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These are the user uploaded subtitles that are being translated: 1 00:00:23,600 --> 00:00:28,711 Welcome to Section 2 of Deep Tissue Massage and Myofascial Release, 2 00:00:28,815 --> 00:00:30,940 a video guide to techniques. 3 00:00:31,269 --> 00:00:34,670 My name is Art Riggs for those of you that are just joining us. 4 00:00:34,789 --> 00:00:39,694 And I am working under the assumption that you have either seen the first section, 5 00:00:39,741 --> 00:00:40,990 the fundamentals section, 6 00:00:41,070 --> 00:00:45,250 or that you are experienced therapists who have cultivated your touch. 7 00:00:45,670 --> 00:00:52,590 So now we will apply those tools that we have learned in the fundamentals section into section 2, 8 00:00:52,630 --> 00:00:54,686 which is the strategies section. 9 00:00:54,878 --> 00:01:00,893 So I will remind you that I'm going to be working considerably faster than I normally work in a regular massage. 10 00:01:01,021 --> 00:01:03,609 And this is because I want to show you many, 11 00:01:03,649 --> 00:01:06,790 many strokes and options for you to improvise with. 12 00:01:07,170 --> 00:01:11,177 So please do feel free to alter any of the strokes I'm using. 13 00:01:11,233 --> 00:01:14,506 If I'm using an elbow and you prefer to use the knuckles or a fist, 14 00:01:14,617 --> 00:01:20,269 please try that and experiment with what works best for you and works best for your clients. 15 00:01:34,790 --> 00:01:38,174 We'll begin our foray up the body with the feet. 16 00:01:38,221 --> 00:01:41,709 I think the feet are tremendously important in many, 17 00:01:41,750 --> 00:01:42,462 many ways. 18 00:01:42,525 --> 00:01:44,670 People injure their feet when they're younger, 19 00:01:44,829 --> 00:01:50,621 develop limping patterns and protective splinting and compensatory patterns. 20 00:01:50,766 --> 00:01:53,969 And as the foot contacts the earth, 21 00:01:54,390 --> 00:01:57,677 that strain pattern will continue all the way up the body. 22 00:01:57,813 --> 00:02:06,890 So it's very important when you're doing structural massage to start thinking about what is actually happening in the ankle joint, 23 00:02:07,049 --> 00:02:08,330 the foot joint, 24 00:02:08,490 --> 00:02:11,481 and how strain patterns move all the way up the leg. 25 00:02:11,586 --> 00:02:19,033 I'm always excited when we move from the fundamentals and theory aspect of deep tissue to actually doing the work. 26 00:02:19,122 --> 00:02:20,858 I can slow down a little bit. 27 00:02:20,993 --> 00:02:23,306 I don't have to be showing a bunch of strokes. 28 00:02:23,418 --> 00:02:32,491 I do want to remind you that you have at your disposal now all of the strokes that we've talked about in the fundamentals tape. 29 00:02:32,635 --> 00:02:36,443 So if I'm using my fingers and you prefer to use the knuckles, 30 00:02:36,572 --> 00:02:40,268 or if I'm using my knuckles and you prefer to use the fist or the fingers, 31 00:02:40,364 --> 00:02:42,443 please feel free to experiment here. 32 00:02:42,532 --> 00:02:47,000 I will be showing you more strokes than I normally would be working. 33 00:02:47,300 --> 00:02:48,780 If I work on this body part, 34 00:02:48,819 --> 00:02:51,372 I want to give you a lot of options to use. 35 00:02:51,475 --> 00:02:55,352 But remember that just as in poetry or good literature, 36 00:02:55,515 --> 00:02:59,295 having a large vocabulary is always very handy. 37 00:02:59,328 --> 00:03:04,800 But sometimes the simplest and most direct way to work is by far the most effective. 38 00:03:04,960 --> 00:03:09,099 So let's begin with the leg and the foot, 39 00:03:09,639 --> 00:03:12,319 and a reminder that I'm going to be using very, 40 00:03:12,360 --> 00:03:13,695 very little lubrication. 41 00:03:13,807 --> 00:03:16,900 I'm really trying to stretch this tissue. 42 00:03:25,169 --> 00:03:32,138 I'm also making the assumption throughout these tapes from now on that you have done your backup work, 43 00:03:32,274 --> 00:03:34,074 you have worked on the outer layers, 44 00:03:34,122 --> 00:03:34,858 you've softened, 45 00:03:34,873 --> 00:03:36,554 you've taken your nice broad strokes, 46 00:03:36,602 --> 00:03:38,550 you've worked at the superficial level. 47 00:03:42,689 --> 00:03:44,057 So beginning down at the foot, 48 00:03:44,114 --> 00:03:51,514 one of the most important joints that we can work with is the talotibular joint. 49 00:03:51,641 --> 00:03:59,189 The talus bone right here articulates with the tibia and as it rotates like this, 50 00:03:59,810 --> 00:04:01,530 it can impede the function. 51 00:04:01,610 --> 00:04:04,361 It also rests upon the calcaneus bone. 52 00:04:04,425 --> 00:04:06,937 So if the calcaneus is too far medial, 53 00:04:07,033 --> 00:04:09,069 if it's too far lateral, 54 00:04:09,409 --> 00:04:14,307 then it's not going to be providing support for the talus bone. 55 00:04:14,484 --> 00:04:20,995 One of the first things I do after I've done my warm up work is just test this foot to see how it moves. 56 00:04:21,108 --> 00:04:27,956 I move to end range and feel if there's a jamming in the front or if there's more tightness in the posterior compartment, 57 00:04:27,987 --> 00:04:30,339 the gastroc and soleus that's preventing it. 58 00:04:30,459 --> 00:04:33,043 The in range feel will tell you a lot. 59 00:04:33,132 --> 00:04:35,747 If it comes to a sudden halt, 60 00:04:35,843 --> 00:04:38,884 then probably it's more of a jamming in the front. 61 00:04:38,971 --> 00:04:39,879 If you keep feeling, 62 00:04:39,910 --> 00:04:44,276 feeling the posterior compartment getting tighter and tighter as you stretch this foot up, 63 00:04:44,348 --> 00:04:49,279 then you're going to know that you're going to want to spend more time on the posterior compartment lengthening that. 64 00:04:49,660 --> 00:04:52,560 So let's just open up the front of this joint right now. 65 00:04:55,180 --> 00:04:56,803 If you're working with someone else, 66 00:04:56,851 --> 00:04:59,899 please feel free at any time to stop this tape and work on. 67 00:05:00,080 --> 00:05:02,279 And work on the small little segments I'm working with. 68 00:05:02,319 --> 00:05:04,264 I do want to get some continuity here, 69 00:05:04,352 --> 00:05:06,740 so I'll be working for a longer time period. 70 00:05:07,919 --> 00:05:11,448 Dina's foot plantar flexes very easily. 71 00:05:11,544 --> 00:05:14,359 She's a swimmer and her foot is very often in this position. 72 00:05:14,480 --> 00:05:19,768 So I don't need a lot of work to lengthen this area to enable her foot to come down. 73 00:05:19,824 --> 00:05:20,327 Other people, 74 00:05:20,384 --> 00:05:21,559 when they lie on the table, 75 00:05:21,640 --> 00:05:23,384 their foot may be resting like this. 76 00:05:23,472 --> 00:05:24,056 In that case, 77 00:05:24,128 --> 00:05:27,666 then you need to determine where is the shortness here. 78 00:05:27,768 --> 00:05:31,053 Pull this foot down and you may feel it along the ankle joint, 79 00:05:31,102 --> 00:05:33,649 you may feel it all the way up to the knee. 80 00:05:34,869 --> 00:05:39,566 So I'm just going to do some nice warm up strokes in this area and I'm also going to consider, 81 00:05:39,718 --> 00:05:42,878 do I want to create mobility of the foot to turn in, 82 00:05:43,014 --> 00:05:43,950 to turn out, 83 00:05:44,070 --> 00:05:45,549 to rotate in which direction? 84 00:05:45,630 --> 00:05:49,469 So I'm always moving this foot and feeling where are the restrictions to movement? 85 00:05:49,549 --> 00:05:53,729 How can I improve function to this foot by doing some strokes? 86 00:06:02,509 --> 00:06:14,373 Let's look at the lower leg and the ankle and foot function to give you a little better idea about the importance of understanding how to free bones in the foot so that you have better function of the ankle. 87 00:06:14,501 --> 00:06:16,489 So as we go down the tibia, 88 00:06:16,989 --> 00:06:22,730 we notice that it articulates in the front right here with a bone called the talus bone, 89 00:06:22,810 --> 00:06:24,189 which I just mentioned. 90 00:06:24,609 --> 00:06:39,465 So the talus bone is extremely important in that it rotates on an axis that is going through just about where this little pin is and enables the foot to plantar flex and dorsiflex. 