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