Name: Self-administered Hip Mobilization (Lateral Distraction)
Uploaded: 2023-04-26T01:02:54.000Z
Duration: 9 min 16 s

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https://stream.mux.com/rQiZsdEokKPUneWtBmNanS4b4D6C01A00RjxLeO3AXoYs.m3u8

Learn how to properly perform hip mobilization techniques in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides expert coaching on setup, positioning, alignment, and technique (including progressions and regressions). Safely improve hip joint mobility, enhance arthrokinematics, and reduce discomfort while supporting optimal lumbopelvic alignment and lower-extremity mechanics. Suitable for all fitness levels. Perfect for athletes, fitness enthusiasts, and rehabilitation clients seeking to reduce pain, improve mobility, and restore optimal movement mechanics while reducing injury risk.

Introduction to Self-Administered Hip Mobilization Techniques

Understanding Hip Joint Dysfunction and Compensation Patterns

Lateral Distraction Technique for Hip Mobilization

Advanced Techniques: Anterior to Posterior Mobilization

Exploring Progressions to Other Mobilization Positions

Self-administered Hip Mobilization (Lateral Distraction)

This is Brent and in this video we're going over self-administered hip mobilization techniques. Now this fills a big gap in our exercise selection, that is our self-administered exercise selection, as we move from just looking at muscles in dysfunction and optimizing human movement, to start looking at arthrokinematic dyskinesis and how we can improve the way those joint surfaces move against each other. I'm going to have my friend Melissa come out, she's going to help me demonstrate these techniques. Now i do have to give a shout out to to Kelly Starrett for some of the innovation behind these techniques, and the use of these monster bands as well as my friends Erin Swanson and Pete Schultz over at dynamic sports physical therapy for showing me some of their modifications, and then of course I got my little twist on stuff based on what I think is happening at the hip. Now the compensation pattern, the arthrokinematic compensation pattern that generally happens at the hip is the femoral head moving superior and anterior in the acetabulum. Now in order to correct that I have a couple options, I can start pushing back posteriorly which we're definitely going to show you that technique, although this is where those practical problems come in, that technique doesn't work as well just for issues around the exercise itself. The other thing that works really well though is a lateral distraction, so a lateral distraction for the hip joint is a very general distraction that will help aim at those posterior and inferior capsule fibers that have adaptively shortened. So how do we do this, well we got to get a band around one leg and it's got to be one of these thick monster bands, you guys try to do this with a resistive band tube and it's going to it's going to hurt, it's going to hurt a lot all right. So we take a thick band we got to put it all the way up against the inguinal ligament, right all the way against that bikini line, and then we're going to flip into quadruped position making sure that this band is pulling directly laterally, and go ahead and adjust the band, oops sorry, stole your pad. Now notice I have got a couple of airex pads set up here, it's because this this techniques a little rough on the knees so get them as much padding as they need to make sure that their kneecaps feel okay. Now once she's in this position and she's got a good amount of tension on that band, remember the hip joint is a big joint, we don't want to pull them so far that they think their hip is going to pop out or that there's going to be pain, but they need a good amount of pressure to get those fibers around the hip capsule to stretch out a little bit. Once I get her here all I'm gonna have her do is rock right. When she does this little rock I want her whole body to rock and I want to make sure she's pushing with this glute, all right. So it is her left glute that's pushing her into a position and that way I get a little gluteus medius activity out of this too. I definitely don't want her pulling with this leg and gearing up her adductors, chances are if she has some lumbo-pelvic hip complex dysfunction or lower leg dysfunction hence why I'm doing this exercise, those adductors are already a little geared up. Once she's done this I know she knows how to find centre, I know she knows how to put pressure on the band, she's good at these oscillatory techniques. I see that she's getting some benefit from 15 to 20 repetitions, we can start taking this up a notch by doing lateral distraction with some osteokinematic motion that can start working on flexion, or start working on extension. Usually I'll start with working on flexion if that's where the restriction is, so I'm going to make sure she's moved to centre, she's got good pressure on the band, she can actually kind of look between her knees, and what I'm going to have her try to do is sit back on her feet, nice and centre. The thing you don't want them to do is to lose all muscle activity, and then you come back up, lose all muscle activity and just fall into their feet, because they'll shift with the band and there won't be any tension on their hip. Alright so she's just going to sit back, keep a tension, keep centre, and then come back. Now as I discussed in the other self-administer mobilization video we did, there's a couple of ways we could do this here; we could go back and forth through this nice large osteokinematic motion. Or let's say she was stuck at 1:10 and had no pain, well I could just do that one to two oscillations per second for 30 seconds right there in that little little tiny area, just kind of going up against that stiffness just like the mobilization techniques we learned in school, or let's say she was somebody who had a little bit of impingement a little bit of pain, well if that was the case I would only have her go back as far as she could pain-free, maybe just touching into that pain a little bit and then coming back out of it. Remember I don't want to exacerbate pain, I don't exacerbate the inflammatory process and all of a sudden she gets up from this technique and she's got a limp because I just made her pain worse, I want to improve her arthrokinematics. So even just doing this through her pain free range is going to help. Now after that we can get really really fancy and we can go all the way from flexion of the hip, all right keeping centre, and then she can start working on a little bit of extension with lateral distraction by going from Child's Pose to that modified push-up position, squeeze her glutes, get all the way down into hip extension, all right and then go all the way back. She does 15 or 20 of these with that nice lateral distraction and you guys will see a lot of that stiffness alleviated. Once again if I thought she had was stuck in one position I could work in that range, but usually by the time you got somebody here you're just cleaning up the very last bits of that arthrokinematic dysfunction. Now the next technique I want to show you guys is every once in a while somebody with with like hip impingement, or a really stubborn hip flexion restriction will get a huge benefit from a self-administered anterior to posterior mobilization, and then I'll explain why this doesn't work out as well as this technique does. What she's going to do is she's going to straighten herself out so that the band is now pulling her femur, that way she's going to stay in this, this quadruped position, but this time I'm going to have her get out as far as she possibly can, assuming that there's no pain, she's going to keep up the band nice and high. Alright can you get out any further or no good. Alright so sit back, alright and you guys can see I have a nice anterior to posterior hip mobilization. The only problem with this is this isn't where the maximal tension is, which that would be nice but that's just not how bands work. So we can have go ahead and have her work a little bit on let's activate our glutes with that anterior to posterior mobilization, but then as I go back to where I really need the tension it's actually backing off. I don't want to say that this technique doesn't work because it absolutely does work and I absolutely do use it, but you guys can kind of see how just the practicality of this exercise. I don't use this one as much as that lateral hip distraction which works wonders it really does. I find that the carry over I get from manual techniques done during a session is incredible for all of my PT's ATC's DC's out there, and for physical for my personal trainers you can try these techniques a little bit and I think for those of you guys who've been working on your corrective exercise strategies, that will help get you to that next point. Now it would make sense that from this position that I could progress to like a kneeling or half kneeling, or even a standing lateral hip distraction or A-P distraction. You can go ahead and sit up. I don't want you to go to make yourself gumby today. It would make sense that I could get into this half kneeling position or maybe a standing position, but what I find is is that as soon as I don't have all points on the floor, all four points on the floor, rather than this being a hip mobilization that actually distracts the hip, it starts just kind of being resistance right. So if I'm in a kneeling position and it's pulling this way it doesn't pull my hip out before I just shift. When I have all four points down I think there's enough restriction in the body, you're creating enough friction with the floor that that mobilization happens first. Something for you guys to work on, something for you to try. So now we got a couple new mobilization techniques, we did the ankle in the last video, hip in this video, I think knee is coming up next. I hope you guys get great outcomes using these self-administered techniques. 

