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Biceps Femoris Manual Static Release
Biceps Femoris Manual Static Release is an effective stretching technique used to release tightness in the biceps femoris muscle, which is located in the posterior thigh and is a major contributor to knee flexion and hip extension. This technique involves placing a foam roller or object under the biceps femoris muscle and slowly rolling along the length of the muscle. This massage-like pressure can help to shift tension, and increase circulation to the tissue for improved flexibility and range of motion. Additionally,
Transcript
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This is Brent of the Brookbush Institute and
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...blank
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in this video we're going over a static
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manual release of the biceps femoris, or
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the lateral hamstring group. Now, if
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you're watching this video, I'm assuming
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you're watching it for educational
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purposes and that you're a licensed
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manual therapist following the laws of
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your scope of practice in your state.
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That means athletic trainers, physical
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therapists, massage therapists,
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chiropractors, osteopaths, you're probably
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all in the clear. Personal trainers, this
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video probably doesn't fall within your
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scope, although, you could use the
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palpation portion of this video as part
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of a learning experience, especially
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learning your anatomy. I'm going to have my
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friend, Sonya, come out. She's going to
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help me demonstrate this technique. Now,
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of course, before I do any manual
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technique, I'm pretty much eighty percent
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sure that the muscle I'm going to target
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is involved in the dysfunction, and the
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only way I can get there is through
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assessment. So, with Sonya, we're going to
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make up a little case. We'll say she came
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in complaining of a little knee pain.
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When I did her overhead squat, maybe she
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had some knees bow in. When I did gniometric
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assessment, she was missing a
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little hamstring length. It's that
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test where we're at 90 degrees of hip
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flexion and then we see how much knee
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extension is left over. So, I have a
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pretty good idea that biceps femoris
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overactivity is part of her dysfunction.
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Now, all of these static manual release
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techniques follow a very similar
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protocol. We need to be able to palpate
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the muscle. We get bonus points for
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knowing where the trigger points are. We
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should probably know if there's any
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other structures around that muscle that
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we could potentially insult, something
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like a nerve or an artery that we want
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to stay away from. And then,
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once we get all of that figured out, we
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want to know what position should the
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patient be in for their comfort, our
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comfort, and so that we have some control
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over the amount of tension within the
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muscle so that we can help localize or
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stabilize those tight fascicles and
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trigger points. In this case, the biceps
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femoris is on the lateral side of
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the posterior thigh, so this is the outer
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hamstring group. You can see I've marked
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off the trigger points. We have a long
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head in a short head of our biceps
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femoris.
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The long head trigger point is right about
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here and the short head is right about here.
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You guys will see that a little closer
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when we do the close-up recap.
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Generally speaking, these trigger
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points are right in the middle of these
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muscle bellies. So if you know that the
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biceps femoris goes from ischial
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tuberosity to fibular head, then
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that's about center. And then the short
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head of the biceps femoris comes off
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that linea aspera at about halfway down,
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so if I go half the distance of her
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femur to fibular head, that's pretty
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close to center. Now for the short head,
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we can go in prone and still have some
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control over how much tension we have in
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this muscle. Remember, your short head
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doesn't cross your hip, so all I have to
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do is be able to
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control how much knee flexion and
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extension I have. I'm then going to use
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my palpations this way, my
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strumming palpations from medial to
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lateral to try to figure out where are
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these tight fascicles. Alright, so I'm
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just going from medial to lateral, and I
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notice that this fascicle is pretty
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tight. You'll notice I put my
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hands down pretty close to where those
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trigger points are, but if I start moving
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from proximal to distal now, I want to
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see if those tight fascicles are
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attached to maybe a tight nodule, maybe a
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local point of hyperactivity. Then I can
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really pin down. I'm going to add
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just a little bit more attention to this
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muscle here, because as I've explained in
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some of these other manual release
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technique videos, if you don't put a
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little tension within the muscle you
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start playing that game of trying
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to put your finger on top of a marble.
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Every time you push down, it slips
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out. So, I want enough tension this way
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that I stabilize that point.
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I think right about there I got Sonya
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making a little face, that's a good point.
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I'm just going to use pressure from my
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thumb. Now, if I wanted to, if I felt
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like I needed both hands, if I was a
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smaller therapist let's say and Sonya
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was a huge individual, which obviously
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she is not, I could use a dowel or maybe
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my knee to keep her in this position, and
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then use my thumb over thumb technique
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here so that I don't have to to wear out
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my hand. Notice that my elbow is locked,
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like I'm trying to get my body
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weight up and over the pressure I'm
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using. I'm not using my grip
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strength. You don't want to wear yourself
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out. And, of course, after about 30 to 120
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seconds, I actually start to feel the
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increase in tissue density that I
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identified disappear. It'll actually
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start to melt or release, which is where
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the name these techniques come from.
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Sometimes you can actually feel a
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release happen. If you ask your patient,
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"How does this feel compared to when I
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put for first put my fingers down? Is it
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as tender?" No. She said it's not as tender.
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Usually it'll be really tender when you
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put your fingers down and over like 30
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seconds it starts to calm down, a lot of
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it calms down within the first 10
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seconds. Alright, so that's short head,
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guys. And, once again, I'm going to do a
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close-up recap. So if you didn't see
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exactly what was going on, don't worry
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about it just keep watching. Go ahead and
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flip over for me, Sonya.
