Technique Of The Week | ||
Unsupported Supine Hooklying Left Glute Max with Right AF ER
What?A supine PRI inhibitory technique used to decrease tonic influences of the right iliacus, right psoas and right adductor magnus in the sagittal plane of the Left Anterior Interior Chain (L AIC) oriented human, during right acetabular femoral external rotational (R AF ER) demand upon right heel strike or early stance during forward progression of the gait cycle. Contralateral activity from the gluteus maximus as a femoral acetabular external rotator (FA ER), while maintaining left acetabular femoral internal rotation (L AF IR), makes this an excellent technique to facilitate femoral or acetabular external rotation on the right during recognizable, concomitant proprioception input from the same muscle group in a different position on the left. Why?Many humans over-utilize their right piriformis, hip flexors and adductors for external rotation of their femur or acetabulum (pelvis) when needed in the gait cycle, during push off from a chair, rolling from side to side in bed, during stance, etc…because of poor mechanical advantage from the right gluteus maximus. The lengthened gluteus maximus, regardless if the femur is flexed or extended, is functioning in too much end range of internal direction because of too much acetabular internal orientation or too much femoral internal rotation. Therefore, reversal of this position will allow for better identification of how the right glute max should function, fire and facilitate external rotation through better mechanical driven isolation and facilitory bilateral transfer feedback from the left gluteus medius. When?A good technique to consider when patients have a difficult time with right heel strike and increased foot or lower extremity external rotation during swing and mid-stance. It should be considered as an inhibitory technique for the right hip flexors, including the right TFL, when all other sidelying or upright PRI techniques fail. A nice technique to use for cross-facilitation on those individuals who do not have good proprioceptive awareness of their gluteal musculature in general…the hypermobile or lax soft tissue individual with right sciatica comes to mind. Where?Follows the three supine right glute max PRI non-manual techniques that are supported; meaning both lower extremities, or feet, are supported at all times by the floor or wall. It precedes the dropped hooklying series of right glute max, positional development. This and the two techniques that immediately follow are good activities to incorporate when back extension demands on your patient will be high because of history, genetics, occupation, etc…and gluteus maximus strength and positional control for single leg support, drive and dynamics will be higher than average. A great sagittal technique for transverse plane oriented individuals (soccer, basketball, golf). This technique is helpful for those who can’t isolate their gluteus maximus for external rotation without experiencing back extension from hip flexor ‘pull’ on their back, when in the sidelying position. Who?Since the right glute max is such an important muscle for myokinematic repositioning and pelvic floor stabilization, it is a key muscle that needs to be facilitated, isolated and correctly used during AF ER and FA ER. It is best isolated and facilitated in the supine position, therefore, the first position recommended to inhibit muscle that carries out external rotation of the femur or acetabulum is supine. The “unsupported” techniques are a progressive step that makes it more difficult to substitute undesirable external rotator activity that promotes the Left AIC pattern that coincides with autonomic positional weakness of the right gluteus maximus. Those that need this re-training are usually working in a crouched state, where the gluteus maximus can become fatigued more easily because of gravitational and positional influences on its eccentric capabilities. Soccer players, basketball players and hockey players readily come to mind. They all are prone to reduced eccentric “feel” of their gluteus maximus not concentric “feel” and have a difficult time isolating their glute maximus for early AF ER or isolated FA ER.
Unsupported Supine Hooklying Left Glute Max with Right FA ER
A great technique for those maintaining right glute max FA ER during late right stance of forward progression in single leg stance activity of the gait cycle. In other words, the right femur has a tendency to roll in at and immediately following right mid stance more than it should, facilitory early use of left hip flexors for left toe clearance. A good technique to use when the right glute max is weaker in right AF IR than right AF ER in the supine hooklying position.
Unsupported Supine Hooklying Right Glute Max with Right AF IR
This technique is very similar to previous techniques but offers an advantage in that the right glute max is working more in an AF IR state, while left leg is going through FA ER. This right glute control is required at left heel strike and is a precursor to what needs to come immediately after left heel strike, right glute max contraction for sufficient right AF ER during left mid stance (L AF IR). A great technique to inhibit the left TFL, since it is in a maximal lengthened state as the left leg goes through left FA ER. It is also a great technique to inhibit the right adductor magnus to facilitate the right psoas, for left spinal rotation, without the right glute max dropping off. This technique can be found on the 2nd Edition Non-Manual Techniques CD-Rom. To order, click here! Previous Techniques
|
||
