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Stretch Lower Extremities

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Stretch Lower Extremities<br />Gluteals/rotators<br />ITB/TFL<br />Gastroc/Soleus<br />Hamstrings <br />Hip /Flexors see <...

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Gluteal/Piriformis Partner Stretch<br />Stand on the contralateral side of the table<br />Put patient into figure 4 positi...

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Gluteal/Piriformis Partner Stretch<br />3<br />Lean onto straight leg to keep hip out of flexion<br />

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Stretch Lower Extremities

  1. 1. Stretch Lower Extremities<br />Gluteals/rotators<br />ITB/TFL<br />Gastroc/Soleus<br />Hamstrings <br />Hip /Flexors see <br />Adductors<br />1<br />
  2. 2. Gluteal/Piriformis Partner Stretch<br />Stand on the contralateral side of the table<br />Put patient into figure 4 position (hip and knee flexion with external femur rotation<br />Step behind the patients bent leg so that the patients foot is on your hip or shoulder<br />Support the knee in the figure 4 position at 90 degree bend<br />Step up the entire leg as a unit<br />3 different angles are recommended<br />2<br />
  3. 3. Gluteal/Piriformis Partner Stretch<br />3<br />Lean onto straight leg to keep hip out of flexion<br />
  4. 4. Gluteal/Piriformis Partner Stretch<br />4<br />
  5. 5. Gluteal/Piriformis Partner Stretch<br />5<br />
  6. 6. Gluteal/Piriformis home stretch<br />Similar position as in partner stretch but with use of a table to add the stretching pressure<br />Keep neutral spine<br />Drop center of gravityto increase stretch<br />Lean in 3 directions from the hip with various foot positions to change stretch angles<br />**Bend from hip not spine if needed**<br />6<br />
  7. 7. Gluteal/Piriformis home stretch<br />7<br />Make sure the hips are square by pulling back on the stretching leg (direction of arrow<br />
  8. 8. Gluteal Stretch with Brugger position<br />8<br />
  9. 9. 9<br />
  10. 10. ITB/TFL Partner Stretch<br />Take the patient into same position as with the hamstring<br />Decrease the stretch on the hamstring slightly<br />Compress the hip on the stretching leg into the table to lock pelvis down<br />Adduct the patient leg across midline<br />Be cautious of burning pain at the IT insertion<br />(lateral distal knee)<br />10<br />
  11. 11. ITB/TFL Partner Stretch<br />11<br />
  12. 12. 12<br />Stretch Band for TFL / ITB<br />Use the compression of the band to lock down the hip onto the table<br />
  13. 13. Do not allow for elevation of the hip from the table<br />13<br />
  14. 14. ITB standing stretch<br />14<br />Maintain neutral spine position<br />
  15. 15. gastroc/Soleus Partner stretch<br />Take the patient into the same position as for the hamstring partner stretch<br />Force the ankle into dorsiflexion<br />Straight leg to involve the gastroc<br />Force the ankle into dorsiflexion with the knee bent to involve the soleus<br />Also can be done with Stretch Band<br />15<br />
  16. 16. Gastroc/soleus Home Stretch<br />Spine in neutral position<br />Bent knee for soleus<br />Straight leg for gastroc<br />See following examples<br />16<br />
  17. 17. Gastroc/soleus Home Stretch<br />17<br />
  18. 18. 18<br />
  19. 19. Hamstrings Partner Stretch<br />Flex the patients hip with knee in full extension<br />Lock contralateral foot in internal rotation or neutral position<br />Support the knee to keep in full extension<br />19<br />
  20. 20. Hamstrings Home Stretch<br />Keep the spine in a neutral position<br />Lying supine using a strap over the foot to pull the leg into hip flexion with knee in full extension<br />Alternative method<br />Standing, foot up on a table<br />Jump stretch band seated<br />20<br />Bad support foot position, should keep into internal rotation<br />
  21. 21. Standing Home Hamstring <br />21<br />-Neutral spinal position <br /><ul><li>Draw leg back to square hips
  22. 22. -support foot neutral or internal rotation</li></li></ul><li>22<br />Avoid Lumbar Flexion, Maintain a neutral spinal position<br />
  23. 23. Hamstrings Home Stretch<br />23<br />stretch band<br />Support foot should be pointing inwards<br />
  24. 24. Jump Stretch Bands<br />24<br />Poor head/neck position<br />
  25. 25. Hip Flexor/Psoas<br />Ischialtuberosity off the end of the bench<br />Flex one leg to the chest<br />Extend the other leg off the bench in a relaxed position<br />Apply downward extension pressure to femur<br />25<br />
  26. 26. Sartorius Partner Stretch<br />Ischialtuberosity off the bench<br />Flex one leg to the chest<br />Extend the other leg off the bench in a relaxed position<br />Bring the leg into hip extension, knee flexion and internal hip rotation<br />26<br />
  27. 27. Sartorius Partner Stretch<br />27<br />Kick leg back and out to create the knee flexion and internal hip rotation<br />
  28. 28. Home stretch Quad/ Hip Flexor<br />28<br />For isolation of psoas, use contralateral flexion and ipsilateralrotation<br />(lean away and rotate towards the side you are stretching)<br />
  29. 29. Hip Flexors<br />29<br />Gluteal(buttock) contraction is critical, hips must be square and not rotated<br />
  30. 30. Adductors Partner Stretch<br />Patient Supine<br />contralateral leg off side of table to stabilize<br />adduct the ipsilateral leg up and out at 45 degree angle<br />Change angles and rotations to work all fascial planes<br />See next slides<br />30<br />
  31. 31. Adductors Partner Stretch<br />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<br />31<br />
  32. 32. Adductors Home Stretch with Band<br />Try to maintain a spinal neutral position during stretching<br />Work in all angles<br />Don’t forget to work the adductors in position 2 where you pull the leg towards the floor<br />32<br />
  33. 33. Adductor Home Stretch (alternative)<br />33<br />Frog Leg Adductor Stretch<br />Standing abduction on table with neutral spine stretches adductors that cross the knee<br />

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