Technique Of The Week

Prone Inferior Glute Max, Adductor Magnus and Quadratus Femoris Stretch

What?

A prone PRI inhibitory technique used to decrease tonic influences of the left tensor fascia latae, left rectus femoris, left sartorius and right quadratus lumborum in the sagittal plane of the left anterior interior chain (AIC) oriented human; and the tonicity of right ischial tuberosity attachment muscle including all the hamstrings.  Inhibition of the above muscle occurs with facilatory demands on the left ischial tuberosity from active hip extensors during the ‘reach’ phase of the technique and stretching through respiratory lengthening of the right adductor magnus, quadratus femoris and lower transverse fiber of the gluteus maximus through right acetabular flexion and abduction of the femur and not through femoral internal rotation on the acetabulum.

Why?

The right adductor magnus and quadratus femoris often become short and restrictive in AF or FA abduction, especially on individuals with overactive left hip flexors.  The active left AIC pattern moves the pelvic center to the right and the left anterior inferior iliac spine to the right and forward.  This orientation dices the left sartorius and rectus femoris FA external rotation capability and the left tensor fascia latae FA internal rotation capability and reinforces anterior rotation of the left innominate through aforementioned hip flexors as sagittal flexors not transverse rotators.  The posterior rotation and orientation of the contralateral innominate reduces the ability to abduct the right lower extremity and shift body weight or the center of gravity to the left; because of ‘pull’ placed on the quadratus femoris and lower transverse gluteus maximus fiber as a result of ischial tuberosity forward and upward rotation and coccyx movement to the left, respectively.  The upward elevation of the inferior ischiopubic rami and outer inferior ischial tuberosity during posterior innominate orientation pulls the proximal adductor magnus up and limits FA abduction, promotes AF IR on the right and adductor magnus shortness.  This PRI non-manual technique is designed to inhibit right acetabular femoral internal rotation and adduction, right inferior glute max tone and restore flexibility and range of motion needed for left posterior innominate rotation and AF IR. 

(The picture below reflects a left adductor magnus although
the disucssion is reflective of a right adductor magnus)
 
Taken from Pansky B, Lawrence E.  Review of gross anatomy: third edition.

When?

A good technique for individuals whom have difficulty with: 1) right active or passive abduction after adduction drop tests become negative or after achieving pelvic neutrality; 2) active right calcaneal eversion; 3) co-activating left quad and right glute max (FA ER) while in left AF IR; 4) left thoracic abduction/left IO-TA development because of contralateral superior iliac proximity to anterior lateral rib cage; 5) right plantar flexor inhibition, right first ray propulsion or right anterior tibial tendonitis.

Where?

Precedes All Four Inferior Glute Max, Adductor Magnus and Quadratus Femoris Stretch technique in the transverse plane because this technique reinforces the need to ‘reach’ back with left lower extremity (AF extension), thus inhibiting left hip flexors and right adductors verses stretching the right adductor magnus, right quadratus femoris, right posterior capsule and right inferior transverse gluteus maximus fiber in a sagittal plane.  By staying on the elbows, thoracic flexion is preserved and posterior pelvic rotation is promoted.  When on ‘all fours’ this technique becomes more of a ‘stretch’ technique than an ‘inhibitory’ technique.  This technique should be considered before implementing the standing hip flexor stretch in the sagittal plane, because of its ease and level of managing pelvic control.  A very high integrative technique to reduce tone and tightness with a very low level of mechanical failure. 

Who?

First transverse plane inhibition PRI non-manual technique recommended because of it’s significant influence on all PRI chains and it’s impact on reducing tri-planar tone of the autonomic nervous system.  Could be used as a follow up stretching technique for patients who had a difficult time reducing tensor fascia latae activity as a primary FA internal rotator.  Also recommended for runners or individuals who experience difficulty with right back strain, right SI dysfunction or right AF impingement or groin pain.  Also, a recommended activity for the left visual midline or anterior visual midline shifted patient. 

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