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Manual Adductor Stretch
The Manual Adductor Stretch is a stretching exercise for the adductor muscles in the inner thighs. These muscles are important for hip and knee stability and play a role in developing healthy movement patterns. The exercise is performed by standing with feet slightly wider than hip-width apart and bending the knees to lower into a semi-squat position. Keeping the arms straight, the hands are placed together, fingertips pointing away from the body. The torso then leans away from the bent knees and pulses
Transcript
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This is Brent, coming at you with another
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this video we're going to go after the adductor complex, those inner thigh muscles
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that have a tendency to get short and overactive in those individuals with
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both lower leg dysfunction, so that's feet turn out and often knees
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cave-in or knees bow out, as well as our lumbo-pelvic hip dysfunction, so that's
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those individuals who have an anterior pelvic tilt, posterior pelvic tilt, or
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have an asymmetrical weight shift. Now, I'm going to have my friend Yvette come out and
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help me demonstrate this exercise. The biggest mistake I see on this
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manual stretch is professionals making it very hard on themselves, rather than
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taking advantage of some kinesiology to make it very easy on themselves to get
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this stretch accomplished. So, first things first, I usually see people do
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this, take on the whole weight of the leg. Now, that might be fine if there's a size
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difference like there is between Yvette and I, where I'm much larger, but if
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Yvette was a professional athlete that was twice my size, to take the entire leg
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and try to stabilize it for the amount of time I'm going to need to stabilize
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for a static stretch could be problematic, especially if I have many
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clients, many athletes, many patients, one after the other. So I need to find an
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easier way to do this. Easiest thing to do, and I'll explain the kinesiology as
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I'm doing this, is actually just let the leg drop off the table. I have her in
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abduction, this is an adductor stretch, all I have to do is have her adjust her
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pelvis either right or left to get the amount of abduction I need to ensure
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that this is a good stretch, and all I did by bending the knee was take the
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gracilis out of the picture. The gracilis is an internal rotator of the tibia. It
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is not common for the internal rotators of the tibia to become short and
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overactive. It's much more common that we get that feet turn out, and the external
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rotators of the tibia overactive. So this is fine, there's no problem here, I can
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then take it a step further. For the most part it's the anterior adductors that get
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tight, it's the anterior adductors that get overactive. Those are the flexors and
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internal rotators of the femur. We think about an anterior pelvic tilt being more
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common, knees duck in is more common than knees duck out. I can force her into a bit
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of a posterior pelvic tilt to improve this stretch by simply taking her other
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leg and pulling her as far into flexion as I can, and then adjusting her pelvis a
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little bit so that she's now just slightly tucked under. You feel a stretch?
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I haven't done anything, I don't have to use any of my own muscular power, I can
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just use gravity and a little bit of kinesiology to get a nice adductor
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stretch. If from here I want to dial it in, I want to refine it a little bit, I now
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have both my hands free to either stabilize at either ASIS, or maybe
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stabilize at the femur as we did in the hip flexor video, and then I can use my
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other hand or even my opposite leg to add a little bit of force this way. So
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for those of you guys who are using some of your PNF protocols where you're doing
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contract-relax, or if you're doing 3 sets of 20 seconds where you're getting
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a release and pushing a little further, all you have to do is either use your
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leg or your hand and you can take her out just a little further, wait you're 30
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seconds to 2 minutes, a little further etc. So a really easy stretch technique as
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opposed to the one we saw before, not to mention much more specific to the adductor
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complex, that pectineus brevis and possibly longus that are actually
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short and overactive in those compensation patterns we talked about.
