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Anterior Hip Capsule Mobilization

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, All Lower Quarter, All Manual Therapy, Mobilization, Pelvic Clocks

Anterior Hip Capsule Mobilization

Prone Hip Flexor Stretch Sequence: Anterior Hip Capsule Mobilization

  • Subject’s left foot is placed on the floor with lumbar spine side bent to the left and right leg in alignment with the trunk
  • Therapist flexes the right knee to assess free range and holds the knee flexed just short of end range
  • Therapist then applies a PA glide to the femur from medial to lateral to find the direction of the greatest restriction
  • The therapist then mobilizes the hip in a PA direction applying grade III to IV mobs for 1-2 minutes

Muscle Energy Technique for the Hip Adductors

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, All Lower Quarter, All Manual Therapy, Hip ABD Firing Pattern, Muscle Energy, Supine Hip ABD and ER

Muscle Energy Technique for the Hip Adductors

  • To stretch right hip – left leg drawn up to chest
  • Therapist’s left hand stabilizes and monitors the right ASIS
  • Right leg taken into abduction, ER until tension felt at the right ASIS
  • Patient asked to pull the leg in
  • Upon relaxation the therapist takes the leg into further abduction and ER and repeats this effort several times

Muscle Energy Technique for ERS Dysfunctions of the Upper Thoracic Spine

in 3 Movement Tests Upper Quarter, 4 Manual Therapy Strategies, All Manual Therapy, All Upper Quarter, Muscle Energy, Scapular Stabilization

Muscle Energy Technique for ERS Dysfunctions of the Upper Thoracic Spine

For an ERS R from C7 to T5:

  • Patient places their R arm on your R leg with their whole arm resting and supported on your R thigh.
  • Place your R hand gently on top of their head and your L thumb on the L side of the interspinous space of the dysfunctional segment to monitor the motion barriers.
  • The patient is initially sitting in a slumped position, but with their head up. Ask the patient to sit up tall from below up by pushing their belly forward until you feel motion at your palpating L thumb.
  • Then with your R hand move the patient’s head from an extended position into flexion introducing flexion from above down to your palpating L thumb so that you create an apex for flexion at the dysfunctional segment.
  • L side bending is then introduced by translating your R leg to the R to create an apex for L side bending at your palpating L thumb.
  • The therapist then adds L rotation thru the head from above down to the dysfunctional segment making sure to go to just the feather edge and not beyond the motion barrier.
  • The patient is instructed to gently side bend their head to the R or pull their R arm down on your leg for 5-7 seconds.
  • When the patient relaxes you introduce additional L side bending to the new motion barrier by translating your R leg further to the R.
  • You repeat 3 to 4 times then reassess.

Manual Therapy to Address Pectoralis Minor Hypertonicity

in 3 Movement Tests Upper Quarter, 4 Manual Therapy Strategies, All Manual Therapy, All Upper Quarter, Manual Stretching, Scapular Stabilization

Manual Therapy to Address Pectoralis Minor Hypertonicity

Note that applying AP glides to the Sternochondral Joints in side lying from T3-5, which helps to diminish tone in the pectoralis minor, should precede manual stretching of this muscle.

Manual Stretching of the Pectoralis Minor:

The therapist’s left hand is placed over the 3-5th ribs to stabilize the origin of the pec minor.

  • The patient’s right arm is taken into horizontal abduction with varying amounts of flexion depending on the direction of greatest restriction.
  • The stretch is applied by tractioning the patient’s R arm longitudinally as the arm is taken into further horizontal abduction.
  • The stretch is held for 30 seconds and repeated 2-3 times.

