0:04 This is Brent of the Brookbush Institute and in this video we're going over our 0:07 static hip flexor stretch. I'm going to have my friend Adam come out he's going to help 0:10 me demonstrate both the wrong way and the right way to do this stretch. Now me 0:15 and you have been personal trainers a long time, let's show everybody how we 0:18 see this done poorly quite often. Alright and you can see he gets 0:23 this nice arch to his back, if he threw his arms back he looks like he should be 0:28 on the front of the Titanic. Although this might be pretty like it's 0:32 definitely not the greatest way to do this stretch. If we think about how much 0:36 hip extension you have, which is just 10 to 15 degrees, we know that this is not 0:42 15 degrees, that's more than 45. He has to be getting that mobility from somewhere 0:46 else and that should worry you a little bit. We want our stretches to be specific. 0:51 You can get out of that position, it even irks me a little bit to see 0:54 you in that position right. It's not a great thing to not know what you're 0:59 stretching, we want to make sure that we're stretching stuff that's short. 1:02 Remember hypermobility is just as dangerous as hypomobility, so if 1:07 we're stretching things that aren't short we could be setting somebody up 1:11 for some dysfunction, or possibly pain in the future. So how can we make this 1:16 specific to just the hip flexors, and the truth is that it's actually easier. The 1:23 the stretch I'm going to show you is way easier than the ones you just saw. 1:26 So Adam is going to set himself up with these nice 90-degree angles, so 1:31 he's going to be 90 degrees with knee right underneath his hip and then leg straight 1:35 back, and then he can go ankle right under this knee, and then this knee is 1:40 level with this hip, so we get these nice right angles and we get easy lines 1:44 to monitor. He's got good straight posture this way, remember your psoas 1:49 connects into your lumbar spine so it is important to even watch how much 1:53 lordosis you're getting here. Now once he's in this position all you have to do 1:58 is go posterior pelvic tilt. Now I don't tell my clients to posterior pelvic tilt 2:04 but that's what we're going teach them. What I usually tell my clients to do is 2:08 can you tuck your tail, alright it's scared dog, 2:15 and if I have to I'll give them a little manual pressure on their PSIS 2:20 usually that'll get people to tuck under, good. Squeeze their glutes is 2:25 another good way to get them to posterior pelvic tilt, and usually if 2:28 you can teach that simple little turn of their pelvis under, can you feel that in 2:35 the front of your hip, it's like immediate. It just makes it so easy, you're just going 2:40 oh hip flexor stretch got it, got it. It's just that easy, and now we can be pretty 2:46 certain because all we've done there with a posterior pelvic tilt is lengthen 2:50 out our hip flexors via some hip extension. Now what I can do from here is 2:58 add a few little modifications if I wanted to go after specific muscles. 3:02 Let's say I've taken my assessment one step further, I went from just doing the 3:07 overhead squat assessment and seeing things like anterior pelvic tilt or 3:10 excessive forward lean that make me think that my hip flexors are tight, to 3:14 now I'm starting to think about well if knees bow in that's femoral internal 3:19 rotation; of my hip flexors, my gluteus minimus and my TFL are internal 3:28 rotators you following me, how can I make a hip flexor stretch specific to 3:34 the TFL and gluteus minimus? It's actually not that hard, I'm going to have 3:38 Adam take this leg and turn it, face the camera real quick for me Adam, he's going to 3:46 take this this foot, hopefully you can see what I'm seeing, and he's 3:51 going to put it behind this ankle. So we don't need a lot of external rotation, 3:57 but just a little bit of external rotation because my TFL and glute minimus 4:01 are internal rotators, so I'm going to externally rotate to lengthen them. He's 4:05 then going to hip hike a little bit, or lean in this way, that's going to adduct his 4:11 hip relative to his pelvis, and you don't even have to do that much because we 4:16 still want just enough room to do a posterior pelvic tilt. Alright so now 4:22 tuck under, and you should feel that more on the lateral side of your hip. How's 4:28 that feeling? Good. So now I'm getting real specific, like I felt like 4:33 okay he had knees bow in, that functional valgus, I know the internal rotators are 4:38 overactive contributing to that knees bow in functional vagus. Maybe I even 4:42 did some goniometry and he had a reduction in either internal rotation or 4:46 external rotation, that gets a little complicated, but I'm getting specific. Now 4:50 what else could I do? Well, let me have you turn around one more time. Alright 4:56 I could go rectus femoris, let's say I have Adam as a patient and I noticed 5:04 that a lot of his issues seemed more geared around the knee. Now if you 5:10 are physical therapists, athletic trainers or