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Now, for the long head of the biceps
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femoris, the long head actually crosses
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the hip, so I have to be able to control
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both her knee and her hip. In this case,
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all I'm going to do is take Sonya's leg
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and put it on my shoulder.
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I'm then going to use my same palpation
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skill of medial to lateral, kind of
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strumming to find the
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tightest fascicles. In this case, I'm
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going to start a little a little distal
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of where that trigger point is. Once I
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find the tightest fascicles, I can then
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start moving a little bit more proximally.
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Once I find the tightest
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point- and that's a little trickier with the
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with the biceps femoris and some of the
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other muscles we've gone over. They're long
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stringy muscles, so you might have to
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search just a little bit. There we go.
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Make sure I have enough tension in her
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biceps femoris to stabilize that point, so
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it's not flopping all over the place
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underneath my thumbs. And then you guys
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notice, I've actually gone thumb over
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thumb here. I'm obviously not going to be
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able to get my arms straight in this
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position, but at least I can use both
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hands to apply that pressure. I am
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using, or trying to use my body weight here
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to lean forward with my hands. How does
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that feel? It feels good. Sonya's a little
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masochistic, she likes pain. This
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is one of those techniques where if
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somebody does enjoy massages though,
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they'll like it because they'll feel
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that release happen. And it's usually pretty
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quick, usually 30 seconds and you'll start to
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get a good release. You could be here up
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to two minutes if you have somebody
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who's really really overactive. So, once
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again, guys, make sure that you are
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careful with your own body position.
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Everybody is all about patient comfort. I
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don't I don't see a lot of patients in
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super uncomfortable positions. I do see a
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lot of therapists
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put themselves in uncomfortable
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positions, which is going to affect your
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longevity. If you plan on doing this
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for a long time, you need to really watch
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your own mechanics. I'm lucky in this
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office that I have so many mirrors, but
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I'll even catch my own bad posture on
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these techniques. Next, we're going to go
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to the close-up recap, guys. We
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have Sonya in position to do the long
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head of her biceps femoris. Remember, when
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we're releasing the long head of the
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biceps femoris, we want control over hip
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flexion so that we can place a little
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bit more tension in those tissues, so
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that we can pin down those overactive
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fascicles as well as the trigger point
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we're going to go after. I'm going to
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start with my medial to lateral or
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lateral to medial strokes pretty close
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to the center of the belly of that
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muscle, which is where that trigger point
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tends to be. I'll go medial to lateral and
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lateral to medial here, looking for the
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most overactive or the densest fascicles.
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You guys can notice that I'm between
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this mass here, which is her vastus
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lateralis and this mass here, which is
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actually her medial hamstrings. I
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actually notice a nice tight fascicle
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right there. I then can move from
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distal to proximal
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or proximal to distal to try
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to see if that overactive fascicle is
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associated with a trigger point. I have a
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nice little, a little tense nodule right
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there. Once I find that trigger point, I'm
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going to go ahead and press just enough
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to start getting a little bit of tension
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back from the tissue. Alright, so as I'm
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pressing, you'll notice tension kind of
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increases on an exponential curve there.
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I want to be right in the trough of that
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exponential curve. I don't want to press
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it all the way down. I'm not trying to
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put a hole in her leg. I don't want
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to see how far or how much tension I
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could place in those tissues. Just apply a
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moderate amount of tension, and then I'm
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going to hold. Notice that my arms are at
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about 90 degrees here, guys. So all I have
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to do to increase tension is lean
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forward a little bit.
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I don't need to use my grip strength. I
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can also use my body here. I can lean
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forward a little bit to add a little bit
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more hip flexion and increase the
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tension in the long head of her biceps
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femoris if I need to to pin down these
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tissues. Once I get a release, I get a
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reduction in discomfort from my patient,
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I can go ahead and move on to the next
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muscle or the next trigger point. In this
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case, we're going to move on to the short
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head of the biceps femoris. I'm going
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to have Sonya flip over for us. You
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guys can see here that I have this trigger
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point marked off, too, but we'll pretend
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that this X isn't here for a second. We
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know that the short head of the biceps
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femoris attaches to the linea aspera and
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the fibular head, and right between it, in
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the middle of the belly of the muscle,
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tends to be where the trigger point is.
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So, I'm going to go ahead and use those
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same medial to lateral and lateral to
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medial strokes to find the the tensest
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fascicles. And once I do, I can start
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moving either proximal to distal or
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distal to proximal to try to find any
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nodule that may be associated with those
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overactive fascicles. Once I find it, I
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can use my thumb over thumb technique. Of
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course, if you guys wanted to play with
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the amount of tension within that muscle,
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I can control the knee with one
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hand and use one hand to do the release
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technique. Once again, we'll hold 30 to 120
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seconds or until we feel a reduction in
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the density of the tissue. Make sure
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you're not pressing too hard. It does
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take a little bit of practice to know
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how much pressure to apply with these
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techniques. So, there you guys have it, the static
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manual release of the biceps femoris, or
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lateral hamstring group. Make sure that
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before you do these manual release
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techniques, you have a good working
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hypothesis of why that structure may be
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overactive. Ideally, before you would try
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any of these techniques on a patient or
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client, you would also practice
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them on a colleague or maybe a mentor
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with great manual skills who you look up
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to. There is no substitute for getting
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feedback from another manual
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practitioner. I hope you guys enjoyed
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this video. I look forward to hearing
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your comments. Please leave your comments
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below. I'll talk with you soon.
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