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Stretch Lower Extremities Gluteals/rotators ITB/TFL Gastroc/Soleus Hamstrings  Hip /Flexors see  Adductors 1
Gluteal/Piriformis Partner Stretch Stand on the contralateral side of the table Put patient into figure 4 position (hip and knee flexion with external femur rotation Step behind the patients bent leg so that the patients foot is on your hip or shoulder Support the knee in the figure 4 position at 90 degree bend Step up the entire leg as a unit 3 different angles are recommended 2
Gluteal/Piriformis Partner Stretch 3 Lean onto straight leg to keep hip out of flexion
Gluteal/Piriformis Partner Stretch 4
Gluteal/Piriformis Partner Stretch 5
Gluteal/Piriformis home stretch Similar position as in partner stretch but with use of a table to add the stretching pressure Keep neutral spine Drop center of gravityto increase stretch Lean in 3 directions from the hip with various foot positions to change stretch angles **Bend from hip not spine if needed** 6
Gluteal/Piriformis home stretch 7 Make sure the hips are square by pulling back on the stretching leg (direction of arrow
Gluteal Stretch with Brugger position 8
9
ITB/TFL Partner Stretch Take the patient into same position as with the hamstring Decrease the stretch on the hamstring slightly Compress the hip on the stretching leg into the table to lock pelvis down Adduct the patient leg across midline Be cautious of burning pain at the IT insertion (lateral distal knee) 10
ITB/TFL Partner Stretch 11
12 Stretch Band for TFL / ITB Use the compression of the band to lock down the hip onto the table
Do not allow for elevation of the hip from the table 13
ITB standing stretch 14 Maintain neutral spine position
gastroc/Soleus Partner stretch Take the patient into the same position as for the hamstring partner stretch Force the ankle into dorsiflexion Straight leg to involve the gastroc Force the ankle into dorsiflexion with the knee bent to involve the soleus Also can be done with Stretch Band 15
Gastroc/soleus Home Stretch Spine in neutral position Bent knee for soleus Straight leg for gastroc See following examples 16
Gastroc/soleus Home Stretch 17
18
Hamstrings Partner Stretch Flex the patients hip with knee in full extension Lock contralateral foot in internal rotation or neutral position Support the knee to keep in full extension 19
Hamstrings Home Stretch Keep the spine in a neutral position Lying supine using a strap over the foot to pull the leg into hip flexion with knee in full extension Alternative method Standing, foot up on a table Jump stretch band seated 20 Bad support foot position, should keep into internal rotation
Standing Home Hamstring  21 -Neutral spinal position  ,[object Object]
-support foot neutral or internal rotation,[object Object]
Hamstrings Home Stretch 23 stretch band Support foot should be pointing inwards
Jump Stretch Bands 24 Poor head/neck position
Hip Flexor/Psoas Ischialtuberosity off the end of the bench Flex one leg to the chest Extend the other leg off the bench in a relaxed position Apply downward extension pressure to femur 25
Sartorius Partner Stretch Ischialtuberosity off the bench Flex one leg to the chest Extend the other leg off the bench in a relaxed position Bring the leg into hip extension, knee flexion and internal hip rotation 26
Sartorius Partner Stretch 27 Kick leg back and out to create the knee flexion and internal hip rotation
Home stretch Quad/ Hip Flexor 28 For isolation of psoas, use contralateral flexion and ipsilateralrotation (lean away and rotate towards the side you are stretching)
Hip Flexors 29 Gluteal(buttock) contraction is critical, hips must be square and not rotated
Adductors Partner Stretch Patient Supine contralateral leg off side of table to stabilize adduct the ipsilateral leg up and out at 45 degree angle Change angles and rotations to work all fascial planes See next slides 30
Adductors Partner Stretch Pressure on the patient leg should change from up and out to down and out to work all aspects of fascia and attachments of various adductors 31
Adductors Home Stretch with Band Try to maintain a spinal neutral position during stretching Work in all angles Don’t forget to work the adductors in position 2 where you pull the leg towards the floor 32
Adductor Home Stretch (alternative) 33 Frog Leg Adductor Stretch Standing abduction on table with neutral spine stretches adductors that cross the knee