Muscle Energy Technique for ERS Dysfunctions of the Upper Thoracic Spine

in 3 Movement Tests Upper Quarter, 4 Manual Therapy Strategies, All Manual Therapy, All Upper Quarter, Muscle Energy, Pectoralis Minor/Posterior Capsule

Muscle Energy Technique for ERS Dysfunctions of the Upper Thoracic Spine

For an ERS R from C7 to T5:

  • Patient places their R arm on your R leg with their whole arm resting and supported on your R thigh.
  • Place your R hand gently on top of their head and your L thumb on the L side of the interspinous space of the dysfunctional segment to monitor the motion barriers.
  • The patient is initially sitting in a slumped position, but with their head up. Ask the patient to sit up tall from below up by pushing their belly forward until you feel motion at your palpating L thumb.
  • Then with your R hand move the patient’s head from an extended position into flexion introducing flexion from above down to your palpating L thumb so that you create an apex for flexion at the dysfunctional segment.
  • L side bending is then introduced by translating your R leg to the R to create an apex for L side bending at your palpating L thumb.
  • The therapist then adds L rotation thru the head from above down to the dysfunctional segment making sure to go to just the feather edge and not beyond the motion barrier.
  • The patient is instructed to gently side bend their head to the R or pull their R arm down on your leg for 5-7 seconds.
  • When the patient relaxes you introduce additional L side bending to the new motion barrier by translating your R leg further to the R.
  • You repeat 3 to 4 times then reassess.

Quadratus Lumborum Hands and Knees Self Stretch

in 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Upper Quarter, Self Stretch, Shoulder Abduction

Quadratus Lumborum Hands and Knees Self Stretch

To Stretch the Right Quadratus Lumborum:

  • Have the patient reach forward with the right hand and grasp a solid object. From this position instruct the patient to sit back diagonally towards the right hip, elongating (stretching) the right side of the back.
  • The right arm may be internally rotated (thumb down) or externally rotated (thumb up). Since the latissimus dorsi is an internal rotator of the shoulder internal rotation of the arm places more stretch selectively on the quadratus muscle.
  • Have the patient hold the stretch position for 30 seconds and repeat 2-3 times alternating sides.

Muscle Energy Technique for a FRS Right in R Side Lying

in 3 Movement Tests Upper Quarter, 4 Manual Therapy Strategies, All Manual Therapy, All Upper Quarter, Muscle Energy, Shoulder Abduction

Muscle Energy Technique for a FRS Right in R Side Lying

  • Extension is introduced from above down and from below up to the barrier
  • Rotation is then introduced from above down to the feather edge of the barrier
  • The segment to be treated must remain perpendicular to the table
  • Using the R forearm the therapist introduces L side bending thru the pelvis by pushing up in an anterior and superior direction
  • Patient is instructed to push the pelvis caudally to activate the R side benders
  • Upon relaxation the therapist takes up the slack thru the pelvis
  • Repeat 3 to 4 times
  • To finish the patient is asked to extend the top leg (L) back while the therapist maintains the correction

Levator Scapulae Self Stretch

in 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Upper Quarter, Cervical Flexion Mobility, Self Stretch

Levator Scapulae Self Stretch

To stretch the right levator scapulae:

  • The patient is instructed to sit with the head positioned in flexion, left side bending and left rotation, as though looking down towards the left hip.
  • Their left hand is placed on top and around their head for support. Instruct the patient not to pull on their head with the left hand.
  • The right hand is placed behind the right hip and grasps the chair/bench.
  • Ask the patient to slowly lean forward and to the left to feel a stretch along the right side of their neck.
  • To facilitate a balance between the levator scapulae and ipsilateral lower trapezius, instruct the patient to pull their right shoulder down and back using the lower trapezius muscle. If done properly they should feel an additional stretch in the levator scapulae muscle.
  • They hold for 20 seconds and repeat 2-3 times on each side.

Supine Piriformis Self Stretch above 90 degrees

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Manual Therapy, Muscle Energy, Rolling, Self Stretch

Supine Piriformis Self Stretch above 90 degrees

To Stretch the Left Piriformis:

  • Have the patient reach under the left leg and grasp underneath the ankle with their right hand and under their left knee with the left hand.
  • Instruct the patient to draw the left and ankle towards their right shoulder using both hands.
  • A stretch should be felt in the left buttocks.
  • Then have the patient push their left knee and ankle into both hands for 5-7 seconds, when the patient relaxes have them draw their left leg further up towards the right shoulder.
  • Have them repeat 3-4 times progressively drawing the left leg further up towards the right shoulder upon each relaxation.
  • Then have them repeat this exercise on the right side.
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