Supine Hip ABD and ER

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

Pubic Symphysis Dysfunction – Self Correction

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Pubic Symphysis Dysfunction – Self Correction

Pubic Symphysis Dysfunction – Self Correction

  • The patient is lying on their back with a ball placed between the knees.
  • Instruct the patient to gently squeeze the knees together.
  • Hold 5 to 10 seconds and repeat 3 to 5 times.

Long Adductor Stretch

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Long Adductor Stretch

Long Adductor Stretch

  • Patient is lying their back with their hips up close to the wall and their knees are bent with a folded towel under the low back.
  • Instruct the patient to straighten their knees and slide their heels up the wall as far as they can while keeping the knees and toes facing straight towards the center of the room.
  • Then have the patient slowly slide their heels out along the wall until feeling a stretch in the groin.
  • Make sure that the patient doesn’t roll their legs outwards by keeping the toes pointing forward.
  • They hold the stretch for 30 seconds then bring the feet back to the midline to release the stretch
  • Repeat 2-3 times for 30 seconds each

Short Hip Adductor Self Stretch

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Short Hip Adductor Self Stretch

Short Hip Adductor Self Stretch

  • The patient is sitting it with their back up against the wall, the soles of the feet are together and the knees are allowed drop out.
  • Patient places their hands on the floor behind the hips. Instruct the patient to press down on their hands to unweight the spine and roll the pelvis forward (toward 6:00). They hold this stretch position for 20 to 30 seconds.
  • They should feel a deep stretch in the groin when rolling the pelvis forward toward 6:00.
  • Then have the patient roll the pelvis back toward 12:00. Repeat this rocking of the pelvis toward 6:00 then back toward 12:00 several times.
  • Instruct the patient not to push the knees down towards the floor with their hands, but ask them to actively attempt to move their knees closer to the floor while rolling the pelvis toward 6:00.

PA Mobilization of the Hip in Prone Crawl

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PA Mobilization of the Hip in Prone Crawl

Mobilization of Medial and Inferior Hip Capsule Prior to Hip Adductor Stretching

Prone

PA Mobilization of the Hip in Prone Crawl

  • Patient is prone with hip flexed, abducted and ER
  • Therapist applies a lateral to medial glide to the hip working all along the hip to find the direction of the greatest restriction
  • PA glides are applied and can be graded from I to IV
  • This technique as pictured also
    mobilizes the right obturator nerve

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

Muscle Energy Technique for the Hip Adductors:

  • Once the hip joint is mobilized then the therapist can stretch the hip adductors with a series of contract/relax efforts
  • Therapist’s left hand stabilizes the pelvis and the right hand abducts the leg to the barrier.
  • Patient is instructed to gently pull the R knee down towards the table for 5-7 seconds.
  • Upon relaxation the therapist abducts the leg further to the new barrier and repeats 3 to 4 times.

Mobilization of Medial and Inferior Hip Capsule Prior to Hip Adductor Stretching

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

Mobilization of Medial and Inferior Hip Capsule Prior to Hip Adductor Stretching

Mobilization of Medial and Inferior Hip Capsule Prior to Hip Adductor Stretching

Lateral Recumbent

To mobilize the right hip:
Patient is left side lying with bottom leg flexed for stability. Therapist supports the patient’s right leg with his right hand and places the hypothenar eminence of the left hand on the greater trochanter of the hip. The leg is taken into abduction in various amounts of hip flexion while the therapist applies a lateral to medial glide to assess joint play. If a restriction is found, the therapist can mobilize in the direction of the greatest perceived restriction.

Unilateral Prone Press Up

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Unilateral Prone Press Up

Unilateral Prone Press Up

To mobilize the left sacral base for anterior nutation:

The patient is lying on their stomach with their right leg off the side placing their right foot flat on the floor.

Their left leg is turned out (externally rotated) so that the inside of their left foot is resting on the table.

With their hands placed under the shoulders they try to straighten their elbows and press up as far as possible.

Instruct them to hold this position momentarily and repeat 8 to 10 times.

For Restricted Anterior Nutation of the R Sacral Base limiting Pelvic Rotation towards 3 o’clock the patient performs the above exercise with the L foot on the floor and the R leg on the table and externally rotated.

For Restricted Anterior Nutation of the L Sacral Base limiting Pelvic Rotation towards 9 o’clock

Robbery with or without Resistance Bands

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Robbery with or without Resistance Bands

  • The patient is standing with their hips and knees slightly bent, elbows straight and hands holding onto resistive bands.
  • Instruct the patient to keep their elbows close to their body as they straighten the knees and hips and move their arms so that their elbows and shoulder blades are pulled down and back towards the opposite back pockets with the palms ultimately facing forward.
  • Their neck should be relaxed and they should not hold their breath during this movement.
  • Ask them to repeat the exercise 3-5 times initially then increase the number of repetitions as their strength improves.