91 00:06:39,658 --> 00:06:44,950 But the talus bone also sits upon the calcaneus bone right here. 92 00:06:49,099 --> 00:06:53,603 So if on the outer side of your leg you have a lot of fascial tightness, 93 00:06:53,731 --> 00:06:57,908 or if you have a compromised ankle from a sprain, 94 00:06:58,004 --> 00:07:09,300 you can see how the relationship of the calcaneus is going to influence how this talus bone rests and articulates with the tibia. 95 00:07:09,379 --> 00:07:13,539 So this is just important things to think about when you're working with the feet, 96 00:07:13,620 --> 00:07:15,348 that you're not just squeezing tissue, 97 00:07:15,443 --> 00:07:16,852 you're going to work with these bones. 98 00:07:16,915 --> 00:07:18,768 How do I get better function? 99 00:07:18,864 --> 00:07:24,096 Is there a lot of fibrous issue in here that's built up that's preventing this from moving? 100 00:07:24,207 --> 00:07:26,223 These are things we want you to consider. 101 00:07:26,391 --> 00:07:30,463 And then when you come out to the next bone in front of the calcaneus, 102 00:07:30,512 --> 00:07:32,496 we've got the cuboid bone, 103 00:07:32,608 --> 00:07:37,663 somebody that's got a very high arch and this bone is rotated this way, 104 00:07:37,831 --> 00:07:43,695 you may want to work with noticing that the plane of articulation is right along this way. 105 00:07:43,768 --> 00:07:48,894 You may want to work by grabbing this bone and rotating it and just freeing it a little bit. 106 00:07:49,062 --> 00:07:55,213 So do study the bones of the feet and try to have a game plan when you're working on your foot. 107 00:07:55,301 --> 00:08:06,973 Do we need to provide more mobility for this medial arch in here so that the navicular bone can actually rotate and these bones, 108 00:08:07,102 --> 00:08:12,713 metatarsals can move in a little bit and have a little lower arch so that we have better balance these. 109 00:08:12,741 --> 00:08:18,310 These are things that you want to start thinking about with the feet so that you're not just squeezing tissue. 110 00:08:20,969 --> 00:08:22,722 The ankle retinaculum. 111 00:08:22,866 --> 00:08:31,789 It is important to work with this ribbon like band that holds the tendons of the leg muscles in place so that they can slide freely and move the foot. 112 00:08:35,370 --> 00:08:40,021 So now I'm just going to sink right in to this retinaculum, 113 00:08:40,165 --> 00:08:44,090 start the foot in a shortened position and do an anchor and stretch. 114 00:08:45,469 --> 00:08:57,590 This is a nice broad stroke and I'm going to work up her tibialis anterior a little ways so that I can get some continuity between these body parts here. 115 00:08:57,710 --> 00:09:00,409 I always try to work across joints. 116 00:09:02,430 --> 00:09:04,406 This might be enough for somebody right there. 117 00:09:04,478 --> 00:09:11,030 This may have a lot more direction than just squeezing tissue like you would with a beginning mass massage. 118 00:09:11,449 --> 00:09:14,834 If I feel specific fibrous restrictions in this, 119 00:09:14,921 --> 00:09:18,497 I can then stand up, 120 00:09:18,553 --> 00:09:24,882 use my body weight and sink into this area and do much more specific work. 121 00:09:25,065 --> 00:09:25,601 Again, 122 00:09:25,706 --> 00:09:29,281 I'm forever trying to find out where's the restriction, 123 00:09:29,346 --> 00:09:31,709 how can I improve mobility of this foot? 124 00:09:39,060 --> 00:09:44,480 I can use my fingers to just stroke this way and go cross fiber on this retinaculum. 125 00:09:50,100 --> 00:09:53,612 Because I do feel some tightness in Dina's calf, 126 00:09:53,755 --> 00:09:56,348 I'm going to work a little bit on the posterior compartment. 127 00:09:56,444 --> 00:09:59,500 One of the advantages of working on the calf muscles. 128 00:10:00,400 --> 00:10:21,739 When a client is lying supine is that you can manipulate with your shoulder this foot into dorsiflexion and flex it and then work with sort of a milking stroke to stretch this muscle. 129 00:10:22,559 --> 00:10:25,815 Don't be limited to always working on the up surface. 130 00:10:25,928 --> 00:10:31,608 The down surface is often a very good surface to work on all through the body. 131 00:10:31,743 --> 00:10:33,463 Those muscles are nice and relaxed. 132 00:10:33,512 --> 00:10:38,968 You don't have to work very hard because they're just going to provide most of the impetus themselves with their own gravity. 133 00:10:39,143 --> 00:10:42,179 And as I anchor on any tight places here, 134 00:10:44,640 --> 00:10:46,100 I'll just push forward. 135 00:10:52,409 --> 00:10:56,130 Notice that I don't limit myself to just working on the foot. 136 00:10:56,250 --> 00:10:57,649 Everything is connected. 137 00:10:57,810 --> 00:10:59,985 Don't feel like you're just going to work on the foot. 138 00:11:00,057 --> 00:11:01,185 You're done with that foot, 139 00:11:01,258 --> 00:11:02,578 then you move up the leg, 140 00:11:02,713 --> 00:11:03,921 try to connect everything. 141 00:11:04,025 --> 00:11:09,870 Sometimes I'll go clear across the knee joint when I'm working to get this feeling connection all the way up the body. 142 00:11:17,930 --> 00:11:22,831 The plantar surface of the foot is an excellent area to work for stretching tissue. 143 00:11:22,986 --> 00:11:25,364 Dina has a rather flat foot, 144 00:11:25,451 --> 00:11:29,987 so I'm going to be careful that I don't try to stretch along the medial arch here. 145 00:11:30,043 --> 00:11:33,331 Her foot turns in fairly easily anyway. 146 00:11:33,396 --> 00:11:35,796 This would be a hypermobility issue, 147 00:11:35,947 --> 00:11:39,075 and I want to be careful to not accentuate that. 148 00:11:39,227 --> 00:11:46,980 But these muscles and this fascia will be strained from the everyday standing and walking and athletic activities that she does. 149 00:11:47,099 --> 00:11:52,349 So I can possibly work a little more cross fiber on these to solve soften that fibrousness. 150 00:11:52,430 --> 00:11:58,701 But I want to be careful not to lengthen them on the other side with somebody with fairly flat feet. 151 00:11:58,846 --> 00:12:03,870 If you can mobilize the lateral arch clear here on the outside, 152 00:12:03,989 --> 00:12:13,038 then that can create some mobility so that all that strain when her foot lands is not transmitted to the medial where we get all these rotational issues. 153 00:12:13,174 --> 00:12:20,599 So I'm actually going to work on Dina's lateral arch here and get some mobility there. 154 00:12:22,180 --> 00:12:36,683 Just using a nice soft knuckle for somebody with a very high arch and lack of mobility, 155 00:12:36,812 --> 00:12:38,699 Then you could do anything you wanted here. 156 00:12:38,740 --> 00:12:45,701 You could move to the inside and start working with that medial arch. 157 00:12:45,846 --> 00:12:49,686 You can also increase the function of the transverse arch here. 158 00:12:49,758 --> 00:12:53,237 All I need to do is put stretch here, 159 00:12:53,373 --> 00:12:58,849 maybe even stretch the ankle a little bit and work along the transverse arch here. 160 00:13:10,360 --> 00:13:12,271 I'm showing a lot of strokes here. 161 00:13:12,376 --> 00:13:14,383 You might actually be working this way, 162 00:13:14,472 --> 00:13:18,800 although only a fraction of these would be enough to increase the function of the foot. 163 00:13:18,840 --> 00:13:20,240 And the next time the person comes back, 164 00:13:20,280 --> 00:13:21,792 you work a little bit differently. 165 00:13:21,936 --> 00:13:30,848 I very often will take my other hand underneath the calcaneus and try to mobilize it internally or externally or lateral or medial, 166 00:13:31,024 --> 00:13:33,180 and possibly even stretch it. 167 00:13:42,289 --> 00:13:45,129 I'm going to show you one other way to work on the bottom of the foot. 168 00:13:45,169 --> 00:13:46,138 That feels very, 169 00:13:46,193 --> 00:13:47,066 very good for your client, 170 00:13:47,098 --> 00:13:50,469 and that is just have them lift their knee up, 171 00:13:51,169 --> 00:13:53,830 have the foot sitting flat on the table like this, 172 00:13:54,930 --> 00:13:58,521 and then take your hand underneath and do any kind of strokes you want to do. 173 00:13:58,545 --> 00:14:01,430 You'll get a nice soft surface with your fingers here. 174 00:14:03,449 --> 00:14:04,466 At the same time, 175 00:14:04,538 --> 00:14:07,122 you can be mobilizing the foot one way or another. 