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Tensor Fascia Latae (TFL) Self-administered Release

Tensor Fascia Latae (TFL) Self-Administered Release is a form of self-myofascial release, or SMR, that is used to treat pain, tension, and mobility issues related to the fascia surrounding the TFL muscle. This type of self-therapy uses a foam roller, massage balls, or other type of ball to apply gentle pressure to the TFL muscle and the surrounding tissue. This pressure can help improve range of motion,

Transcript

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This Brent of the Brookbush Institute,
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...blank
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and in this video we're going to go over
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tensor fascia lata or TFL
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self-administered release technique. I'm
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going to have my friend Melissa come out,
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she's going to help me demonstrate this
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technique. Before we get into the
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technique itself that, it does help to
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know a little bit about the anatomy of
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the tensor fascia lata, where it's
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located. Alright so if you guys know
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where your ASIS is, it's just posterior
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to your ASIS, your anterior superior
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iliac spine. But let me take it a step
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back. If you don't know where your
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anterior superior iliac spine is, find the
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top of your pelvis, which a lot of people
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call their hips, which is weird because
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your hip joints down here. This is your
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pelvis so if you find the top of your
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pelvis, your iliac crest as it's called,
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and you follow it anteriorly all right
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towards the front, eventually you'll find
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this bony notch before it all becomes
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soft tissue. Well firm tissue in
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Melissa's case because you've got a
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six-pack going here, right it must be
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nice. But this bone right before this
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softer tissue being her rectus abdominis
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and her obliques, is her anterior superior
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iliac spine. So right behind that, this
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soft tissue in here, which I can actually
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feel some some pretty pretty dense
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fascicles that are probably going to
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give her a little tenderness already,
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that's the tensor fascia lata. Now the next
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question we have to answer is how broad
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and how long is this muscle. So if we
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follow the ASIS and go back up the iliac
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crest, and then we find the greater
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trochanter just a few inches below it. So
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the greater trochanter is another bone,
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another notch that you can feel right
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here, that's more related to where
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your hip joint actually is. So one of the
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tricks you can do is if you lift your
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leg and then put it down, lift your leg
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put it down, you guys might be able to
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feel the greater trochanter moving
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underneath the skin, that might help you
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palpate. So if we go from iliac crest to
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greater trochanter, that's approximately
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the length of my TFL. And then if I know
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where my greater trochanter is, I
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actually know the breadth as well because
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it goes from ASIS
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to just posterior a vertical line from
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the greater trochanter. Right so we got
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this about this width and the
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length from iliac crest to greater
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trochanter, in kind of a triangle shape.
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That's what you're going to search with
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one of our release tools, you got that.
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Now we're going to add pressure by
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having her laid down on top of one of
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these release tools, and we have a few
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ways to go. We can go cheap and just grab
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any any ball will work. We use softballs
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a lot for home exercise programs. This is
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one of those sand-bell type weighted
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weighted balls they tend to work really
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good, if you happen to be in a gym that
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has them. If you want to take it a step
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up from there we do love our trigger
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point materials, and we got a little
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partnership going with them -only because
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I was already using their product, I
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do happen to like it. One thing I like
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about their products is its PVC pipe
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rolled with foam, so as the foam breaks
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down, as you get more advanced it
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actually gets harder as opposed to a lot
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of our foam roll products that tend to
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get softer as you use them, which is not
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going to be good for your progression.
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And then if you really really want to
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take it up a notch, it is at a little
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different price point, but for the
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technology it is it's pretty it's really
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affordable for the technology. It is this
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is a new product we have fallen in love with
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called the Hypersphere from Hyperice.
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And what this does is it vibrates, it
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vibrates that at a very high frequency.
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Yeah so by adding vibration what I would
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assume is happening is on top of
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stimulating Golgi tendon organs and
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Ruffini endings to help us get autogenic
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inhibition, we're going to go ahead and
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also stimulate our Merkels and Pacinian
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corpuscles which are vibratory
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receptors, which may also help us with
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inhibition at least based on the
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clinical outcomes;
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and what we've seen in practice you get
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really great and effective release from
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this, and maybe even release was a little
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bit faster than you do with something
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like a foam roll or a ball. So I'm going
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to turn this thing back on, and I'm just
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going to start it on the low setting
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here for Melissa. She's going to go
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right into that area that we were just
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talking about right, so just behind ASIS.
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We want to stay off of bones, so you're
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not going to foam roll a bone away.
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I want her to roll from ASIS back towards
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her glutes, but not on her glutes right,
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and she can roll in between her iliac
