Name: Manual Hip Flexor Stretch (Thomas Test Position)
Uploaded: 2023-04-26T01:02:30.000Z
Duration: 7 min 10 s

English captions

https://stream.mux.com/00ahhB2R00h02Gisg3nb5c5QfWsp01OGPiOYzEWzPoxtq5M.m3u8

Learn how to properly perform the manual hip flexor stretch (Thomas test position) in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides expert coaching on setup, positioning, alignment, and safe stretch application to improve hip flexor flexibility and hip mobility. Enhance hip extension range of motion while supporting optimal lumbopelvic alignment with this targeted stretching technique. Perfect for athletes, fitness enthusiasts, and rehabilitation clients seeking to reduce anterior hip tightness, improve mobility, and restore optimal movement mechanics while reducing injury risk.

Introduction to Manual Stretching and the Thomas Test

Stabilizing the Client and Body Positioning

Stretching Techniques for Hip Flexor Targets

Adjusting Stretches for Specific Muscle Groups

Safety and Client Transition After Stretching

Manual Hip Flexor Stretch (Thomas Test Position)

This is Brent coming at you with our very first manual stretching video. In this video we're going to go after the hip flexor complex, using a very common testing position which is the Thomas test position. I think you guys will find that stretching the hip flexors using the Thomas test position is both very comfortable for you, as well as your patient or client. I think you'll also find that with some good body positioning, you can use both hands to specifically target the hip flexor that you're trying to get extensibility out of. I'm going to have my friend Leanne come out, she's going to help me demonstrate this exercise. Now, first things first, if I want to stretch Leanne's hip flexors I need to be able to pull her femur into extension, which means it's got to be off the table, none of this can be up on the table. So I'm going to queue Leanne to sit on her tailbone, no lower, and then from there I'm going to have her grab her opposite leg. She's going to pull her opposite leg into her torso, this is going to posteriorly tilt her pelvis. As she posteriorly tilts her pelvis that'll give me a little bit of lumbar flexion, which will help me protect her from going into excessive lumbar extension as she goes back. I think what you will find is a lot of the people who need good hip flexor stretching, are the same people who have a history of low back pain, and we don't want to do anything to reignite or exacerbate low back pain, that can definitely be a problem moving forward in our routines. From here, I'm going to go ahead and throw a towel over her foot, that's just so I don't get foot prints on my shirt, and then I'm going to go ahead and use my torso to stabilize this leg. If I use my torso to stabilize this leg two things happen: number one, Leanne can relax, she no longer has to pull on this leg which is going to make it easier for me to get autogenic inhibition or those releases I'm looking for on the opposite leg. Second, by using my torso I have both hands free to make sure I can dial into the hip flexor, or dial in to great technique for this stretch. First things first, I'm going to use this hand to control her pelvis through this leg. She's at her end range, so if I feel her tilting this way, I can actually get her to tilt back by just pushing this way. If I think she's going into an anterior pelvic tilt, I can lean a little bit with my torso and force her back into a posterior pelvic tilt. So I can do a lot to control her pelvis and make sure she stays neutral here, just by controlling this knee, and controlling this foot with my torso. Now, let's talk about all of the different things we can do with this part of the stretch, the actual stretch part of the stretch, to let it dial in to the specific hip flexor I'm looking for. Now, if you have iliacus and psoas tightness, that's what you've assessed to be tight, probably the best bet is to posteriorly tilt as far as you can, making sure that lumbar spine is actually flat, that'll pull the psoas longer, and then I'm going to go femur in neutral, that way I know there's no compensation happening, and then I'm going to push down into extension until just past that first resistance barrier, and hold until I get a release. So psoas iliacus, we're going to go posterior pelvic tilt, neutral position of the femur. Now, if I want to turn this into a TFL stretch, the TFL does internal rotation of the femur, as well as a little bit of abduction, and external rotation of the tibia. So I can pull her foot in, that's internal rotation of the tibia, I can pull her tibia this way, which is external rotation of the femur, and then use my hand and my leg a little bit to pull her into just a little bit of abduction, and she should go from feeling this stretch more in the lower ab, or just just inside her ASIS, to now just passed her ASIS on the side here where her TFL lies. Do you feel that? -Yes. Good. So we went from psoas to TFL just by turning her in a little bit, and pushing her in a little bit. Now, if I had assessed that her pectineus was tight, your pectineus as an adductor muscle is a little different in the sense that it has an innervation from the femoral nerve, that femoral nerve is the same nerve that innervates all of our hip flexors, so it has a tendency to get tight with the hip flexors. If I wanted to make this a little bit more of a pectineus stretch, I'd actually go in the opposite direction of my TFL. So now I'm just going to push her into a little bit of abduction, and extension. So we've got  psoas, TFL and pectineus. And then, of course, the last one, which I see abused a little bit, to get rectus femoris all I really need to do is get her back into neutral, and kick that leg to just past 90. The reason I say this gets abused a little bit is I see people, number one, take this stretch a little too far. Instead of that mild discomfort they go for darn near pain, and they try to pull this leg up towards the table. One thing I can definitely tell you is more is not better. The harder you stretch somebody, the more muscle spindle activity you'll get, and the more their muscle is going to fight back against you. That's not going to help you get autogenic inhibition, that's not going to help you get a release, that's going to lead to an increase in extensibility and soft tissue adaptation. So all we need is a little mild stretch here, and just using my leg to pull it back just past 90, use my hand, once again I'm going to correct her pelvic position. You can kind of see me adjusting here to make sure her foots on the right place on my torso, I'm using this hand, I'll push her just a little bit past the first resistance barrier, and I'm going to hold until she lets go. So there you have it, we've got psoas with straight on with a posterior pelvic tilt, TFL is adduction, turning her leg in, turning her foot and tibial internal rotation, we've got pectineus which was pushing into abduction a little bit, and rectus femoris was taking a leg under. And then of course, you're going to hold with mild discomfort until you get a release to happen, and you can wait for two to three releases as you push further and further into that resistance barrier. Now, be very careful, as you get somebody out of this position, just like we were careful to get Leanne into this position, we don't want to drop this leg and let her pelvis pull her into an anterior pelvic tilt, hyperextension of lumbar spine and then she's having low back pain again. So what I'm going to have Leanne do is go ahead and grab this leg again, both hands, once she has this leg I'm going to go ahead and get out of the way of this leg, because we're going to have her step down on this leg, and I'm going to help her pull up, and then she can just slide off the table, onto that leg that we just stretched, no low back pain. I hope you enjoy this manual stretch. If you haven't done manual stretching before I suggest you practice on a few people before you actually practice on a client or patient. For my trainers out there you can practice on a few of your personal trainer buddies. Everybody loves to be stretched! So I hope you get a huge increase in extensibility from this stretch, I hope you are working on your technique, I'll talk to you soon.

