So psoas an iliacus, starting your hip
flexors guys. So my psoas, we will do
iliacus here. My psoas goes from lumbar vertebrae to lesser trochanter. If you
can see it in that picture, my lesser trochanter is a smaller bump, a smaller
chunk of bone. Inside here this is deep in like your groin muscles is where you
would feel this attachment. My iliacus attaches from my iliac fossa,
what's a fossa? Depression, right. A depression iliac is an ilium. Your
iliacus actually connects to this whole surface here, and then goes in. So what
what joint these muscles cross? Hip.
Oh you know what we got to do, word bank. Oh that's a nice marker.
I'm trying guys I looked for the better ones, and realized there was one just
sitting there. Alright word bank. Part of the problem is we wear out markers as
the day goes on. Word bank, we're doing hip, what type of joint is the hip?
Ball-and-socket, that was close.
What joint actions can a ball-and-socket do? All of them, even the scapular ones?
Alright let's name them; flexion, extension, adduction, abduction, internal
rotation, external rotation. Two more, horizontal adduction, horizontal
abduction, cool. Yes sir.
Circumduction I would not consider a joint action unto itself. It's making
circles right, which is more like the combination of several joint actions,
like horizontal adduction to adduction, to horizontal
abduction to abduction, you know it's like a a combination of movements. Yeah every
once in while you see circumduction and textbook and you're like, how often do
people make circles that you needed their own joint action to do this? And
there are no muscles that cause circumduction. Like that's not a
joint action that muscles do, I don't know. So word bank -hip we're good there.
Psoas, iliacus, so lumbar spine, ilium, lesser trochanter crosses the hip. What
joint actions will this guy do, he runs up and down in front of the hip? Flexion,
we know it's very good at flexion. Do you think it can cause anything else to
happen? How'd you guys come up with external rotation?
It wraps around this way right, so as it pulls up, what happens to my femur? Yeah
it twists, very well-put, twists out. You guys see that? It'll do this thing. The
psoas and iliacus help you do the Michael Jackson, I never realized that.
Now I just want to touch on something. I want to give you guys a little inference
on exercise selection, because I know that's a lot of what you guys will be
doing in the future. Strengthen or stretch the hip flexors? 'Stretch'. What do most
people do to them? Strengthen them. Strengthening your hip
flexors implies that they're what? Weak, or in need of hypertrophy. But these
muscles often get shortened, why? Because you sit, typical day for the typical
client. You get up in the morning, you sit down, you eat breakfast. You jump in your
car where you sit down right, those are both what position for the hip?
Hip flexion. So my hip flexors shortened. So sit down eat breakfast, sit down in
the car, to get out of the car to come to work and sit behind a desk, right and
then after that super hard day at work you have to get back in the car and sit;
where you're probably going to go home and make some dinner and sit on the
couch for three or four hours, only so that you can go to sleep in the fetal
position. Right like isn't this kind of like that, you're like holy cow do you
ever get out of hip flexion. Now the problem with this is is when muscles
stay in a shortened position, they tend to do what? They tend to actually
adaptively shorten, which if my hip flexors shortened here's what happens
right; this is hip flexed, everybody's clear with that. If I go to stand up I
can only go as far as my hip flexors will let me right, and then I get stuck.
Well am I going to walk around like this?
Some people do, but do most people? Yeah, right let's not do that. So
how do I, how do I get myself kind of out of this position and straighten? I
extended my spine right. Is this a good posture? Do we see a lot of this though?
Yeah this is what's called an anterior pelvic tilt. Sure is that going to be
real healthy for my low back? No. Could you guys, everybody stand up and do that
actually. Yeah so start a little hip flexed, kind of imagine your hip flexors
be in tight. You can even kind of put your hands on your, you guys know where your ASIS are?
