00:00 - 00:03This is Brent coming at you with our very first manual stretching video. In
00:03 - 00:07this video we're going to go after the hip flexor complex, using a very common
00:07 - 00:10testing position which is the Thomas test position. I think you guys will find
00:10 - 00:14that stretching the hip flexors using the Thomas test position is both very
00:14 - 00:18comfortable for you, as well as your patient or client. I think you'll also
00:18 - 00:22find that with some good body positioning, you can use both hands to
00:22 - 00:27specifically target the hip flexor that you're trying to get extensibility out
00:27 - 00:31of. I'm going to have my friend Leanne come out, she's going to help me demonstrate this
00:31 - 00:36exercise. Now, first things first, if I want to stretch Leanne's hip flexors I
00:36 - 00:40need to be able to pull her femur into extension, which means it's got to be off
00:40 - 00:46the table, none of this can be up on the table. So I'm going to queue Leanne to sit on
00:46 - 00:50her tailbone, no lower, and then from there I'm going to have her grab her
00:50 - 00:54opposite leg. She's going to pull her opposite leg into her torso, this is
00:54 - 00:58going to posteriorly tilt her pelvis. As she posteriorly tilts her pelvis
00:58 - 01:03that'll give me a little bit of lumbar flexion, which will help me protect her
01:03 - 01:08from going into excessive lumbar extension as she goes back. I think what you
01:08 - 01:11will find is a lot of the people who need good hip flexor stretching, are the
01:11 - 01:15same people who have a history of low back pain, and we don't want to do
01:15 - 01:19anything to reignite or exacerbate low back pain, that can definitely be a
01:19 - 01:23problem moving forward in our routines. From here, I'm going to go ahead and throw a
01:23 - 01:26towel over her foot, that's just so I don't get foot prints on my shirt, and
01:26 - 01:32then I'm going to go ahead and use my torso to stabilize this leg. If I use my torso
01:32 - 01:37to stabilize this leg two things happen: number one, Leanne can relax, she no longer
01:37 - 01:40has to pull on this leg which is going to make it easier for me to get autogenic
01:40 - 01:45inhibition or those releases I'm looking for on the opposite leg. Second, by using
01:45 - 01:51my torso I have both hands free to make sure I can dial into the hip flexor, or
01:51 - 01:56dial in to great technique for this stretch. First things first, I'm going to use
01:56 - 02:02this hand to control her pelvis through this leg. She's at her end range, so if I
02:02 - 02:06feel her tilting this way, I can actually get her to tilt back by just pushing
02:06 - 02:10this way. If I think she's going into an anterior pelvic tilt, I can lean a little
02:10 - 02:14bit with my torso and force her back into a posterior pelvic tilt. So I
02:14 - 02:19can do a lot to control her pelvis and make sure she stays neutral here, just by
02:19 - 02:24controlling this knee, and controlling this foot with my torso. Now, let's talk
02:24 - 02:28about all of the different things we can do with this part of the stretch, the
02:28 - 02:33actual stretch part of the stretch, to let it dial in to the specific hip
02:33 - 02:37flexor I'm looking for. Now, if you have iliacus and psoas tightness, that's
02:37 - 02:42what you've assessed to be tight, probably the best bet is to posteriorly
02:42 - 02:46tilt as far as you can, making sure that lumbar spine is actually flat,
02:46 - 02:53that'll pull the psoas longer, and then I'm going to go femur in neutral, that
02:53 - 02:57way I know there's no compensation happening, and then I'm going to push down
02:57 - 03:01into extension until just past that first resistance barrier, and hold until
03:01 - 03:07I get a release. So psoas iliacus, we're going to go posterior pelvic
03:07 - 03:12tilt, neutral position of the femur. Now, if I want to turn this into a TFL
03:12 - 03:17stretch, the TFL does internal rotation of the femur, as well as a little bit of
03:17 - 03:24abduction, and external rotation of the tibia. So I can pull her foot in, that's
03:24 - 03:29internal rotation of the tibia, I can pull her tibia this way, which is
03:29 - 03:34external rotation of the femur, and then use my hand and my leg a little bit to
03:34 - 03:38pull her into just a little bit of abduction, and she should go from feeling
03:38 - 03:44this stretch more in the lower ab, or just just inside her ASIS, to now just passed her
03:44 - 03:50ASIS on the side here where her TFL lies. Do you feel that? -Yes. Good. So we went from psoas
03:50 - 03:54to TFL just by turning her in a little bit, and pushing her in a little bit. Now,
03:54 - 03:59if I had assessed that her pectineus was tight, your pectineus as an adductor
03:59 - 04:02muscle is a little different in the sense that it has an innervation from the
04:02 - 04:05femoral nerve, that femoral nerve is the same nerve that innervates all of our
04:05 - 04:10hip flexors, so it has a tendency to get tight with the hip flexors. If I wanted
04:10 - 04:12to make this a little bit more of a pectineus stretch, I'd actually go in the
04:12 - 04:18opposite direction of my TFL. So now I'm just going to push her into a little bit
04:18 - 04:28of abduction, and extension. So we've got psoas, TFL and pectineus.
