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This is Brent of the Brookbush Institute,
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and we're going over manual release of
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the gastroc and soleus complex. Keep in
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mind this is a video for educational
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purposes, and I'm assuming that if you're
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watching this video to learn this
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technique you are a licensed manual
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practitioner, and you are going to pay
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attention to the laws on scope of
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practice in your state. Sorry personal
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trainers this video doesn't fall within
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your scope. I'm going to have Brian come
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out, he's going to help me demonstrate
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this technique. Now you can assume that
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if I'm going to release the gastroc and
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soleus complex, I have already done a set
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of assessments that had given me an
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indication that he either lacks
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extensibility, over showing signs of over
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activity in his gastroc and soleus
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complex, that could be things like the
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overhead squat assessment where feet,
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flat feet turn out, or an excessive
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forward lean may all indicate over
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activity here. It might have just been
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something as simple as a dorsiflexion
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goniometry. I see a lack of
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dorsiflexion these two muscles could
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restrict that. I could have done my
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gastroc soleus muscle length test and
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that could have given me an indication
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that there was some over activity here.
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Now once we have determined that this is
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an area we want to palpate and look for
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further signs of over activity, it is
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helpful to know your trigger points. All
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right so your common trigger points are
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very much related to motor points, which
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is where we have the neuromuscular
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Junction intervating the muscle, and
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this is often a site of dysfunction
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within these overactive muscles. All
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right so you can see here I've I've gone
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ahead and put circles where the common
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soleus trigger points are, and then X is
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where the common gastroc trigger points
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are. It is helpful for me to kind of know
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round about where those are, but i'm
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going to show you guys how to find them
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even if you didn't have them all
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memorized. What I generally do is I take
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one of the the pads of my thumb, and I
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start kind of strumming perpendicular to
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the fascicles, kind of like I'd be
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rubbing over guitar strings.
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Another little hint here guys is if you
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use your thigh to press into
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dorsiflexion a little bit, that helps put
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some tension, helps lengthen out this
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muscle, it'll help pop those fascicles
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into your finger, so I can see here's a
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tight fascicle. Now what I want to do is I
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want to go proximal and distal to see if
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what's causing the tightness in that
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fascicle, is actually a nodule or a
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specific location of a trigger point, and
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so I can start doing my strumming, kind
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of up and down and seem to be getting
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cold there, warmer, warmer all right, right
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there that's a nice spot. So once i found
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that spot, to help my me pin that spot
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down so that it doesn't end up feel like
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I'm trying to put my finger on a marble
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right, where it just kind of keeps
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popping out, I want to go ahead and put a
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little bit more tension by pressing them
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into dorsiflexion. Actually let me have
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you move down just a little bit Brian,
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Be careful guys as you push
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somebody into dorsiflexion you don't
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push the front of their ankle into the
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end of the table, that's painful. Alright
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so find that little spot again. I'm going
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to make sure I put a little stretch on
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that muscle, that's going to help pull
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everything down, help centralized that
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trigger point, and then I'm actually
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going to use a little distal to proximal
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force with my thumb here, to kind of pin
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it up this way. So rather than trying to
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do this, I'm putting a little stretch and
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pinning up this way, and then to add a
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little bit more pressure i'm actually
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going to go ahead and let this be my
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dummy thumb. So i'm not using this hand
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to apply pressure, i'm going to use this
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hand to apply pressure. The amount of
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pressure i apply is actually going to be
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up to, I wouldn't say the first
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resistance barrier, but the first
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significant increase in resistance from
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this tissue. I think you guys will find
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that as you press into tissue it's
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almost like an exponential curve right,
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you have this nice linear increase in
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how much pressure you get back, and then
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all sudden it's like this really really
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big increase in tension. So I'm going to
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press right
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up into that trough of that curve till I
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got a significant resistance, but not
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past it, and then all I have to do is use
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my body weight, nice straight arms, nice
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good posture, and hold it until that
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point starts to go away; and then if i
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have time, i can start moving through
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some other trigger points that may exist
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in this muscle. Okay so going through
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this whole technique again, i went ahead
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and put just a little bit of pressure
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into Brian's foot here, that's going to
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help dorsiflex his ankle, put a little
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bit of tension into this system, lengthen
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those fibers out so that they're going
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to pop into my fingers a little bit. I
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then run my thumb across the fascicles
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of the gastroc or the soleus, in this
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case alright I'm going to look for the
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most tender fascicles. Once I find those
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tighter denser fascicles, i'm going to
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move proximal and distal and i find like
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that's a pretty good spot right there.