176 00:14:07,225 --> 00:14:10,370 The main thing is you're not just squeezing tissue in the foot. 177 00:14:10,490 --> 00:14:12,210 You are increasing mobility. 178 00:14:12,370 --> 00:14:14,514 You're getting all these bones moving. 179 00:14:14,562 --> 00:14:18,338 I'm very often thinking about the bones in the foot. 180 00:14:18,394 --> 00:14:20,146 How do they articulate with each other? 181 00:14:20,218 --> 00:14:21,954 How can I mobilize them? 182 00:14:22,122 --> 00:14:25,149 So I'm very often moving bones around here. 183 00:14:26,819 --> 00:14:30,315 I can actually do a snowplow by curving my fingers slightly, 184 00:14:30,427 --> 00:14:35,639 anchoring the foot and pushing toward the calcaneus here. 185 00:14:38,660 --> 00:14:44,204 We'll go into more detail on the bottom of the foot when we talk about plantar fasciitis in the injuries. 186 00:15:01,520 --> 00:15:10,855 The front of the shin or the tibia is another area that is sometimes neglected by early massage students because of the bony surface of the tibia. 187 00:15:10,887 --> 00:15:13,912 It just feels like it's pretty vulnerable, 188 00:15:13,976 --> 00:15:16,679 but it's also an area that really gets bound up. 189 00:15:16,719 --> 00:15:21,879 The fascia here and the superficial muscles can get very, 190 00:15:21,920 --> 00:15:25,175 very caught up with the tibia here and bound there. 191 00:15:25,248 --> 00:15:27,974 So I like to do a lot of work on the front of the shin. 192 00:15:28,111 --> 00:15:28,570 Clients, 193 00:15:28,649 --> 00:15:29,370 when they stand up, 194 00:15:29,410 --> 00:15:30,681 can feel a lot of difference. 195 00:15:30,745 --> 00:15:33,497 So this is a great one to be using nice soft fingers. 196 00:15:33,594 --> 00:15:42,042 And I'm just thinking about maybe an eighth of an inch down that I'm taking all this fascia and this skin and I'm just lengthening it and softening it. 197 00:15:42,225 --> 00:15:43,625 I can work about this speed. 198 00:15:43,658 --> 00:15:45,909 You don't have to work quite so slowly there. 199 00:15:48,609 --> 00:15:52,073 A lot of people after massage have never even been touched on this area. 200 00:15:52,161 --> 00:15:54,545 If you want to use a nice soft surface, 201 00:15:54,578 --> 00:15:59,490 you can just get on the inside of your arm here with your hand rotated this way. 202 00:15:59,530 --> 00:16:03,549 So you're using the fleshy surface and just work on up. 203 00:16:14,409 --> 00:16:14,882 Of course, 204 00:16:14,906 --> 00:16:23,980 the tibialis anterior is probably the most important muscle on the front of the shining the tibialis anterior muscle. 205 00:16:24,140 --> 00:16:26,540 This muscle is often tight and fibrous, 206 00:16:26,620 --> 00:16:34,524 but it is important to determine whether it is short or long in its tightness so that you can determine whether to place the muscle on a stretch. 207 00:16:34,572 --> 00:16:40,203 When working with dorsiflexes the foot, 208 00:16:40,371 --> 00:16:41,628 most people know about that. 209 00:16:41,683 --> 00:16:47,430 So somebody that's foot is needing to often raise up, 210 00:16:47,469 --> 00:16:49,189 such as a bicyclist or something like this, 211 00:16:49,230 --> 00:16:50,757 when they're pulling up on the pedal, 212 00:16:50,853 --> 00:16:52,629 then this muscle can get overworked. 213 00:16:52,709 --> 00:16:57,846 But the other issue I want to talk about with the tibialis anterior is that as it travels down, 214 00:16:57,918 --> 00:16:59,686 goes underneath the retinaculum here, 215 00:16:59,757 --> 00:17:02,501 it actually connects to the medial arch of the foot, 216 00:17:02,605 --> 00:17:08,421 and it's what holds the stability of this medial arch so that it doesn't rotate too much. 217 00:17:08,526 --> 00:17:10,310 So somebody with a very, 218 00:17:10,349 --> 00:17:11,574 very flat foot, 219 00:17:11,662 --> 00:17:11,801 you, 220 00:17:11,816 --> 00:17:17,717 you're not going to want to lengthen this too much because you want to have that shortness to hold this foot up on the other side. 221 00:17:17,854 --> 00:17:18,389 However, 222 00:17:18,509 --> 00:17:19,990 this muscle may be very, 223 00:17:20,030 --> 00:17:21,050 very tight. 224 00:17:22,590 --> 00:17:26,566 So what you would want to do is rather than stretching the muscle, 225 00:17:26,758 --> 00:17:30,610 work on it in a shortened position instead of pulling the foot down. 226 00:17:31,469 --> 00:17:36,930 So now let's go back to some of the earlier strokes I've demonstrated and return to lengthening this area. 227 00:17:37,319 --> 00:17:42,419 So the first stroke might be the anchor and stretch. 228 00:17:43,080 --> 00:17:46,020 So I'm moving this Tissue in the opposite direction. 229 00:17:50,599 --> 00:17:55,632 You'll notice some people that really have a lot of problem pulling their foot up. 230 00:17:55,735 --> 00:17:57,312 And there's sort of a jerkiness there. 231 00:17:57,336 --> 00:18:00,415 I mentioned this earlier in the previous fundamentals tapes. 232 00:18:00,527 --> 00:18:13,340 And you may want to actually facilitate shortening by moving the leg in this direction so that these muscles can be helped out by you in a shortening direction as well. 233 00:18:15,080 --> 00:18:17,168 If you want to do a lengthening direction, 234 00:18:17,264 --> 00:18:25,780 all you need to do is come above and facilitate that lengthening by moving in that direction. 235 00:18:28,280 --> 00:18:30,304 Notice that my fist is nice and soft. 236 00:18:30,352 --> 00:18:31,740 There's a lot of play here. 237 00:18:39,169 --> 00:18:40,954 It's a very important muscle. 238 00:18:41,002 --> 00:18:43,177 Don't forget to work the tibialis anterior. 239 00:18:43,274 --> 00:18:45,337 Let's show some other strokes on the near leg. 240 00:18:45,394 --> 00:18:45,990 Now, 241 00:18:46,930 --> 00:18:49,385 these have been fairly broad strokes I've been showing. 242 00:18:49,497 --> 00:18:56,665 And sometimes you can feel that this tibialis anterior is rotated medially and really bound up to the tibia here. 243 00:18:56,737 --> 00:19:01,864 There's very little freedom between the tibia and the tibialis anterior. 244 00:19:01,991 --> 00:19:02,936 So on that, 245 00:19:03,087 --> 00:19:06,087 I will just take my knuckles here and you can use the soft part, 246 00:19:06,144 --> 00:19:07,895 or depending on their sensitivity, 247 00:19:07,927 --> 00:19:12,168 you can use more and more of the little sharper part of the knuckle. 248 00:19:12,264 --> 00:19:13,719 And you can do some very, 249 00:19:13,759 --> 00:19:16,980 very precise work moving up the leg here. 250 00:19:19,759 --> 00:19:21,879 It doesn't always have to be in a straight line. 251 00:19:22,000 --> 00:19:25,800 You can take your hand and get rotational work like you would with a thumb. 252 00:19:25,879 --> 00:19:26,101 And. 253 00:19:26,136 --> 00:19:28,442 And yet you can see the mechanics are very easy here. 254 00:19:28,545 --> 00:19:30,458 I'm keeping my wrist in a neutral position, 255 00:19:30,514 --> 00:19:34,269 and most of the turning is coming from my whole body and my shoulder. 256 00:19:41,250 --> 00:19:42,810 Another tool that you can use, 257 00:19:42,850 --> 00:19:51,482 if you're coming up here with somebody that's got a fairly good pain threshold and is nice and relaxed so you're not feeling them flinch, 258 00:19:51,545 --> 00:19:54,994 is the elbow is a wonderful tool to work on the front of the leg. 259 00:19:55,081 --> 00:19:58,098 All you do is you want to be sure that you're not sliding off, 260 00:19:58,153 --> 00:19:59,850 because there's a lot of issues. 261 00:20:00,480 --> 00:20:06,264 Here of this muscle rotating and along the longitudinal axis here. 262 00:20:06,352 --> 00:20:27,730 So you just take your thumb and your hand and create a little area that you can put your elbow in and then work on up every once in a while. 