August 20, 2009

Practitioner hip flexor stretch

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Sharon and I are going to show you the practitioner version of the hip flexor stretch and it's a beauty and this can be done, believe it or not, even when someone's back is sore because of the way we positioned the person.

If your hip flexors are tight, this method will get you started, quickly. This can be used, if the directions are followed, EVEN if your lower back is sore, because this stretch does not allow the lower back to extend.

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Kit Laughlin:

Sharon and I are going to show you the practitioner version of the hip flexor stretch and it's a beauty. And this can be done, believe it or not, even when someone's back is sore because of the way we position the person first up.

You'll notice she's got her front foot in front of her front knee and she's going to support herself with her left hand as she lowers herself down into the hands under the shoulders support position.

If the front foot is not in front of the knee, she's going to do that little creeping forward action with the foot to move it in front of the knee.

Then I'm going to get behind her. Notice my alignment and positioning. My front foot in front of my knee and you'll see that Sharon ... the hips are almost level but not quite, so what I'm going to do is I'm going to adjust her very slightly like this and then with my right hand, I'm going to very, very softly and gently lean so that her hips go forward and down towards the floor.

Can you feel that Shaz?

A little bit.

Okay, and then she's going to creep this foot a little bit further forward like that in order to level the hips. That's the critical dimension. The hips need to be roughly level with respect to the floor, but you'll see that her back is still perfectly straight. There's no extension happening in the lumbar spine and extension is a thing which hurts the back when it's sore.

Okay. So in that position there, I'm going to ask her to very gently, using the muscles on the front of the back of the front leg, I should say, and her arms, to just gently pull herself forward a tiny bit to increase the stretch.

Can you feel that?

Yeah.

Okay, and then she gets used to that. She breathes in and out a few times. Then the contraction can be added. This makes it much stronger.

I take this hand, my left hand, off the hip. I put it on the front of the leg here and I tap the leg for a tactile cue and I say, "Gently try to drag your right knee forward", and at the same time I'm leaning a bit harder with my right arm so that no movement is the result. And I count backwards for her.

In a real situation I would have finished that count by now, but count backwards for your partner. Five, four, three, two, one. Then you stop.

The hands go back in the start position. I say, "Sharon, take in a deep breath", and as she breathes out, "Please pull yourself forward gently a little bit further". And if you look closely, you can see now the hip is now more extended than what it was. And so the further the leg gets into extension the more you walk the front foot out.

So breathe and relax. Now, if you see the back start to bend backwards as it is now you can ask the person to bend the elbows so the back stays curved. You can have someone lean on a support or if they're loose enough they could even go down onto their elbows but this position here is excellent.

Now to come out of the stretch position, she pushes back with the front leg so this happens and what we'll do, we'll spin around and we'll show you what that looks like from the other side.

To show you the other side, Sharon's just going to change legs in the same position. So when you're ready Shaz, just swing that right leg out to the front. We make sure that the front foot is far enough in front. She supports herself with the right hand and then lowers her body down so that she's in the hands underneath the shoulders position.

And I move myself into position and it doesn't matter which way you've got your own legs. I might just put them the other way because it's a bit clearer and easier to see, but you can see here the tendency in this exercise.

Firstly, this leg is going out to the side and it usually wants to do that but try and keep it in close to the body.

And the second thing is too, is as we ease the hips towards the floor, you'll see now that this hip is lower than this hip. So at that point we use a little foot creeping action to creep the front foot further forward. Then as you can see that lowers this hip and it squares the pelvis up with respect to the floor and now it becomes a true hip flexor stretch.

Take a breath in Sharon, and when you're ready gently, slowly pull yourself forwards and down like that. Is that enough?

Okay, don't exaggerate it. That's lovely.

This is the key arm for support. We actually have this hand behind the sacroiliac joint and that provides a pivot point around which extension in the back leg can occur and the hip flexors are stretched as a result.

So let's say she's used to that stretch by now. This hand comes off this hip down towards the front of the leg. I tap the leg and say, "Gently pull your left leg forward." So it's as though she were pulling the knee to the chest. Five, four, three, two, one. Stop.

Relax. Breathe in. And on a breath out pull yourself gently further forwards. Now what she's doing is she's using the hamstring muscle on this leg plus these muscles underneath her arms to pull the whole body forward and the net result, as you can see, is the leg moves back in respect to the spine.

Bend your arms a little bit too Sharon, to keep a little bit of a flexion in the lumbar spine.

Now, if you're doing this at home and the person wasn't strong enough to hold themselves up on bent arms like this, you'd actually put the elbows on a support, like a couple of telephone books or something like that. But the idea is the key point here is to keep a little bit of forward bend in the spine. That way you can't hurt it.

To come out of the exercise, gently push back with this leg and normally we'd recommend to the patient to walk. Just hop up and walk around and see how everything feels. Off you go. And walk around.

Excellent. That is the best hip flexor stretch we have at the moment and it's the one that I recommend you use in the clinic.

 

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