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Once i have a spot i'm going to go ahead
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and kind of go up this way with the
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pressure on the gastroc and soleus, put a
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little bit more pressure into his foot
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so I dorsiflex them a little bit more.
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I'm going to use the opposite hand to
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press right up to that resistance
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barrier, and then I'm going to hold that
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until that goes away. There is one other
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protocol with four six to eight second
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holds, if you guys prefer that protocol
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you can do that too. So I could sit here,
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hold two, three, four, five, six, relax. Go
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back in maybe a little deeper into the
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tissue this time one, two, three, four, five,
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six. If not if i'm going back to just
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that static hold, and it's usually a 20
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to 30 second static hold. After I've done
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that release technique, in Brian's case
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I'd probably go ahead and flip them back
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over do some joint mobilizations. If I
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thought maybe
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is his talus was shifted anteriorly,
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or whatever other joint mobilizations
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that needed to do in his ankle complex,
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and then follow that up with a
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lengthening technique if I thought these
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muscles were short. So I wouldn't use
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release techniques alone, but this would
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certainly be the first step, and be
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helping to regain some ankle mobility
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and calm down any over activity in the
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gastroc and soleus complex. Just to go
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over quickly guys in a more close-up
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view so you can see exactly what it is
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I'm doing, notice i have my thigh, the
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bottom of brian's foot here, so i can
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control dorsiflexion and plantar flexion,
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and the amount of tension in the system.
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I can use this thumb to kind of dig into
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about midway through the gastroc there,
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just unto the first signs of tissue
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resistance, and I can kind of move across
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the fascicles perpendicular to them, and
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kind of strum to find the most dense or
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the highest activity in those fascicles.
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We're going to assume that those
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increased activity in those fascicles is
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a sign of this over activity and
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dysfunction. Once I get there I'm going
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to go ahead and move proximal, distal and
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actually I can feel that there's not as
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much tissue density, not as much give
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back resistance here, as there is here, so
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I know I'm getting closer. And then right
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about here I actually do feel a nice
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tight nodule. Now I kind of mentioned to you
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guys before, it's a little hard to pin
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down if you just kind of go thumb over
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thumb on top. It's also very very painful
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to do it this way, it might help, be a
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little bit more helpful to go a little
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bit more broad with your finger, use this
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as your dummy thumb. So now no more
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pressure in this hand, I'm going to go
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ahead and push into dorsiflexion just a
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little bit, so i feel that a trigger
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point come into my thumb, and then i'm
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going to use my other hand to press
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until i feel that that big increase in
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tissue resistance. As I kind of mentioned
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I think of an exponential curve right,
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and if it's an
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curve that I feel resistance, I want to
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be right in the trough So I'm going to go right here again, and I'm going to go ahead and
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hold that for 30 seconds, or as i
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mentioned earlier in this video we
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could do four, eight second holds. I think
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this feels pretty good though, I should
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get a release here. Brian is starting to
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feel it let go a little bit, yeah usually
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it's a very tender spot at first, and
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then within a few seconds everything
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calms down. So there you guys have it,
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manual release of the gastroc and soleus
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complex. Grab a partner, grab a colleague,
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get to practicing. This is probably not
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something you want to do to the next
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patient that walks in the door if you've
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never done it before. The gastroc and
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soleus do tend to be very tender muscles
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when it comes to compression and manual
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release techniques. I would definitely
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get another manual therapists with
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experience in these techniques if you
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can, getting the feedback from another
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manual therapists is education that
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cannot be replaced. If not if nothing
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else, get a group of you guys together so
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you can start talking about whose
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pressures felt the best, or whose hands
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felt the best, and what you guys are doing
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to help dial this technique in. I hope
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you learned from this video, I hope you
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will integrate this technique into your
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manual practices. I look forward to
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hearing about what type of outcomes you