So your ASIS follow your ilium to that notch, now imagine it
kind of gets stuck right, and then extend at your spine. Oh yeah, you think this
might be a cause of some of the low back pain we see? You know the worst part
about this is right, is you get cats, you'll have somebody like this, you guys
can sit down, they go to the doctor and of course their doctor tells them, what
do they need to do to get over the low back pain? Strengthen their core. So what
do they do? They do a bunch of lumbar extension, like dude I think you were
already there; followed by some ab work
right. How many of you guys see it? Gotta do Roman chair leg lifts for your "lower
abs," aka your psoas, and then I'm going to walk over and because I'm super strong I'm
going to grab two dumbbells and do this right, and then I'm walking to gym and go,
"Man I feel that in my low back, I hope it's working." Problem, can we do better? A
little bit of functional Anatomy knowledge and at the very least you guys
are going to change what?
You're not going to even try to work your lower abs because you know they
don't exist, and you know all that's going to do is strengthen an already
short, tight psoas. So rather than strengthen a short, tight psoas, you're
probably going to stretch it, maybe show them a kneeling hip flexor stretch
right, so that maybe they'll get back into this position, which you think
that'll have a little impact on some of that low back soreness? Absolutely. Yeah
obviously strong core absolutely helps, I'm talking about what exercises you
select, do the three exercises I select, were those good? No, but do you see that? Yeah.
I'll watch guys who want a strong core do hip flexor work for 20 minutes. Do you
need to strengthen your hip flexors, probably not that much, probably not that
much. I'm not going to take all your leg raises away, I know some of you guys like
to do that type of stuff, but you don't need that much, like let's do some other
stuff. Let's do some more sophisticated exercises like chops, static chop
patterns. How many of you guys have done this thing right? Like some of those anti-
rotation exercises that work on stability. Planks, bridges. Who said
bridges before? Yeah we'll talk about that, we'll talk about that a little bit
when we get to core. But you guys get what I'm saying? You don't need more psoas.
Tensor fasciae latae, I mean you guys have heard of this one?
The TFL alright, so let's break this one down.
TFL goes from a point just posterior your anterior superior iliac spine, which
you just palpated, your ASIS right. Where just behind that it hooks into your
iliotibial band, uses your iliotibial band as a tendon, which then inserts into
lateral condyle of the tibia.
What joint does this cross? Let's start there. Hip, yeah we'll stay with hip
for today. So is it on the front side of the hip, the back side of the hip? Lateral,
it's a little forward though too right. So it's like on the outside, like your
TFLs right here. Everybody know where the TFL is? Stand up real quick.
Stand up sit down, stand up sit down, stand up sit down. Alright feel your
ASIS, right now go just behind it, this point right here, in fact I can get more
specific than that; everybody find your ASIS that bony notch, follow your ilium
up to its highest point, then find your greater trochanter, see how that
makes a triangle right. You kind of got your mid-ilium, ASIS, greater trochanter
in that triangle. Alright in that triangle is your TFL. So is
it on the front side of the hip? Yeah, it's on the front side. Is it on the
lateral side of the hip? Cool, now keep that in mind, go ahead and sit back down.
If it's a little on the front side it will contribute to hip flexion right.
This will get shorter if I flex my hip, if it's on the lateral aspect of my hip
what else will it contribute to? Abduction. Now because of the way this
attaches this way, yeah it'll contribute to internal rotation with that little
bit of obliquity it has, everybody get that? A hip pointer? It'll it, like a
contusion? I think a lot of things can happen at the hip, let's start there.
If you got hit there and it caused a bruise like and that got really tight it
would not feel good. Sometimes that muscle gets tight and causes hip joint
issues which can also be very painful right, like this muscle's involved in like
have you guys ever heard of hip impingement syndrome? This muscle would
be involved. Have you guys ever heard of iliotibial band syndrome?
Yeah. Can you stretch your iliotibial band? Can you foam roll your iliotibial
band? That's also a good question. I'm going to crush some spirits right now,
the answer is no and no. Your iliotibial band is a thick piece of connective
tissue, it's not muscle. You can't relax your iliotibial band, it's not
contractile tissue. You guys remember from biology right muscle is contractile.
Is connective tissue contractile? No, no in fact when you do iliotibial band foam
rolling, what you're actually affecting is the muscle underneath it. But if I
really wanted to get my iliotibial band to be looser, what could I affect?