263 00:20:27,769 --> 00:20:29,329 No matter what I'm doing on the tibia, 264 00:20:29,410 --> 00:20:31,074 I try to go over the knee joint, 265 00:20:31,121 --> 00:20:33,310 at least to connect this area here, 266 00:20:34,570 --> 00:20:40,429 and then contact the back of the leg so that we're not always just working on the front. 267 00:20:43,450 --> 00:20:46,509 This gives the person a little respite from all this deep work. 268 00:21:10,500 --> 00:21:13,599 The gastrocnemius muscle and Achilles tendon. 269 00:21:14,019 --> 00:21:20,713 A tight gastrocnemius muscle can cause strain upon the Achilles tendon and be associated with Achilles tendonitis. 270 00:21:20,852 --> 00:21:26,930 Do take care to notice if the lateral or medial head of the gastrocnemius is causing more strain. 271 00:21:29,109 --> 00:21:33,069 Working on the posterior compartment of the lower leg or the calf muscles, 272 00:21:33,230 --> 00:21:38,109 the prone position is by far the most expedient way to accomplish this. 273 00:21:38,230 --> 00:21:40,382 One thing I've started with here, 274 00:21:40,406 --> 00:21:42,510 if you take a look at this bolster, 275 00:21:42,590 --> 00:21:47,902 is this is the usual position that people are working on, 276 00:21:47,926 --> 00:21:49,390 the posterior compartment. 277 00:21:49,469 --> 00:21:51,950 And certainly when you're not working on this area, 278 00:21:51,989 --> 00:21:54,858 this is a very good idea to have a bolster here. 279 00:21:54,914 --> 00:22:02,189 But I do want you to notice as you move up the leg and show the transition of the gastrocnemius over the knee, 280 00:22:02,609 --> 00:22:05,034 that this muscle is going to be shortened. 281 00:22:05,081 --> 00:22:10,201 I'm not going to be getting as much of a stretch as I would if the knee were fully extended. 282 00:22:10,346 --> 00:22:11,449 So for this reason, 283 00:22:11,569 --> 00:22:18,842 I'm going to demonstrate the posterior calf work with Dina's foot off the table so she has slid down off the face rest. 284 00:22:18,945 --> 00:22:25,189 I think you'll find that if you allow yourself the freedom to ask your clients to move a cage occasionally, 285 00:22:25,349 --> 00:22:27,574 you'll get a much more functional massage. 286 00:22:27,701 --> 00:22:28,598 In reality, 287 00:22:28,693 --> 00:22:36,774 I might leave Dina into the face rest in the prone position and just move her leg off the table a little bit so that I can get some stretch here. 288 00:22:36,861 --> 00:22:38,289 But in this position, 289 00:22:38,590 --> 00:22:41,909 I'm not going to be able to show the work as well because my body would get in the way. 290 00:22:41,949 --> 00:22:45,090 So I'm going to move her back to her foot hanging over the table here. 291 00:22:46,990 --> 00:22:52,740 First thing that I want to cover is that when you're putting your lotion on, 292 00:22:54,879 --> 00:22:59,687 you're not just going to be slathering the lotion on without thinking. 293 00:22:59,783 --> 00:23:02,792 I immediately start evaluating this leg, 294 00:23:02,895 --> 00:23:04,872 seeing where the strain patterns are. 295 00:23:04,975 --> 00:23:11,144 Dina is fairly even because she has a fairly low arch and a lot of shock goes up the inside. 296 00:23:11,192 --> 00:23:17,783 I feel a little bit of tension Right along the medial head of the gastroc more than on the lateral head. 297 00:23:17,872 --> 00:23:23,907 A lot of people with high arches or runners are going to have much more tension on the lateral head of the gastroc. 298 00:23:24,003 --> 00:23:26,836 And so you want to be deciding where do you want to put your work in? 299 00:23:26,907 --> 00:23:28,211 If you need precise, 300 00:23:28,276 --> 00:23:29,171 focused work, 301 00:23:29,276 --> 00:23:34,319 you don't want to be giving the same amount to the medial head of the gastroc as the lateral head. 302 00:23:35,259 --> 00:23:41,764 Sometimes even a few separation strokes that we've talked about where you're separating muscle compartments, 303 00:23:41,812 --> 00:23:47,159 you may want to take your fingers and just sort of get a little clarity between these two heads. 304 00:23:56,469 --> 00:23:57,533 After your kneading, 305 00:23:57,581 --> 00:24:02,062 work your effleurage moving into a little deeper level. 306 00:24:02,165 --> 00:24:07,449 I'm going to come into my forearm and work up this way. 307 00:24:07,909 --> 00:24:09,966 Notice that my wrist is nice and relaxed. 308 00:24:09,997 --> 00:24:12,062 If I have my wrist up tight or my fist, 309 00:24:12,205 --> 00:24:14,990 that's going to transmit to her with a different fist feeling. 310 00:24:19,649 --> 00:24:19,961 Now, 311 00:24:19,985 --> 00:24:28,298 the advantage to having Dina's foot over the edge of the table and her knee fully extended is that I can stretch this gastroc all the way down. 312 00:24:28,434 --> 00:24:30,793 So what I want to do is to free up both hands. 313 00:24:30,841 --> 00:24:37,194 I'm going to stand and put my knee right on the front aspect of Dina's foot, 314 00:24:37,281 --> 00:24:38,954 and I can stretch this. 315 00:24:39,122 --> 00:24:42,810 So now I can work on this in a stretched position and. 316 00:24:42,850 --> 00:24:46,538 And try to affect a release of that muscle rather than just a softening. 317 00:24:46,634 --> 00:24:50,970 I may want to do a raking stroke so I'll get clear at the top. 318 00:24:51,009 --> 00:24:56,970 So now I'm facilitating a stretch by moving the same direction so I'm raking toward myself. 319 00:24:57,129 --> 00:24:59,730 I'm just leaning into this with my body weight and. 320 00:25:00,320 --> 00:25:03,060 Sort of pulling my body back at the same time. 321 00:25:03,600 --> 00:25:05,900 I'm not doing all this work with my arm. 322 00:25:27,280 --> 00:25:34,631 One of the strokes we described in the fundamentals tapes was how to free muscles from adhesions and restrictions to deeper structures and even bones. 323 00:25:34,776 --> 00:25:38,119 These restrictions can impede the proper function of muscles and joints. 324 00:25:38,200 --> 00:25:41,335 So what I'm going to do now is just going to grab this gastroc, 325 00:25:41,448 --> 00:25:43,640 lift it away from the bone, 326 00:25:43,799 --> 00:25:45,143 and roll it. 327 00:25:45,311 --> 00:25:45,975 And remember, 328 00:25:46,008 --> 00:25:46,584 when you're rolling, 329 00:25:46,631 --> 00:25:48,183 you're not just going to go back and forth. 330 00:25:48,231 --> 00:25:52,856 What you're trying to do is to really free the end range of mobility here. 331 00:25:52,927 --> 00:25:54,487 So as I come near the end here, 332 00:25:54,543 --> 00:25:54,792 I'm. 333 00:25:54,805 --> 00:25:57,043 I'm really trying to roll this muscle around the bone. 334 00:25:57,091 --> 00:26:00,212 I'm not rolling the bone as I come to the end, 335 00:26:00,235 --> 00:26:02,948 then I'm just going to wait and wait for this to soften. 336 00:26:03,043 --> 00:26:05,587 And you'll feel that muscle melt and relax. 337 00:26:05,683 --> 00:26:07,640 And then you can roll it a little farther. 338 00:26:08,540 --> 00:26:13,299 You can take your hands and just lift the muscle off the leg here and move it up and down. 339 00:26:13,340 --> 00:26:15,719 It's supposed to be able to slide along that bone, 340 00:26:17,260 --> 00:26:18,884 get a hold a little bit further down. 341 00:26:18,971 --> 00:26:21,939 And I can feel her soleus right down at the tips of my fingers. 342 00:26:22,019 --> 00:26:23,640 It's a little bit tight here. 343 00:26:29,459 --> 00:26:31,799 After I've done some fairly intense work, 344 00:26:32,500 --> 00:26:35,243 then I swing out to a little bit broader, 345 00:26:35,292 --> 00:26:37,932 integrative strokes and maybe even cross the knee joint here. 346 00:26:37,956 --> 00:26:38,203 Remember, 347 00:26:38,251 --> 00:26:40,400 the gastroc does cross the knee joint. 348 00:26:45,700 --> 00:26:48,049 So if I want to isolate the soleus, 349 00:26:48,180 --> 00:26:51,010 all I need to do is lift the leg up. 350 00:26:51,549 --> 00:26:55,206 Then the gastroc becomes nice and loose because of this angle here. 351 00:26:55,358 --> 00:26:59,189 And I can isolate the soleus first. 