chiropractors you could even 5:13 goniometric assessment to see if they had enough knee flexion. Maybe 5:16 there's somebody who's post-surgical, right we know that the rectus femoris has 5:20 just geared way up, lots of overactivity, lots of active trigger points, lots of 5:26 shortening and we want to figure out a way to lengthen it. Well, Adam he's 5:30 already in the habit of doing this, but if we take the hip flexor 5:33 stretch and we go from this plantar flat foot out position to 5:39 dorsiflexed, notice that increases the amount of flexion at the knee which is 5:44 now going to lengthen the rectus femoris a little bit; and what Adam should have 5:48 noticed is when he goes from, so flop your foot all the way out, when he goes 5:53 from their, posterior pelvic tilt, good and then tucks his toe in, then all of a 5:58 sudden he feels a lot more down the center of his thigh, cool. Alright 6:03 so that's great, so that's a little bit more rectus femoris. 6:07 So we have got TFL which was the turn the foot in and lean over a little bit, and 6:14 then we have rectus femoris which is throw the the toes in there and get a 6:21 little bit more knee flexion, and then you of course have the first 6:25 variation we showed you which is probably just more of a good general hip 6:28 flexor stretch, maybe would incorporate a little bit more psoas and iliacus 6:33 because the TFL and the rectus femoris have a little bit more slack in 6:37 them than these other two positions I've showed you. Now let me harp on 6:42 a couple of things that I don't like to see. The couch stretch has become incredibly 6:47 popular, I want you to keep in mind that if I take this foot throw it up on 6:54 something this way, and then jam my body back against my foot, that number one it 6:59 is incredibly aggressive, and we have to get out of the habit of if it didn't 7:05 work I need more. If it didn't work it might not be the right technique. I've 7:12 never seen anybody get additional benefit from the couch stretch that I 7:16 couldn't get from a kneeling hip flexor stretch, especially with toes in, 7:21 it's just too much. Not to mention the couch stretch is just rectus femoris. You're 7:27 shortening the rectus femoris so much at the knee, or lengthening it so much at 7:32 the knee, that when you go into a posterior pelvic tilt the limiting 7:35 structure is always going to be your rectus femoris, and you are going to miss 7:38 TFL glute minimus, psoas and iliacus every time. So if your goal was to fix 7:43 something like knees bow in or an anterior pelvic tilt, you're losing. 7:46 You're losing because you're leaving a lot behind. Now the other thing that I 7:51 don't like to see, is I don't like to see the very fancy hip flexor stretch which 7:59 is Adam if you raise your right arm, and then Adam side bends towards 8:06 me, good and then he rotates back this way. Now the problem with this stretch is 8:16 not that it's not theoretically sound, it is a very theoretically sound stretch. 8:23 What we're doing here is we're trying to lengthen the psoas as far as possible, 8:28 remembering that our psoas attaches to the vertebral bodies of L1 through L5, so 8:35 if I side bend a little bit, I pull my psoas a little longer on that side, 8:42 and then if I rotate back it lengthens even further. The problem with 8:49 this stretch is as soon as people do this stuff they tend to lose their 8:53 posterior pelvic tilt, they tend to arch their 8:55 back and then they tend to go into hip hiking, and now what we have is a 9:00 theoretically great stretch with bad form; and I have to be honest I've never 9:07 seen good form on that stretch ever, especially once left alone. It's one of 9:13 those stretches where maybe you can get it set up right in clinic, maybe you can 9:16 get it set up right with coaching, but as soon as you give it for a home exercise 9:19 program, as soon as you walk away from your patient, as soon as you turn your 9:22 back it becomes like this mess of they just look like Al'Dente noodles, 9:28 like hey look I'm stretching my hip flexors, and it kind of goes back into 9:32 our what we call the Titanic stretch, right, good. Alright last 9:40 point I'm going to make harping on the static hip flexor stretch here is 9:43 this is not a stability exercise, so feel free to give somebody something to hold 9:57 on to. Let them hold on to a wall, like I like to do these stretches right next to 10:01 a wall or like a weight rack so I can hold on to, there's nothing wrong with 10:04 that, we're trying to stretch, we'll do stability exercises later, and first 10:11 steps first, let's go all the way back to can we just do a good static hip flexor 10:19 stretch. I know I'm giving you a lot to think about with modifications and maybe 10:23 things you shouldn't do, but where we should start is stable position, 90, 90, 90, 10:29 90. Can you posteriorly pelvic tilt, hold for 10:35 30 to 120 seconds calmly, and get a good release. That's it, 10:41 that's where we're going to start. If you have any questions leave them in the 10:45 comments box below, thank you Adam.
