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Gluteus Maximus Manual Muscle Testing (MMT) for an Active Population

The Gluteus Maximus Manual Muscle Test (MMT) for an Active Population is a comprehensive assessment technique used to determine the health and strength of the gluteus maximus muscles (buttocks) in an active individual. This test involves manually testing the strength of the gluteus maximus in various positions, as well as its flexibility and ability to tolerate pressure. This test can give an indication of any imbalances or weaknesses in the muscle, as well as assess the readiness

Transcript

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This is Brent of the Brookbush Institute,
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...blank
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today we're talking about gluteus
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maximus manual muscle testing for an
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active population. So we're going to go
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ahead and set that Kendall scale aside,
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with the one through five the pluses and
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minuses, and can the person move against
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gravity and through a full range of
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motion and resist manual pressure from
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the practitioner. We're going to set all
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of that aside. We're going to replace it
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with a simpler scale -strong, weak with
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compensation, or with pain. But we're
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going to make the test more provocative.
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I'm going to talk about some stuff today
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guys about range of motion as well as
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overactive synergists, and how to inhibit
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them so that this test becomes much more
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provocative for those individuals who
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are leading an active lifestyle. They go
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to the gym, or they play sports, or maybe
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even a professional athlete. Alright so
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I think we need to find a little bit
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more congruence between what we see in
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movement assessment, versus what we see
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in these manual muscle tests; and like I
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said that probably has to do with how
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provocative is the manual muscle test
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itself. I'm going to have my friend
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Melissa come out, she's going to help me
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demonstrate. So she's going to lie prone,
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first thing we need to talk about is
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what are all of the synergists for an
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inhibited glute, and what we end up with
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is this deep longitudinal subsystem
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dominance. When the glute max becomes
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inhibited, so she'll start using her
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erector spinae, her biceps femoris and her
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adductor Magnus the posterior head, to do
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an extension type pattern; which
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unfortunately becomes lumbar extension
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as well as hip extension, to try to make
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up for the fact that the glute is not
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doing what it's supposed to do. What we
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need to figure out during this test is
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how to ensure that when I get a strong
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extension from my patient or client, that
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it's not this compensation pattern and
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that it is in fact a strong glute max. So
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I'm going to use some techniques to
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reciprocally inhibit those overactive
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synergists, and make sure that all I
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leave behind is the glute. So starting
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with her erector spinae, we're going to
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draw in and maybe even have her make a
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six-pack. Let's go ahead and have her
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contract her rectus abdominis a little bit.
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So now she can't extend at the spine, I'm
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left with only hip extension. Her erector
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spinae are not going to be able to help
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her out. Now let's take care of the other
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hip extensors right, so we have adductor
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Magnus and biceps femoris. Now Kendall has
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you try to create active insufficiency
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by shortening this muscle as far as you
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possibly can. Now I know this is anecdotal
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but i don't really like this
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flexed knee thing, you know I think too
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many times I've heard man I really feel
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that in my my hamstrings; and if somebody
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feels it in their hamstrings my guess is
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is that their hamstrings are working
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pretty hard, and I want just the glutes.
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So I'm actually go opposite, i'm going to
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have Melissa extend her leg, we're even
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going to have her reinforce a triple
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extension pattern, so she can point her
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toe. We're going to make sure she
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contracts her quad real hard, extends her
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knee. and I'm hoping that this quad
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contraction reciprocally inhibits our
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biceps femoris. Now as far as my adductor
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Magnus, I'm going to have Melissa move as
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close to me as she possibly can, all the
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way to the edge of the table; and I'm
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going to have her abduct against my thigh here. So
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now that she's abducted, I know her
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adductor Magnus has to be shut down. So I
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got her drawn-in, contracted, making her
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leg as long as possible, she's pushing
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against my leg; and now i'm gonna say go
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ahead and try to squeeze your butt, and
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run your leg kind of against my thigh
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here. Now that i got her in extension, you
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guys need to put quite a bit of force
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through to the point that you know
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somebody has a really strong glute. What
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should probably move, is you should be
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able to push down on their leg and see
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their whole whole body move as one
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segment. Not their whole body move is
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like a compensation pattern like they're
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doing something weird, but as you push
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down here, you can almost feel her want to
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tip this way. The glutes a big strong
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muscle, I should be able to push down
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really really really hard and she should
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be able to hold it. Now
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what are the common things you guys are
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going to see when somebody doesn't have
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a strong glute max, well you could see
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weakness. I could set her up into this
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whole position get her pushed in, and
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then like just push her back down to the
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table with almost no no real force
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applied. Remember this is a bigger muscle
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guys, unlike your tibialis
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posterior -posterior tibialis where I had
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to be careful how much force I applied,
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because your posterior tib isn't the
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biggest muscle in the world. Her glute
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max I should be able to lean, even though
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I'm a bigger individual than she is, I
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should have be able to lean and she should be able to
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hold me up. If I can just kind of lean
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over without much added force and push
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her right back down to the table, I'm
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going to give that a W for weak. Now I don't
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get too many weak glutes, I do get some, I
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do get some weak glutes where you take
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out all of their synergists and and they
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really don't know how to get this guy
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firing. What you'll see a lot of is like