352 00:26:59,230 --> 00:27:01,926 I'll just leave it in a fairly shortened position to work on it. 353 00:27:01,998 --> 00:27:03,445 I'm going to sink through this nice, 354 00:27:03,477 --> 00:27:06,170 soft gastroc now with my fingers, 355 00:27:11,550 --> 00:27:12,229 just feel. 356 00:27:12,270 --> 00:27:13,222 Wherever there's tension, 357 00:27:13,286 --> 00:27:14,449 I can roll it. 358 00:27:22,449 --> 00:27:31,114 And then I can just put the forefoot underneath my axilla or armpit here and stretch that soleus. 359 00:27:31,162 --> 00:27:31,322 Now, 360 00:27:31,346 --> 00:27:33,657 I've already done some softening in a shortened position, 361 00:27:33,794 --> 00:27:35,210 so now I can stretch it. 362 00:27:35,330 --> 00:27:37,306 And way back in the Fundamentals video, 363 00:27:37,377 --> 00:27:41,469 you remember sinking through the gastrocnemius to palpate the soleus. 364 00:27:42,370 --> 00:27:46,710 I'm just going right through the gastroc with both my fingers like this, 365 00:27:48,210 --> 00:27:54,349 finding tension in that soleus and then anchoring there and stretching away from that tendon. 366 00:27:57,729 --> 00:27:58,681 Farther up I go, 367 00:27:58,705 --> 00:28:00,509 I get into the belly of the muscle. 368 00:28:14,750 --> 00:28:17,770 I want to spend a little time on the Achilles tendon. 369 00:28:18,430 --> 00:28:22,069 A lot of early massage classes Only focus on the belly of the muscle. 370 00:28:22,150 --> 00:28:25,090 And if you can free this Achilles tendon to move, 371 00:28:26,030 --> 00:28:27,126 to be flexible, 372 00:28:27,237 --> 00:28:28,837 you'll be doing a big service, 373 00:28:28,894 --> 00:28:30,389 particularly to athletes. 374 00:28:30,550 --> 00:28:35,270 So I'm going to keep my knuckle on this side so you can see what my hand looks like. 375 00:28:35,310 --> 00:28:38,325 But you certainly could come on both sides to work here. 376 00:28:38,397 --> 00:28:38,933 And basically, 377 00:28:38,981 --> 00:28:42,150 I visualize that I'm lifting this Achilles tendon, 378 00:28:42,229 --> 00:28:43,478 I'm mobilizing it. 379 00:28:43,533 --> 00:28:47,759 I can take my hands and work in different directions like this, 380 00:28:48,139 --> 00:28:52,319 and just work my way up the Achilles and try to soften that. 381 00:29:08,699 --> 00:29:10,068 Can use my fingers, 382 00:29:10,163 --> 00:29:12,515 and you can sort of crimp the Achilles if you want. 383 00:29:12,587 --> 00:29:15,469 So I'm going up in one and and down on the other. 384 00:29:18,970 --> 00:29:23,713 What we're doing is we're softening the sheath that surrounds the Achilles tendon right here. 385 00:29:23,882 --> 00:29:26,050 And then I would just reverse the direction. 386 00:29:26,209 --> 00:29:27,745 Any place I feel tension, 387 00:29:27,858 --> 00:29:28,641 I sink in there, 388 00:29:28,665 --> 00:29:30,430 and I wait and I slow down. 389 00:29:36,889 --> 00:29:39,790 And then we work down to the plantar surface of the foot again. 390 00:29:40,089 --> 00:29:51,982 I just want to demonstrate proper use of body mechanics that I'm going to be getting my body far enough away that my elbow is straight and I can lean right into this foot. 391 00:29:52,086 --> 00:29:55,918 Any of the things that we did in the supine position you can do here. 392 00:29:55,973 --> 00:29:57,422 You can flex the foot, 393 00:29:57,605 --> 00:29:59,509 you can rotate the foot one way or another. 394 00:30:00,080 --> 00:30:02,839 And just find strain patterns and work on that. 395 00:30:02,960 --> 00:30:03,192 Now, 396 00:30:03,216 --> 00:30:04,280 if you prefer, 397 00:30:04,360 --> 00:30:07,000 rather than getting farther back with your chair, 398 00:30:07,040 --> 00:30:08,231 as I'm doing here, 399 00:30:08,416 --> 00:30:09,939 you just slide forward, 400 00:30:10,720 --> 00:30:13,380 anchor that elbow against your own body, 401 00:30:13,759 --> 00:30:17,207 and then as you lean forward with your own body weight, 402 00:30:17,303 --> 00:30:20,312 that's going to provide the force for you. 403 00:30:20,416 --> 00:30:21,608 I actually prefer this. 404 00:30:21,664 --> 00:30:23,928 It's a little bit easier for you. 405 00:30:23,984 --> 00:30:26,019 Your lever arm isn't quite as long. 406 00:30:29,309 --> 00:30:32,646 Don't forget to work on the foot in the prone position. 407 00:30:32,798 --> 00:30:37,878 It affords all sorts of mobility and flexion potential here. 408 00:30:37,933 --> 00:30:41,990 And you can grab the Achilles and the calcaneus here, 409 00:30:42,109 --> 00:30:44,981 and you can start mobilizing that this way and that. 410 00:30:45,085 --> 00:30:45,942 And of course, 411 00:30:46,045 --> 00:30:47,686 you do this a little bit more slowly. 412 00:30:47,718 --> 00:30:50,341 I'm trying to show you a lot of strokes in a short time period, 413 00:30:50,445 --> 00:30:56,295 But I can grab this calcaneus and I can rotate it medially, 414 00:30:56,408 --> 00:30:58,392 or if I feel it's too far medial, 415 00:30:58,456 --> 00:31:04,659 I can then just take my thumbs and rotate it laterally wherever I feel tension here. 416 00:31:10,799 --> 00:31:25,126 You can drastically alter the way your client's foot plant and tensions patterns move up their body by mobilizing this foot so that it acts as a shock absorber. 417 00:31:25,317 --> 00:31:28,450 So it's excellent work to free up this foot. 418 00:31:42,909 --> 00:31:44,555 The quadriceps muscles. 419 00:31:44,718 --> 00:31:54,099 Notice that the rectus femoris is the only quadriceps muscle that crosses the hip joint and is important for hip flexion along with the psoas muscle. 420 00:31:56,120 --> 00:31:57,471 The supine position is, 421 00:31:57,495 --> 00:31:57,840 of course, 422 00:31:57,879 --> 00:32:05,180 the most expedient way to work on the quadriceps group and hip function and on the knee as well. 423 00:32:05,640 --> 00:32:08,752 So before blindly diving into this area, 424 00:32:08,855 --> 00:32:14,780 I like to evaluate the whole leg and hip and knee function a little bit before I start working. 425 00:32:15,430 --> 00:32:20,610 So one of the first things that I check is external rotation of the hip and internal. 426 00:32:21,110 --> 00:32:24,174 Dina is pretty neutral here. 427 00:32:24,262 --> 00:32:24,909 A lot of people, 428 00:32:24,949 --> 00:32:26,701 their leg will already be rotated out. 429 00:32:26,725 --> 00:32:28,590 They've got plenty of movement to the outside, 430 00:32:28,710 --> 00:32:29,741 and in that case, 431 00:32:29,846 --> 00:32:31,758 you'll see that they're limited on the inside. 432 00:32:31,854 --> 00:32:35,901 So I may at that time hold the knee into an internal rotation. 433 00:32:35,966 --> 00:32:39,581 When I'm working to try to increase this ability for internal rotation, 434 00:32:39,725 --> 00:32:41,870 somebody that's very internally rotated, 435 00:32:41,949 --> 00:32:48,110 I may want to rotate the leg out when I'm working to try to increase its ability to rotate in that direction. 436 00:32:48,449 --> 00:32:53,913 I very often will see where are the blocks to energy running up and down this leg. 437 00:32:54,002 --> 00:32:59,641 I can compress the hip joint and see is that acetabulum free? 438 00:32:59,746 --> 00:33:01,849 Does that femur seem to glide a little bit in there? 439 00:33:01,889 --> 00:33:03,626 Dina's feel is actually pretty good. 440 00:33:03,698 --> 00:33:04,969 And Then I'll pull it out. 441 00:33:05,090 --> 00:33:07,481 And are there joint issues? 442 00:33:07,586 --> 00:33:11,466 Are there soft tissue issues that are compressing this joint? 443 00:33:11,657 --> 00:33:15,026 Dina's moves up a little more easily than it moves down. 444 00:33:15,098 --> 00:33:23,762 Some of this fascia and the tensor fasciae latae muscle and all of this are a little bit short in preventing this femur from dropping out here. 445 00:33:23,866 --> 00:33:29,710 The main thing is you don't want to just start massaging this area without having a plan. 446 00:33:30,969 --> 00:33:31,425 Generally, 447 00:33:31,457 --> 00:33:33,394 I start with fairly broad strokes, 448 00:33:33,442 --> 00:33:39,427 and I think that the best tool that I can use on the quadriceps group is the forearm. 