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spine and greater trochanter. And what
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she's going to look for is the most
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tender spot, that most tender spot we're
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going to assume is our our tender
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pointer or trigger point. Everything else
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could potentially be a satellite site,
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which is essentially a referral pain
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pattern that comes from the original
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trigger point itself. So you don't want
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to just chase down every spot guys, you
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do want to find the most tender spot, and
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once you find that you want to hold from
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there. We can kind of mess with with her
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posture here a little bit, we probably
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could make some improvements. I'm going to have
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you bring this leg up actually right, and
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then you can kind of use this leg to
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help take off some pressure, and then I
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want her to straighten this leg out so
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that the TFL is in a somewhat lengthened
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position right, but I do want this leg
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relaxed. So I'm going to ask her to go ahead and
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lay her knee soft, because what I don't
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want to do is use this leg, go ahead and
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lock your knee again. I can tell she's
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pushing down into the ground here right,
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and now if we think about what the TFL
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does it is an abductor. She's probably
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using a stiff leg and pushing down in
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the ground to contract her TFL, and do
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something called guarding. We want no
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guarding, we want that muscle totally
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relaxed so that we get the best release
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possible. Now who's going to need a
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tensor fasciae latae release, that's a
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that's a very important question. This
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isn't something that you just throw
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anybody for any reason, this should be
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something that is targeted and aids in
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improving the quality of human movement
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based on your assessment. So if we were
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going to talk about something like the
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overhead squat assessment, the tensor
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fascia lata is an internal rotator,
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flexor an abductor of the hip, which
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means knees bow in, knees bow out,
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anterior pelvic tilt, excessive forward
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lean are all signs that may potentially
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indicate over activity of the tensor
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fascia lata. If you're using goniometry,
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a lack of external rotation right
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since this muscle is an internal rotator,
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would indicate a potential need to
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release the TFL, and then in a somewhat
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paradoxical fashion if somebody lacks
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internal rotation that also might
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indicate TFL over activity, especially if
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you're measuring internal rotation at 90
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degrees of hip flexion. That has to do
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with our arthrokinematic dysfunction and
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the fact that the TFL will also
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anteriorly and superiorly glide the
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femoral head in the acetabulum. So knees
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bow in and knees bow out, anterior pelvic tilt
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excessive forward lean, internal or
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external rotation during goniometry,
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are all potentially good reasons to do
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your tensor fascia lata release. You want
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to try the other side, all right here's how
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you set up one more time. You will notice
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that we have a mat down, this can get
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quite uncomfortable to hold for a couple
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minutes as our release techniques take
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time. I do see a lot of people rush
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through their foam roll techniques, rush
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through their mobility techniques in
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general which includes stretching, and
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even our self-administered joint
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mobilizations we want to make sure that
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once we do a technique, we do it right so
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that we get the result we're looking for.
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I used to hate when my mother told me
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to the fastest way to get something done,
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was to do it the right way the first
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time, and your like arggh right, you're like
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because it just takes long and I just want
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to get it done, but it's going to take a
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lot longer if you
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a half ass it over and over and over and
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over again to get the result that you're
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looking for. How does that hypersphere
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feel, fast yeah, a little it's a little
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intense the first couple times you did
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it. Now of course if she was in so much
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pain in this position with this hard
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small object right, because if something
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is small and something is very firm we
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end up having a lot of pressure because
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the surface area is very small, what I
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could do is go hey it looks like you
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can't relax into this position; and if
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you can't relax and you're going to
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guard, we're not going to get a release.
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So what I could go back to do is let me
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have this, let's go ahead and try this with
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a foam roll, see how that feels. Don't
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automatically assume that more pain is
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better, more pain is not better, a better
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release is better. So she feels more
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comfortable on a foam roll and she can
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actually relax and get a release. This is
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where we can start, over time we can
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decrease the surface area or increase
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pressure by maybe using a harder object.
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And of course with all of these
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techniques we want to make sure that we
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assess, address and reassess. I hope you
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guys have enjoyed this video, take some
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time to practice this before you give it
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to your patients and clients. I think
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you'll find that there's little little
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form cues and stuff that you'll pick up
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just by trying to figure the technique
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out yourself. If you have any questions
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please leave a comment below.