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Stretch Lower Extremities

  • 1. Stretch Lower Extremities Gluteals/rotators ITB/TFL Gastroc/Soleus Hamstrings Hip /Flexors see Adductors 1
  • 2. Gluteal/Piriformis Partner Stretch Stand on the contralateral side of the table Put patient into figure 4 position (hip and knee flexion with external femur rotation Step behind the patients bent leg so that the patients foot is on your hip or shoulder Support the knee in the figure 4 position at 90 degree bend Step up the entire leg as a unit 3 different angles are recommended 2
  • 3. Gluteal/Piriformis Partner Stretch 3 Lean onto straight leg to keep hip out of flexion
  • 6. Gluteal/Piriformis home stretch Similar position as in partner stretch but with use of a table to add the stretching pressure Keep neutral spine Drop center of gravityto increase stretch Lean in 3 directions from the hip with various foot positions to change stretch angles **Bend from hip not spine if needed** 6
  • 7. Gluteal/Piriformis home stretch 7 Make sure the hips are square by pulling back on the stretching leg (direction of arrow
  • 8. Gluteal Stretch with Brugger position 8
  • 9. 9
  • 10. ITB/TFL Partner Stretch Take the patient into same position as with the hamstring Decrease the stretch on the hamstring slightly Compress the hip on the stretching leg into the table to lock pelvis down Adduct the patient leg across midline Be cautious of burning pain at the IT insertion (lateral distal knee) 10
  • 12. 12 Stretch Band for TFL / ITB Use the compression of the band to lock down the hip onto the table
  • 13. Do not allow for elevation of the hip from the table 13
  • 14. ITB standing stretch 14 Maintain neutral spine position
  • 15. gastroc/Soleus Partner stretch Take the patient into the same position as for the hamstring partner stretch Force the ankle into dorsiflexion Straight leg to involve the gastroc Force the ankle into dorsiflexion with the knee bent to involve the soleus Also can be done with Stretch Band 15
  • 16. Gastroc/soleus Home Stretch Spine in neutral position Bent knee for soleus Straight leg for gastroc See following examples 16
  • 18. 18
  • 19. Hamstrings Partner Stretch Flex the patients hip with knee in full extension Lock contralateral foot in internal rotation or neutral position Support the knee to keep in full extension 19
  • 20. Hamstrings Home Stretch Keep the spine in a neutral position Lying supine using a strap over the foot to pull the leg into hip flexion with knee in full extension Alternative method Standing, foot up on a table Jump stretch band seated 20 Bad support foot position, should keep into internal rotation
  • 21.
  • 22.
  • 23. Hamstrings Home Stretch 23 stretch band Support foot should be pointing inwards
  • 24. Jump Stretch Bands 24 Poor head/neck position
  • 25. Hip Flexor/Psoas Ischialtuberosity off the end of the bench Flex one leg to the chest Extend the other leg off the bench in a relaxed position Apply downward extension pressure to femur 25
  • 26. Sartorius Partner Stretch Ischialtuberosity off the bench Flex one leg to the chest Extend the other leg off the bench in a relaxed position Bring the leg into hip extension, knee flexion and internal hip rotation 26
  • 27. Sartorius Partner Stretch 27 Kick leg back and out to create the knee flexion and internal hip rotation
  • 28. Home stretch Quad/ Hip Flexor 28 For isolation of psoas, use contralateral flexion and ipsilateralrotation (lean away and rotate towards the side you are stretching)
  • 29. Hip Flexors 29 Gluteal(buttock) contraction is critical, hips must be square and not rotated
  • 30. Adductors Partner Stretch Patient Supine contralateral leg off side of table to stabilize adduct the ipsilateral leg up and out at 45 degree angle Change angles and rotations to work all fascial planes See next slides 30
  • 31. Adductors Partner Stretch Pressure on the patient leg should change from up and out to down and out to work all aspects of fascia and attachments of various adductors 31
  • 32. Adductors Home Stretch with Band Try to maintain a spinal neutral position during stretching Work in all angles Don’t forget to work the adductors in position 2 where you pull the leg towards the floor 32
  • 33. Adductor Home Stretch (alternative) 33 Frog Leg Adductor Stretch Standing abduction on table with neutral spine stretches adductors that cross the knee