449 00:33:39,514 --> 00:33:40,975 Elbow is going to be a little bit too sharp, 450 00:33:41,008 --> 00:33:42,448 and it will be rolling like this. 451 00:33:42,503 --> 00:33:50,740 So I just start with a nice fleshy part of my forearm and do some nice long strokes. 452 00:33:51,800 --> 00:33:52,352 Again, 453 00:33:52,455 --> 00:33:58,927 I may want to rotate this femur with my other hand and move in a diagonal as I'm going up, 454 00:33:58,984 --> 00:34:00,939 rather than just going straight up. 455 00:34:01,479 --> 00:34:10,620 This is the difference that will make you stand out to your clients when you start working with direction and purpose. 456 00:34:14,240 --> 00:34:17,255 Dina's IT band here is a little bit tight, 457 00:34:17,367 --> 00:34:19,379 so this is going to be good work for her. 458 00:34:21,040 --> 00:34:25,175 If I have areas that want a little more specificity than the forearm, 459 00:34:25,288 --> 00:34:26,968 then I may switch to the fist. 460 00:34:27,064 --> 00:34:29,300 And the fist works excellently here. 461 00:34:29,600 --> 00:34:30,120 Remember, 462 00:34:30,199 --> 00:34:33,536 don't spend your time doing huge long strokes. 463 00:34:33,687 --> 00:34:37,220 If only 2 or 3 inches of the muscle, 464 00:34:37,800 --> 00:34:39,300 have the fibrousness, 465 00:34:40,279 --> 00:34:41,872 go to where the tension is. 466 00:34:41,975 --> 00:34:44,100 Don't be perfunctory in your strokes. 467 00:34:50,920 --> 00:34:54,096 I may want to do some of the work that we've talked about, 468 00:34:54,168 --> 00:34:56,336 freeing the quadriceps from the femur, 469 00:34:56,447 --> 00:34:58,208 so I may grab it, 470 00:34:58,343 --> 00:34:59,759 lift it up from the bone. 471 00:35:01,280 --> 00:35:02,343 Do some ringing, 472 00:35:02,472 --> 00:35:03,767 do some up and down, 473 00:35:03,903 --> 00:35:06,139 do some rotation around the bone. 474 00:35:06,879 --> 00:35:07,944 People love this. 475 00:35:08,032 --> 00:35:28,460 You just keep your hands nice and soft and work with freeing this muscle. 476 00:35:33,350 --> 00:35:36,542 The tensor fasciae latae and iliotibial band. 477 00:35:36,686 --> 00:35:39,758 When creating balance and ease in the iliotibial band, 478 00:35:39,853 --> 00:35:50,369 be sure to address both the tensor fasciae latae and the gluteus maximus to equalize pressure between the posterior and anterior placements of these muscles. 479 00:35:53,679 --> 00:35:56,503 Let's talk a little bit about separating muscle compartments. 480 00:35:56,631 --> 00:35:58,439 I think you can see fairly well. 481 00:35:58,560 --> 00:36:01,655 Dina's IT band is fairly well defined here. 482 00:36:01,807 --> 00:36:07,959 One of the first things I do is I see if it seems to be moved more easily toward the front or toward the back. 483 00:36:08,079 --> 00:36:12,664 I feel like Dina's moves toward the front fairly easily. 484 00:36:12,712 --> 00:36:15,031 It's not too bound to the hamstrings group, 485 00:36:15,135 --> 00:36:16,632 but when I pull it down, 486 00:36:16,736 --> 00:36:19,864 I feel a lot of restriction from facial areas here. 487 00:36:19,951 --> 00:36:20,359 And like, 488 00:36:20,400 --> 00:36:23,878 it may be adhered to the vastus lateralis over here. 489 00:36:24,024 --> 00:36:28,829 So I'm going to start working to define that border of the IT band. 490 00:36:32,930 --> 00:36:33,993 As I mentioned, 491 00:36:34,121 --> 00:36:37,481 this is moving very nice and smoothly along the hamstring. 492 00:36:37,546 --> 00:36:38,841 It's not bound very much, 493 00:36:38,945 --> 00:36:41,001 so I'll give a few early cues to that. 494 00:36:41,105 --> 00:36:48,537 And then I'm going to spend most of my time working on the upper surface or the anterior surface of that IT band, 495 00:36:48,634 --> 00:36:53,239 trying to free it from that quadriceps group. 496 00:36:53,780 --> 00:37:02,040 I may grab it with this hand and start pulling the quadriceps away from it and just work all the way up. 497 00:37:06,260 --> 00:37:14,599 I may just get right along that border of vastus lateralis here and just try to separate it here. 498 00:37:15,789 --> 00:37:18,969 This is excellent work for people that have knee problems. 499 00:37:22,430 --> 00:37:25,237 Nice soft hands. 500 00:37:25,334 --> 00:37:27,542 I can work on the knee joint itself. 501 00:37:27,605 --> 00:37:30,449 I'm just feeling where all this fascia is. 502 00:37:30,990 --> 00:37:32,969 Are there any strain patterns? 503 00:37:33,710 --> 00:37:37,370 How can I soften this so that this kneecap can slide easily? 504 00:37:37,710 --> 00:37:40,325 Most kneecap problems with tracking, 505 00:37:40,358 --> 00:37:40,885 in other words, 506 00:37:40,918 --> 00:37:42,449 how it slides up and down. 507 00:37:42,909 --> 00:37:44,406 Probably 75%, 508 00:37:44,478 --> 00:37:47,481 at least the kneecap is pulled too laterally. 509 00:37:47,605 --> 00:37:51,250 It's adhered to these tendons coming down from vastus lateralis. 510 00:37:51,330 --> 00:37:56,129 It's adhered to fibers of the IT band. 511 00:37:56,210 --> 00:37:59,425 And so any work you can do to just grab this kneecap, 512 00:37:59,538 --> 00:38:00,669 slide it over, 513 00:38:01,370 --> 00:38:05,750 and create a little bit of stretching here can be beneficial. 514 00:38:16,819 --> 00:38:19,819 Just plain softening on the IT band is, 515 00:38:19,860 --> 00:38:20,268 of course, 516 00:38:20,324 --> 00:38:20,539 very, 517 00:38:20,580 --> 00:38:21,836 very worthwhile. 518 00:38:22,027 --> 00:38:24,235 If I am going to be using my fist here, 519 00:38:24,307 --> 00:38:30,812 I'm going to have my elbow right against my body so that I'm not muscling all the forces then coming off my feet, 520 00:38:30,876 --> 00:38:37,479 and I just take a nice soft fist and move up this way. 521 00:38:47,150 --> 00:38:53,750 Another popular way of working on the IT band is to bend the leg up here and then rotate it this way. 522 00:38:53,789 --> 00:38:56,069 The more that it's over this way stretched, 523 00:38:56,150 --> 00:38:58,370 you're going to be stretching the IT band here. 524 00:38:59,550 --> 00:39:03,669 And I'll just take a nice soft forearm and work my way down. 525 00:39:03,789 --> 00:39:05,813 If I feel it going one way or another, 526 00:39:05,901 --> 00:39:07,957 I'm just going to do whatever direction I feel. 527 00:39:08,014 --> 00:39:13,180 I'm going to go a little bit of a diagonal this way because I want to free it up here with the upper hamstrings. 528 00:39:14,639 --> 00:39:19,656 The drawback to this is that I am compressing this femur joint here. 529 00:39:19,728 --> 00:39:23,379 So I'm not giving her a cue to have this femur dropping out. 530 00:39:26,480 --> 00:39:28,680 If somebody is quite flexible, 531 00:39:28,839 --> 00:39:33,300 you can actually take their leg on the other side and get more rotation in here. 532 00:39:34,800 --> 00:39:35,512 And this, 533 00:39:35,615 --> 00:39:42,651 the farther up that I go toward the quadriceps group and the tensor fasciae latae, 534 00:39:42,716 --> 00:39:44,839 this will create more stretch here. 535 00:39:47,300 --> 00:39:52,019 I probably am not going to get on this side and push this way because I'll just be rotating her whole body this way. 536 00:40:08,640 --> 00:40:09,592 In the prone position, 537 00:40:09,695 --> 00:40:11,224 most people work on the hamstring. 538 00:40:11,272 --> 00:40:15,160 And I still think it's probably all in all the best way to work on the hamstring. 539 00:40:15,240 --> 00:40:25,448 But I do want to cover our theory of putting muscles in stretched position to affect a release of the muscles so that we're not just softening and squeezing muscle. 540 00:40:25,544 --> 00:40:25,757 For. 541 00:40:25,783 --> 00:40:26,385 For this reason, 542 00:40:26,457 --> 00:40:35,750 I'm going to demonstrate work on Dina's hamstrings when she's in the supine position to show the advantage of body positioning on effecting a stretch. 543 00:40:36,329 --> 00:40:37,426 So as you can imagine, 544 00:40:37,457 --> 00:40:38,642 if she's face down, 545 00:40:38,746 --> 00:40:41,905 all she will get is a neutral length on the hamstrings. 546 00:40:42,018 --> 00:40:42,530 However, 547 00:40:42,649 --> 00:40:43,921 in the supine position, 548 00:40:44,026 --> 00:40:48,258 if I lift Dina's leg up and keep her knee straight, 549 00:40:48,433 --> 00:40:58,237 I can be working on the posterior hamstring back here at the lower edge or end of it and beginning a stretch. 