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Now, in some individuals we have a propensity for not the anterior adductors
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to get tight, but the posterior adductors. These are those individuals who have
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knees bow out, or in an asymmetrical weight shift if somebody has SI joint
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dysfunction, they're going to be tight on the side of the SI joint dysfunction in
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their posterior adductor magnus. Now the adductor magnus has a propensity to
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extend or it extends the hip rather than flexes the hip. So we're going to have to
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use different mechanics than the stretch we just used. The easiest way to go about
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doing this that I have found, is we're going to take Yvette up into flexion
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here and abduction, I'm then going to rest her shoe, and you can use a
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towel if you want to make sure you keep somebody shoes off your pants, but I'm
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going to rest that on my ASIS, I'm going to use my other hand to palpate
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her ASIS on the opposite side, and then I have this hand to stabilize her knee.
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Actually Yvette, let me get you just a little closer to me on the table. Alright,
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so I'm just watching my mechanics there, I was reaching over the table. I'm going
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to stabilize this ASIS, stabilize this knee, now I can control the amount of
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flexion by just scooting forward until I feel that first resistance barrier, and I
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can use this hand to either support, to make sure she's not guarding, or to give
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a little bit of over pressure to further stretch her adductor magnus. Once again
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I'm going to hold for 30 seconds to 2 minutes. I can then go further into the
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stretch. If I want to use my PNF contract relax antagonist, contract protocols, I
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can do all that from this position, I'm in a very strong stable position so she
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can extend back into my ASIS, she can push up into my hand, whatever I need her
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to do. How does that feel? Good. Now, the last stretch I'm going to show you
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is for a particular problem that we sometimes face with adductor
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stretching. This is not going to be something that you use for everyone
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necessarily, and there are some other techniques that can you can use to get
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around this technique, but every once in a while you'll pull somebody into
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an adductor stretch, and you'll go okay where do you feel it, and rather than say
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inner thigh, which is obviously where we want this stretch felt, they say, "I feel a
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pinch here." Well that's a problem. Pinching is not going to help
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our stretch, in fact, it's probably going to start stimulating some of those
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nociceptors, get us guarding, we're never going to get that release that
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we're looking for. So there's a trick we can use to make sure that this doesn't
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happen. I'm going to have Yvette come to the other side of the table, she's then going to
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lay on her side facing away from me, back herself all the way up into my hip
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because I want her nice and close to me to save my mechanics once again,
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you can just use a hip to make sure they're blocked out and don't back
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themselves up off the table. I'm then going to have her bend this bottom leg so
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that she's stabilized. Now, the reason why we're getting pinching up on this side
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of the hip, partly anyway, is that we had inferior capsule
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tightness. So what we need to find a way to do, is to depress the femoral head. So what
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I'm going to do is I'm going to grab Yvette's leg like so, so I'm nice
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and cradled, and then that way right when I stand up this will be on stretch, I'm
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then going to use this hand right over her greater trochanter, I'm actually
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going to use this space in here, and I'm going to create a little bit of pressure
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that way towards this heel. So I'm going to go pressure towards that
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heel, stand up, and how does that feel Yvette? Alright, so now I've taken that
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femoral head, pressed it down making sure I stretch that inferior capsule, I no
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longer get the pinching on the side of the hip, and this is a pretty good
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stretch. Now, the disadvantage of this stretch over the two stretches that we
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just did is this does take a lot more work from me. It is not easy to lift the
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weight of somebody's leg. So, once again, just a quick review, we had the
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anterior adductors.
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It was leg hanging off, and then this, the contralateral leg, was up, forcing
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somebody into a posterior pelvic tilt, you can then add as much force
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as you need. We had the adductor magnus stretch, that's for individuals with
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knees bow out, or that asymmetrical weight shift caused by SI joint
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dysfunction. That was here. So I'm pulling into flexion and abduction. And then the
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last technique we went through was for those individuals who feel pinching,
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is going to be side-lying, bottom leg nice and stable, you're going to
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stabilize the greater trochanter, cradle the leg, stand up, and use a little
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inferior glide to make sure that pinching goes away and we get a little
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bit of an inferior capsule stretch. I hope you keep working on your
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manual stretching technique, I think you'll find that the better your
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technique is, the better results your clients, patients, and athletes get. I look
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