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different compensations starting to
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happen. Probably the most common one is
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is you'll go ahead and have them do this
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and then as soon as you push, they start
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arching here. Right you'll see them, can
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you kind of arch for me as I push down,
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so they go into an anterior pelvic
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tilt, like they start doing this thing.
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You might even see some hip flexion on
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this side as they try to figure out a
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way to pull up. That's probably the most
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common, and then of course they' get
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a C for with compensation. And I'm going to
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start going to, if I saw too much lumbar
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extension, one of my lumbar extensors
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that'd be my erector spinae. My erector
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spinae are probably overactive, maybe I
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want to try to get some release and
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lengthening here, and then start working
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on that glute maximus activation. Some
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other signs you might see is not being
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able to hold the abduction against your
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thigh, or you might see them actually try
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to bend their knee and recruit their
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hamstrings. Now another really
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interesting test to try somebody who's a
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little bit more advanced, or maybe you
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want to do something that's a little bit
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more sensitive pretest post-test. I
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learned in these
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Maitland workshops I have been taking for
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certified orthopedic manual therapists,
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this little test that they showed us in
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one of the workshops works really really
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well. I think it's a a fascinating thing
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to do in a lab, get a bunch of your your
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colleagues together and just try doing
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what i'm about to show you, glute max
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activation, and then try it again. And
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here's how it goes, you guys are going to
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make your your hands like this right,
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you're going to go biceps femoris, so
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lateral hamstring. Your thumbs are going
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to be over the glute max, and then this
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other pinky is going to be over their
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erector spinae. What you're going to do
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is have them go ahead and extend at
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their hip, and what you're going to try
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to figure out is the timing of these
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three things. So what I felt with Melissa
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which is not great, is biceps femorisM
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erector spinae and then glutes came in
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last. What I would like to feel when I
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asked her to squeeze her glute and extend
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her hip is glute first, followed by biceps
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femoris, and then if she gets in further
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into extension gets her leg up off the
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table, then her erector spinae has to
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fire to stabilize her pelvis. Alright so
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I would do this again, go ahead and
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squeeze, that was a little bit better
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just from her hearing me talk, and having
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good body control. She went biceps
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femoris, erector spinae and then glute, but
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it was a little bit more combined. If we
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had a little bit more time on this video
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I would have her do a bunch of glute max
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activation stuff, maybe some hip flexor,
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hip flexor release and lengthening stuff,
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and try it again. So now you guys got two
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tests here, you guys got the glute max
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manual muscle test. What you're going to
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do is activate your core, go ahead and
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activate your quad, push against your
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thigh for abduction. Have them go into
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extension, and really squeeze they're
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glute. They're going to see if you can
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push them back down to the table, make
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sure you're watching for both weakness
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and compensation.
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You then have the timing test which
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should be glute, biceps femoris, erector
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spinae. Not biceps femoris, erector
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spinae, glutes which is a very common
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compensation pattern. One more little
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geek out molar for you guys, remember
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that strength is range of motion
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specific. So Melissa had a lack of hip
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extension, she had tight hip flexors, is
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she going to be able to get into
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extension real well. Is she going to be
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able to get into extension without
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compensation, probably not. That's going
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to have an effect on her test. Realize
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also that if you lengthen and release
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her hip flexors, alright she had a tight
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tfl gluteus minimus I went after that, psoas
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an iliacus got that out of the way, adductors,
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anterior adductors got those out
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of the way; got her all the way back to
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good hip extension; well she's been
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missing that ten degrees of hip
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extension, is she going to be very strong.
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So another thing you could do with this
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test is maybe you want to test it see if
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her glute max is strong, but then go
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ahead and do her mobility work, test it
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again. If it was strong before the
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mobility work but weak after, it might be
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that she's weak in her new range of
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motion. Sorry for the last minute and a
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half of this video guys, i know that's a
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little bit of an anatomy geek out but
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i've given you a lot to think about here.
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We have a manual muscle test with
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reducing the contribution of overactive
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synergists. You guys had the sequence tests,
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hopefully glute max, biceps femoris then
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erector spinae. And now you have a little
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range of motion to think about. Make sure
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that when you're doing this test as they
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gain range of motion you re-test, so
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they're not only strong through the
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range of motion they had, but the new
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range of motion you're giving them back
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to get them back to optimal. I hope you
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guys have enjoyed this video, I look
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forward to hearing about your results on
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these tests. Really try to do your pre
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and post-tests. If you're new to manual
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muscle testing do the manual muscle test,
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do some activation techniques, do the
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manual muscle test again. Start with your
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colleagues is always a good idea,
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grab some of your fellow personal
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trainers, physical therapist, athletic
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trainers, chiropractors. Get a study group
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together and practise these, and then by
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the time you get them to your client and
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patient, you're already be nice and
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comfortable. I look forward to hearing
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from you guys again soon.