the technique. Do you feel
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better?" I hope you guys enjoyed the
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close-up recap. There you have it- static
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manual release for the adductor magnus.
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Remember, if you're going to do a manual
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release technique, you should be 80% sure
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that that muscle is involved from your
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movement assessment. Don't use manual
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techniques alone as assessments,
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especially in the case of this technique.
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You're going to want to pre-test and
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post-test, and then give your client or
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patient confidence that you put your
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hands where you put your hands for good
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reason. I would definitely suggest, in the
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case of this and all manual release
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techniques, that you grab a friend,
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grab a fellow student, grab a colleague,
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grab a fellow professional. If you can,
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grab an experienced manual therapist to
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practice this technique on first, before
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trying it on a client or patient. There
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is no better education than being able
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to practice this on a fellow manual
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practitioner and have it done to you by
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that practitioner and start exchanging
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notes. These videos are great, but they do
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not make up for the practical
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application component that you will need
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to feel comfortable in practice. I hope
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you guys enjoyed this video. I look
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forward to seeing your comments, your
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questions. I'm happy to answer anything
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you guys ask. I'll talk with you soon.