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Self-administered Hip Mobilization: Lateral Distraction:

 " to a stable object about 18" from the floor (just above hip height when in 

Put the affected leg through the band, and assume a 

 position, on hands and knees, perpendicular to the direction of the band. The band should be set to pull the femur from medial to lateral.

Note: An ab mat or cushion may be placed under the knees for comfort.

Move the band over the inside of the thigh, as proximal as can be achieved in this position (abutting the inguinal ligament).

Start the technique with the knees under the hips and tibia parallel.

Move far enough from the stable object to ensure tension is maintained on the band for the entire oscillation.

Gently rock the entire body back and forth, using body weight, the gluteus medius, and the shoulder musculature on the affected side to initiate movement. Once the movement has been initiated, allow momentum to do the majority of the work.

Note: Do not pull with the contralateral 

 , and try to avoid moving the pelvis alone; resembling a "dog wagging its tail".

Continue oscillating 2 - 3", at a tempo of 1 - 2 oscillations per second, for 15 - 30 seconds.

Note: One pilot study showed a trend that suggests end range hip mobilization may be more effective than mobilization in a neutral range (5). Clinically, we have noted end range mobilizations may provide additional benefits for some individuals. This manual mobilization may be modified by sitting back into the heels with feet wider than knees to increase hip flexion and/or hip internal rotation.

Self-administered Hip Mobilization (Lateral Distraction)

Self-administered Ankle Mobilization

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Self-administered Hip Mobilization: Anterior to Posterior with Flexion

Knee Mobilization

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