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This is Brent coming at you with our third
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for the hip flexors. You guys been using like a dynamic overhead squat assessment,
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these are great tests to help narrow down your exercise selection after you've
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seen something like an anterior pelvic tilt, or an excessive forward lean, that implies
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short, overactive hip flexors, which there are several of, right? Which one do we
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need to target? Which ones do we need to release? Which ones do we need to stretch?
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That's what these tests are for. So in previous videos, you guys saw we did the
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Ely Test for rectus femoris, we did the Ober's test for the TFL. Now we're going
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to do a Modified Thomas Test with my friend Yvette here, to implicate the
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iliacus and psoas, or to rule them out.
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So, first things first, we want to get Yvette nice alignment here.
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She's got feet pointing up, knees are in line with her feet.
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She's hip width here, and her trunk isn't twisted.
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She's nice and straight all the way up. Now, I'm going to use one hand, palpate
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underneath her lower back and lumbar spine.
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This is the setup for this test. This test is actually fairly simple.
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Once we get here, all I need Yvette to do is pull her knee up towards her
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I'm going to have her pull far enough that I feel her lumbar spine flatten
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That's going to force her into a posterior pelvic tilt, which is relative
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hip extension. If her iliacus and psoas
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are at optimal length, her leg should stay down on the table with foot
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pointing up.
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Remember your psoas and iliacus are not only hip flexors,
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but also external rotators, so this is actually negative.
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She has a negative Modified Thomas Test, which means I don't need to address the
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psoas and iliacus, even if she does have an anterior pelvic tilt, even if she does
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have an excessive forward lean. If you guys have been watching our assessment videos,
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Yvette did test positive for the Ober's test,
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so maybe I would target the TFL instead. I'm going to have her go ahead and do the other side
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and make sure that both sides are even, but let's go ahead and pull this side up,
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same thing just make sure she pulls up to the lumbar spine flattens out.
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I'm going to have you do that one more time Yvette. On this side, I see just a slight indication of
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tightness. Her knee
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came up just a little bit, so she's being pulled a little bit into hip flexion
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here, so we probably have slightly tighter hip flexors on her left side
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than her right side, but still this is not, this is not a big positive. A big positive
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would be where you saw somebody do this.
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That would be tight, tight, psoas and iliacus. Or maybe a subtler sign is she
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pulled this way and her foot would flop out that way. Once again, that's going to be
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psoas and iliacus.
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So there you guys go. This test kind of rounds out our three assessment videos.
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We had Ely's, Ober's, and now the Modified Thomas Test. If she had tested positive
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I know, at least my personal trainers would have a little bit of an issue
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right, we can't do any sort of self-administered release for the psoas
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and iliacus. Please don't shove a tennis ball or a softball into your abdomen.
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That's definitely not safe. There are some delicate structures in there,
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like your common iliac artery,
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for example, that would be not a good thing to rub up and down on every day. You
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could definitely create some damage there as well as there's your femoral
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nerve in there, and of course, your internal organs. We want to stay away
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from those. If you guys did think that these were implicated as tight for the
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individual you're working with, you could do a hip flexor stretch, like the kneeling
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hip flexor stretch, and see if that improves your problem. If it seems a
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little stubborn to you, that's the time to refer out to, of course, a license manual
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therapist, who has some experience addressing these structures with manual
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techniques. Of course, I know my PTs, ATC's, and some of my LMTs out
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there, if you guys see a positive on this test,
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probably the best thing to do is manual release
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first, and then your kneeling hip flexor stretch.
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I hope you guys enjoy these assessment videos. I hope it helps narrow down your
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exercise selection, giving you some very specific, targeted programs, that get you
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much better results in the long run.
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Talk to you soon.