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