550 00:40:58,414 --> 00:41:00,237 As I feel this muscle release, 551 00:41:00,374 --> 00:41:04,569 I might move my body a little bit closer and move her up even more. 552 00:41:12,629 --> 00:41:16,798 Different people will have stress in their upper hamstring or their lower hamstring. 553 00:41:16,894 --> 00:41:19,150 It depends what kind of activity they're doing. 554 00:41:19,269 --> 00:41:27,626 Somebody that's working on an elliptical stair climber may have a lot of tension in the upper hamstring as it contracts to bring that hip back. 555 00:41:27,778 --> 00:41:32,585 Somebody that's bicycling may have more strain on their lower hamstring. 556 00:41:32,778 --> 00:41:40,489 So another thing you can do is actually bend the leg so that we have a little bit of relaxation of the lower hamstring, 557 00:41:40,569 --> 00:41:42,329 which will enable you to sink in. 558 00:41:42,370 --> 00:41:43,530 I'm using my thumbs here. 559 00:41:43,569 --> 00:41:47,706 You could also use your knuckles or your fingers and you feel where strain patterns are. 560 00:41:47,778 --> 00:41:52,250 Dina has a lot more strain on her medial hamstring than her lateral. 561 00:41:52,329 --> 00:42:02,578 So I'm actually going to take my thumbs and not worry so much about this lateral aspect and move to the inside and anchor that and just see how does this knee, 562 00:42:02,674 --> 00:42:03,506 when it straightens, 563 00:42:03,537 --> 00:42:04,561 how does it work? 564 00:42:04,745 --> 00:42:08,306 Does it work as a straight on hinge or are there a lot of rotational forces? 565 00:42:08,418 --> 00:42:11,153 If I feel my hands pulling one way or another, 566 00:42:11,241 --> 00:42:15,550 then I'm going to counter that strain so that this knee will work in a straight way. 567 00:42:17,289 --> 00:42:22,913 This is again the same type of thing that your clients will notice a difference when they never had their hamstrings worked on this way. 568 00:42:23,002 --> 00:42:24,909 Bicyclists love this work. 569 00:42:25,530 --> 00:42:28,705 So all I'm doing is softening that muscle, 570 00:42:28,818 --> 00:42:32,229 anchoring and then stretching. 571 00:42:34,330 --> 00:42:37,469 If I want to work on the belly of the muscle in a stretched position, 572 00:42:38,490 --> 00:42:40,189 I just need to step back. 573 00:42:40,969 --> 00:42:43,590 Tell Dina to keep her knee relatively straight. 574 00:42:44,889 --> 00:42:47,057 And then with a long lever arm, 575 00:42:47,234 --> 00:42:48,789 just work with my fist. 576 00:43:05,460 --> 00:43:07,099 The lower hamstring, 577 00:43:07,259 --> 00:43:09,948 it's not really that important if I'm going to be focusing. 578 00:43:10,044 --> 00:43:11,996 This would actually be the upper part of her hamstring, 579 00:43:12,027 --> 00:43:12,635 but the lower. 580 00:43:12,668 --> 00:43:14,843 As far as your picture is involved here, 581 00:43:15,012 --> 00:43:15,771 it's okay. 582 00:43:15,836 --> 00:43:23,400 If I bend Dina's knee here so that there's softening in the distal aspect of the hamstring. 583 00:43:23,740 --> 00:43:31,840 I can then come in and do an anchor and stretch by anchoring this hamstring here and stretching away as I move down. 584 00:43:34,219 --> 00:43:35,560 Could use a fist. 585 00:43:40,139 --> 00:43:44,759 And sometimes you'll find a lot of fibrous tissue just distal to the ischial tuberosity. 586 00:43:45,159 --> 00:43:50,379 And that's where you want to get very specific and use your knuckles or your fingers if they're strong enough. 587 00:43:50,840 --> 00:43:52,848 I just find fibrous areas here. 588 00:43:52,903 --> 00:43:54,192 I sink in there, 589 00:43:54,376 --> 00:43:55,807 wait for them to soften, 590 00:43:55,903 --> 00:43:57,780 and get a bit more of a stretch. 591 00:44:08,039 --> 00:44:13,342 You want this hip joint to be working in a straight line like this. 592 00:44:13,445 --> 00:44:13,901 A lot of people, 593 00:44:13,925 --> 00:44:14,413 when you push, 594 00:44:14,461 --> 00:44:16,045 you'll find it goes like this, 595 00:44:16,197 --> 00:44:17,565 or there's a lot of restriction. 596 00:44:17,598 --> 00:44:19,038 You just can't even go over here, 597 00:44:19,093 --> 00:44:22,973 or you'll even find sort of a bunching in the front here. 598 00:44:23,141 --> 00:44:26,446 So I test this joint for function here. 599 00:44:26,598 --> 00:44:28,862 If I have some specific work to do, 600 00:44:28,966 --> 00:44:36,766 I can also have Dina help me out by grabbing her knee so that I can do rotational work with the femur as I'm working here. 601 00:44:36,838 --> 00:44:40,480 So I can take this femur and this tissue, 602 00:44:40,819 --> 00:44:42,360 rotate it this way, 603 00:44:43,939 --> 00:44:47,160 and then work for this hip tracking in a straight line. 604 00:44:55,300 --> 00:44:59,379 This is very good work to do after you've already warmed up the hamstrings in a prone position. 605 00:45:00,160 --> 00:45:02,248 There you can do some non specific work, 606 00:45:02,303 --> 00:45:03,016 soften that, 607 00:45:03,088 --> 00:45:05,432 and then when you've noticed strain patterns when you turn them over, 608 00:45:05,456 --> 00:45:06,280 you can work on this. 609 00:45:06,320 --> 00:45:08,823 You don't need to do all the strokes I'm doing here. 610 00:45:08,912 --> 00:45:12,140 Just focus on whatever area seems to have the most tightness. 611 00:45:25,039 --> 00:45:30,718 Another interesting adjunct you may want to add to your massage strokes are joint mobilization moves. 612 00:45:30,814 --> 00:45:39,369 We talked about this in the fundamentals tape about how to mobilize different vertebra and start thinking about how one joint relates to another. 613 00:45:39,829 --> 00:45:44,781 The hip joint is one of the most locked up joints that people have in their bodies. 614 00:45:44,845 --> 00:45:49,182 And if you can give them some more freedom there by moving it through the range of motion, 615 00:45:49,326 --> 00:45:52,078 rather than just working it in a passive position, 616 00:45:52,213 --> 00:45:54,350 you can really increase their mobility. 617 00:45:54,429 --> 00:45:58,829 So I'm just going to show you a few stretches to do here that are a little bit different from, 618 00:45:58,869 --> 00:45:59,021 say, 619 00:45:59,045 --> 00:45:59,774 yoga stretches. 620 00:45:59,822 --> 00:46:03,950 I'm working with the ligamentous component of that joint articulation. 621 00:46:04,450 --> 00:46:06,950 So if we take a look at Dina's hip here, 622 00:46:07,489 --> 00:46:12,810 we can go through some of the ranges of motion that are involved in hip movement. 623 00:46:12,890 --> 00:46:14,590 This would be hip flexion. 624 00:46:15,250 --> 00:46:16,554 This would be hip extension. 625 00:46:16,602 --> 00:46:16,762 Now, 626 00:46:16,786 --> 00:46:21,593 we're not going to be able to increase extension very much because we're going to just come to neutral here. 627 00:46:21,682 --> 00:46:23,945 So I'm not going to talk about that right now. 628 00:46:24,097 --> 00:46:28,554 But this would be internal rotation of the femur. 629 00:46:28,602 --> 00:46:29,977 You can see it when her leg is down. 630 00:46:30,034 --> 00:46:31,909 Basically it's just running like this. 631 00:46:33,719 --> 00:46:37,168 So this is internal rotation and this is external rotation. 632 00:46:37,263 --> 00:46:40,768 What you can do is with the knee at a right angle here, 633 00:46:40,903 --> 00:46:42,207 if you brace that here, 634 00:46:42,263 --> 00:46:43,951 you can use this as a lever. 635 00:46:44,096 --> 00:46:49,775 So what I do is I move Dina into a position until I feel a rotational component coming in. 636 00:46:49,847 --> 00:46:51,296 As when I move her past here, 637 00:46:51,367 --> 00:46:53,215 her leg wants to externally rotate. 638 00:46:53,328 --> 00:46:57,626 So what I might do is go to her flexion endpoint here. 639 00:46:57,808 --> 00:46:59,477 Keep this knee at a right angle, 640 00:46:59,573 --> 00:47:02,250 and then I will internally rotate. 