The TFL. The TFL uses the iliotibial band as a tendon. So if I get my TFL to tone
down, relax a little bit, lengthen it a little bit, will that help
take some of the tension off my iliotibial band? You guys get what I'm saying? I'm
going to say nine times out of ten iliotibial band syndrome, overactive TFL.
It's kind of like that picture alright, you can see how it invests in this
iliotibial band all throughout, but yeah it gets, the the muscle itself goes a
little bit past the greater trochanter. It's probably a little bit bigger the
muscle itself at least width and length wise, it's probably a little bit bigger
than the back of your hand. It does but we'll get to that in a bit alright, it
contributes to rotation at the knee which we might save for a later course.
Flexion, abduction, internal rotation at the hip though, everybody is cool with
that, you understand that, we can move forward? Guys are starting to bury these
muscles really quick.
That doesn't mean you get to go home at 4:30 though. Rectus femoris,
all the muscles in the quads do the same thing, except for the one that wrecked it
for us. The rectus femoris right, what is different about the rectus femoris? It
crosses two joints, which two joints?
Uh-oh two joint, what does that mean? New word bank. All of these word banks.
Knee, what type of joint is it? Hinge we're going to call it a hinge for today,
cool with that. It also rotates though, and I said sometimes it's called a...you
remember the word? Condyloid. Alright word bank knee, what does a hinge joint do?
Flexion and Extension.
Alright rectus femoris crosses up and down in front of the hip, connects into
something called your AIIS, anterior inferior iliac spine, which is deep. It's
a little harder to palpate there guys. So but it's below the ASIS, its here right,
run straight down in front of the hip, which means it's probably going to do what?
Flexion, easy. It runs up and down over the front side of the knee, what's it
going to do? Extension. Give you a little tidbit about
the rectus femoris, how many of you guys, well actually you know what I'll save
that, hold on one second -let's go on to the next muscles. Everybody's cool with
the rectus femoris. The quadriceps;
vastus lateralis, intermedius and medialis. What are those words referring
to? Location right. So where is my lateralis? Lateral side. Your vastus
lateralis is your outer thigh all right. Your vastus medialis which one is that?
Visually it's the inner one right, it's a little teardrop muscle, it actually goes
up, you can see in this picture, that the medialis actually goes all the way up;
but there's a couple muscles that have been removed from this picture, that cut
off your view right. It gets covered up by some other muscles which is why you
only see a teardrop, but that muscle goes all the way up, and then our intermedius
runs right in the middle. What's on top of the intermedius? The rectus femoris,
good. Now all of those muscles connect to the femur. Vastus lateralis, vastus
intermedius, vastus medialis; and then they hook into the patellar tendon and
go to the tibial tuberosity, across what joint? The knee. Does these muscles cross
the hip? No they go in front, in front of the knee right. So what joint action are
they going to cause? Yeah so vastus causes knee
what? Extension. Now I know this is old-school and most people don't still
do this, but I want to crush the myth anyway. If I do leg press with my feet
together versus my feet wide, does that change which vastus muscle I work? No
they still do knee extension, that's all the vastus brothers can do.
We said that the vastus brothers cross what joint? The knee. Okay will this work
my outer thigh? No my outer thigh is actually my vastus lateralis, which does
knee extension. You want to freak somebody out, go to somebody in the gym
who you catch doing this and go, you know what your outer thigh doesn't even move
your hip, it does this, why don't you go do leg extensions. See what they'll say,
you'll have them boggled because they'll be like, what but it's on the outside.
Just the way the body is designed. How do you stretch your quads? Take the femur into
hip back into hip extension. Wait a second
knee flexion is this, that would stretch my quads right? Because my vastus, my vastus
group doesn't cross the hip, why isn't this a stretch? Because my vastus muscles
usually don't get short, that's part of it. Who does get short of my quads? My
rectus femoris, which is why people do this thing right, because now I'm
lengthening it both the knee and the hip, does that make sense? Never thought about
that did you. Go ahead, next time somebody goes alright stretch your quads, just
walk over to a table and be like...
I'm in knee flexion, this is stretching your quads right. Then remind them that