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Adductor Magnus Static Manual Release

Adductor Magnus Static Manual Release is a soft tissue technique intended to treat muscle tension and tightness along the Adductor Magnus (inner thigh) muscle. This technique involves manual compression and friction to the affected area, helping to break up myofascial restrictions, increase range of motion, and reduce pain. The Adductor Magnus Static Manual Release technique can be used as part of an overall treatment plan to improve muscular imbalances, biomechanical dysfunctions, and injuries

Transcript

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This is Brent of the Brookbush
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...blank
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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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groin.
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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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magnus.
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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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release.
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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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muscle,
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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.