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