This document provides instructions for stretching various lower extremity muscle groups. It describes partner and home stretches for the gluteals, IT band, gastroc/soleus, hamstrings, hip flexors, sartorius, quads, and adductors. Proper form is emphasized, such as maintaining a neutral spine, changing the angle and direction of stretches to target different areas, and using straps or bands to provide additional pressure. Partner stretches involve one person positioning the patient's leg while home stretches can be done independently using furniture, walls, or resistance bands for leverage and pressure.

1. Stretch Lower ExtremitiesGluteals/rotatorsITB/TFLGastroc/SoleusHamstrings Hip /Flexors see Adductors1

2. Gluteal/Piriformis Partner StretchStand on the contralateral side of the tablePut patient into figure 4 position (hip and knee flexion with external femur rotationStep behind the patients bent leg so that the patients foot is on your hip or shoulderSupport the knee in the figure 4 position at 90 degree bendStep up the entire leg as a unit3 different angles are recommended2

3. Gluteal/Piriformis Partner Stretch3Lean onto straight leg to keep hip out of flexion

4. Gluteal/Piriformis Partner Stretch4

5. Gluteal/Piriformis Partner Stretch5

6. Gluteal/Piriformis home stretchSimilar position as in partner stretch but with use of a table to add the stretching pressureKeep neutral spineDrop center of gravityto increase stretchLean 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 stretch7Make sure the hips are square by pulling back on the stretching leg (direction of arrow

8. Gluteal Stretch with Brugger position8

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10. ITB/TFL Partner StretchTake the patient into same position as with the hamstringDecrease the stretch on the hamstring slightlyCompress the hip on the stretching leg into the table to lock pelvis downAdduct the patient leg across midlineBe cautious of burning pain at the IT insertion(lateral distal knee)10

11. ITB/TFL Partner Stretch11

12. 12Stretch Band for TFL / ITBUse the compression of the band to lock down the hip onto the table

13. Do not allow for elevation of the hip from the table13

14. ITB standing stretch14Maintain neutral spine position

15. gastroc/Soleus Partner stretchTake the patient into the same position as for the hamstring partner stretchForce the ankle into dorsiflexionStraight leg to involve the gastrocForce the ankle into dorsiflexion with the knee bent to involve the soleusAlso can be done with Stretch Band15

16. Gastroc/soleus Home StretchSpine in neutral positionBent knee for soleusStraight leg for gastrocSee following examples16

17. Gastroc/soleus Home Stretch17

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19. Hamstrings Partner StretchFlex the patients hip with knee in full extensionLock contralateral foot in internal rotation or neutral positionSupport the knee to keep in full extension19

20. Hamstrings Home StretchKeep the spine in a neutral positionLying supine using a strap over the foot to pull the leg into hip flexion with knee in full extensionAlternative methodStanding, foot up on a tableJump stretch band seated20Bad support foot position, should keep into internal rotation

21. Standing Home Hamstring 21-Neutral spinal position Draw leg back to square hips

22. -support foot neutral or internal rotation22Avoid Lumbar Flexion, Maintain a neutral spinal position

23. Hamstrings Home Stretch23stretch bandSupport foot should be pointing inwards

24. Jump Stretch Bands24Poor head/neck position

25. Hip Flexor/PsoasIschialtuberosity off the end of the benchFlex one leg to the chestExtend the other leg off the bench in a relaxed positionApply downward extension pressure to femur25

26. Sartorius Partner StretchIschialtuberosity off the benchFlex one leg to the chestExtend the other leg off the bench in a relaxed positionBring the leg into hip extension, knee flexion and internal hip rotation26

27. Sartorius Partner Stretch27Kick leg back and out to create the knee flexion and internal hip rotation

28. Home stretch Quad/ Hip Flexor28For isolation of psoas, use contralateral flexion and ipsilateralrotation(lean away and rotate towards the side you are stretching)

29. Hip Flexors29Gluteal(buttock) contraction is critical, hips must be square and not rotated

30. Adductors Partner StretchPatient Supinecontralateral leg off side of table to stabilizeadduct the ipsilateral leg up and out at 45 degree angleChange angles and rotations to work all fascial planesSee next slides30

31. Adductors Partner StretchPressure on the patient leg should change from up and out to down and out to work all aspects of fascia and attachments of various adductors31

32. Adductors Home Stretch with BandTry to maintain a spinal neutral position during stretchingWork in all anglesDon’t forget to work the adductors in position 2 where you pull the leg towards the floor32

33. Adductor Home Stretch (alternative)33Frog Leg Adductor StretchStanding abduction on table with neutral spine stretches adductors that cross the knee