04:28 - 04:34And then, of course, the last one, which I see abused a little bit, to get rectus
04:34 - 04:38femoris all I really need to do is get her back into neutral, and kick that leg
04:38 - 04:43to just past 90. The reason I say this gets abused a little bit is I see people,
04:43 - 04:46number one, take this stretch a little too far.
04:46 - 04:51Instead of that mild discomfort they go for darn near pain, and they try to pull
04:51 - 04:56this leg up towards the table. One thing I can definitely tell you is more
04:56 - 05:00is not better. The harder you stretch somebody, the more muscle spindle
05:00 - 05:04activity you'll get, and the more their muscle is going to fight back against you.
05:04 - 05:08That's not going to help you get autogenic inhibition, that's not going to help you get
05:08 - 05:13a release, that's going to lead to an increase in extensibility and soft
05:13 - 05:17tissue adaptation. So all we need is a little mild stretch here, and just using
05:17 - 05:23my leg to pull it back just past 90, use my hand, once again I'm going to correct her
05:23 - 05:27pelvic position. You can kind of see me adjusting here to make sure her foots on
05:27 - 05:32the right place on my torso, I'm using this hand, I'll push her just a little bit past
05:32 - 05:37the first resistance barrier, and I'm going to hold until she lets go. So there you
05:37 - 05:42have it, we've got psoas with straight on with a posterior pelvic tilt,
05:42 - 05:48TFL is adduction, turning her leg in, turning her foot and tibial internal
05:48 - 05:53rotation, we've got pectineus which was pushing
05:53 - 05:58into abduction a little bit, and rectus femoris was taking a leg under. And
05:58 - 06:03then of course, you're going to hold with mild discomfort until you get a release
06:03 - 06:07to happen, and you can wait for two to three releases as you push further
06:07 - 06:11and further into that resistance barrier. Now, be very careful, as you get somebody
06:11 - 06:14out of this position, just like we were careful to get Leanne into this position,
06:14 - 06:19we don't want to drop this leg and let her pelvis pull her into an anterior
06:19 - 06:22pelvic tilt, hyperextension of lumbar spine and
06:22 - 06:25then she's having low back pain again. So what I'm going to have Leanne do is go ahead
06:25 - 06:31and grab this leg again, both hands, once she has this leg I'm going to
06:31 - 06:33go ahead and get out of the way of this leg, because we're going to have her
06:33 - 06:37step down on this leg, and I'm going to help her
06:37 - 06:41pull up, and then she can just slide off the table, onto that leg that
06:41 - 06:46we just stretched, no low back pain. I hope you enjoy this manual stretch.
06:46 - 06:50If you haven't done manual stretching before I suggest you practice on a few
06:50 - 06:54people before you actually practice on a client or patient. For my trainers out
06:54 - 06:57there you can practice on a few of your personal trainer buddies.
06:57 - 07:01Everybody loves to be stretched! So I hope you get a huge increase in
07:01 - 07:04extensibility from this stretch, I hope you are working on your technique,
07:04 - 07:08I'll talk to you soon.