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Manual Hip Flexor Stretch/Thomas Test Position (Pectineus and Adductor Stretch):

Have your client assume a position at the bottom of the table with their legs completely hanging off, but the sacrum supported by the table.

It is easiest to achieve this position by having your patient stand up, walk to the bottom end of the table, sit their sacrum on the edge of the table, pull the knee opposite the side you wish to stretch to their chest, and then gently assist them rolling back onto their back.

You will position yourself in front of the flexed leg with the hanging leg against your hip/thigh. You may use your chest to block the flexed leg so that your patient may relax. You can use the flexed leg to control the amount of pelvic tilt and or adjust pelvic alignment in the frontal plane.

Using your palm or web space of the hand closest to the hanging leg; gently press the leg down into extension until you reach the first resistance barrier.

You can then use your hand or hip to gently take up any “slack” into adduction and preferentially stretch the tensor fasciae latae

Hold this position for 30-120 seconds or until a reduction in tension/release is felt.

Move deeper into the stretch, or move on to the next muscle in your corrective intervention.

More is not better: A mild sensation of stretch is plenty. Increasing tension to a point of moderate discomfort or pain will only result in muscle guarding, an increased risk of injury, and/or a less effective stretch.

Manual Hip Flexor Stretch (Thomas Test Position)

Manual Adductor Stretch

Manual Calf Stretch

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