641 00:47:02,590 --> 00:47:05,573 And I don't keep an active movement here. 642 00:47:05,662 --> 00:47:10,054 I just go to the end range and I call this almost like picking a lock. 643 00:47:10,181 --> 00:47:12,198 I try to move with small, 644 00:47:12,334 --> 00:47:18,729 steady little increments until I find the right angle that all of a sudden this hip can start rotating. 645 00:47:21,629 --> 00:47:23,849 Then I might move them more into flexion. 646 00:47:24,169 --> 00:47:24,945 Try it again. 647 00:47:25,018 --> 00:47:25,873 Go into internal, 648 00:47:25,921 --> 00:47:27,189 go into external. 649 00:47:31,289 --> 00:47:32,289 So if I step back, 650 00:47:32,330 --> 00:47:41,669 you can see what I'm doing is I am rotating this lever that's going straight down into her acetabulum to work on internal and external rotation. 651 00:47:42,169 --> 00:47:58,120 I can also being careful not to compress the patella Just put some pressure straight down on the knee so that it's going to be moving like this. 652 00:47:58,580 --> 00:48:00,240 In the acetabulum, 653 00:48:00,659 --> 00:48:02,379 I can do some general rocking. 654 00:48:02,460 --> 00:48:04,460 I can come near the end and say, 655 00:48:04,500 --> 00:48:05,451 what position do I want? 656 00:48:05,475 --> 00:48:10,891 I'm going to move her leg over here so that I'm almost pushing it out of that acetabulum a little bit, 657 00:48:10,915 --> 00:48:13,120 and there I feel a little bit of a melt. 658 00:48:15,069 --> 00:48:16,770 I can open up her leg, 659 00:48:17,550 --> 00:48:19,250 the abduction here, 660 00:48:19,710 --> 00:48:21,062 and do the same thing. 661 00:48:21,165 --> 00:48:23,093 If I put her leg in a neutral position, 662 00:48:23,262 --> 00:48:25,830 I feel like this is about as far as it wants to go. 663 00:48:25,949 --> 00:48:28,038 I might just bring her to that end range, 664 00:48:28,133 --> 00:48:30,774 support her with my legs so those muscles aren't contracting, 665 00:48:30,901 --> 00:48:32,370 and just push down, 666 00:48:33,150 --> 00:48:34,741 see if I can increase that. 667 00:48:34,846 --> 00:48:36,870 If I want to do a stroke while I'm working there, 668 00:48:36,909 --> 00:48:37,925 that's fine. 669 00:48:38,117 --> 00:48:40,165 But I'm basically working with the joint. 670 00:48:40,277 --> 00:48:42,150 Once I get it down to its end range, 671 00:48:42,229 --> 00:48:44,692 I may want to take my hand underneath here, 672 00:48:44,806 --> 00:48:49,383 have the knee bent and work internal and external rotation. 673 00:48:49,431 --> 00:48:50,424 In this position, 674 00:48:50,592 --> 00:48:57,304 people will become limited in internal and external rotation in different positions. 675 00:48:57,431 --> 00:48:58,919 So some people are very, 676 00:48:58,960 --> 00:49:03,752 very mobile in internal and external rotation in a flexed position or an extended position, 677 00:49:03,855 --> 00:49:06,024 but not in an abducted position. 678 00:49:06,192 --> 00:49:15,539 So the main thing you want to do is you want to be sure to support this knee so that there isn't torsion between the tibia and the femur here and start working with these rotational issues. 679 00:49:30,240 --> 00:49:37,819 I have Dina's feet propped up at a fairly high angle for working on the posterior knee and then moving up to the hamstring. 680 00:49:38,240 --> 00:49:49,278 I think it's important to have enough flexion in the knee here that the posterior knee area or the popliteal area will be fairly soft so that you can sink in here. 681 00:49:49,334 --> 00:49:51,966 This is an area that if it's put on too much of a stretch, 682 00:49:52,158 --> 00:49:56,254 it's not going to feel real good to your client and they're going to resist against you. 683 00:49:56,341 --> 00:49:59,086 So when I'm working on the posterior knee, 684 00:49:59,278 --> 00:49:59,790 I'm thinking. 685 00:50:00,320 --> 00:50:03,463 Mostly about strain patterns at a superficial level. 686 00:50:03,632 --> 00:50:06,328 How does the fascia on the outside seem to run down? 687 00:50:06,384 --> 00:50:07,944 Is it shorter on the outside, 688 00:50:08,112 --> 00:50:10,939 or is it shorter on the medial aspect? 689 00:50:11,599 --> 00:50:14,903 And then I think about tension patterns from the gastrocnemius. 690 00:50:14,952 --> 00:50:19,335 Both heads cross and attach the posterior femur, 691 00:50:19,527 --> 00:50:24,888 and then the hamstrings cross and put other strain patterns in. 692 00:50:25,024 --> 00:50:27,783 So I'm going to just talk about the posterior knee right now. 693 00:50:27,871 --> 00:50:29,431 There are two other muscles that are, 694 00:50:29,455 --> 00:50:32,628 although not very important for knee flexion, 695 00:50:32,804 --> 00:50:34,564 if they get strained or sore, 696 00:50:34,612 --> 00:50:36,115 if you've hyperextended a knee, 697 00:50:36,148 --> 00:50:36,740 they can be very, 698 00:50:36,780 --> 00:50:40,195 very painful and can very much impede the function of the knee. 699 00:50:40,387 --> 00:50:43,640 That would be the popliteus and the plantaris muscles. 700 00:50:44,700 --> 00:50:45,875 Both of these are small, 701 00:50:45,948 --> 00:50:46,179 little, 702 00:50:46,219 --> 00:50:48,899 almost vestigial muscles that cross the knee joint, 703 00:50:48,979 --> 00:50:52,531 but they can very much go into spasm and be very painful. 704 00:50:52,676 --> 00:50:56,740 So I usually bolster the foot up at a fairly high angle, 705 00:50:56,820 --> 00:50:57,066 so. 706 00:50:57,107 --> 00:50:58,606 So that this area is soft. 707 00:50:58,718 --> 00:51:00,526 And then with very soft hands, 708 00:51:00,557 --> 00:51:03,049 I work much slower than I've been showing here. 709 00:51:04,549 --> 00:51:10,477 One of the things that I've been doing when I show multiple strokes is that I've been working faster than I usually do. 710 00:51:10,614 --> 00:51:14,090 This is just to show you a multitude of possibilities for working. 711 00:51:14,390 --> 00:51:15,373 So on this, 712 00:51:15,542 --> 00:51:22,969 I'm actually going to lift Dina's foot up a little bit farther so that I can really sink into this area. 713 00:51:25,629 --> 00:51:27,414 I can anchor on plantaris, 714 00:51:27,462 --> 00:51:43,209 which travels from the lateral side of the femur in a diagonal down to the lower medial leg and make very slow and small movements with the anchor and stretch techniques to try to soften that muscle. 715 00:51:43,629 --> 00:51:48,950 You might want to spend five minutes or more working on this area very, 716 00:51:48,989 --> 00:51:50,090 very slowly. 717 00:51:51,079 --> 00:51:52,063 It has a tendency, 718 00:51:52,111 --> 00:51:53,183 if you work too hard, 719 00:51:53,272 --> 00:51:55,920 to not necessarily flare up right away, 720 00:51:55,959 --> 00:51:57,695 but the next day it might be sore. 721 00:51:57,808 --> 00:51:59,739 So work this incrementally here. 722 00:52:15,560 --> 00:52:17,139 The hamstring muscles, 723 00:52:18,020 --> 00:52:21,467 although they share a common origin at the ischial tuberosity, 724 00:52:21,563 --> 00:52:27,611 notice that the different attachments below the knee cause different degrees of stress and torsion on the knee. 725 00:52:27,675 --> 00:52:32,719 And it is important to differentiate which muscles are tight when planning your strategy. 726 00:52:35,300 --> 00:52:38,360 There's really not a lot of important, 727 00:52:38,979 --> 00:52:42,348 special strokes to take on the hamstrings. 728 00:52:42,443 --> 00:52:43,084 Basically, 729 00:52:43,211 --> 00:52:44,955 it's a nuts and bolts approach. 730 00:52:45,108 --> 00:52:46,268 Soften the tissue, 731 00:52:46,364 --> 00:52:47,467 lengthen the tissue, 732 00:52:47,563 --> 00:52:48,843 find strain patterns. 733 00:52:48,891 --> 00:52:50,156 Is it strained toward the outside? 734 00:52:50,228 --> 00:52:51,883 Is it strained toward the inside? 735 00:52:52,012 --> 00:52:54,960 And I take some nice broad strokes. 736 00:52:57,460 --> 00:52:58,331 At the same time, 737 00:52:58,355 --> 00:53:14,852 I'm taking my left hand and trying to basically stretch the hamstrings and all this external tissue to get a message to this knee joint to let loose and to open up this way. 738 00:53:14,955 --> 00:53:15,364 Basically, 739 00:53:15,412 --> 00:53:17,479 I'm distracting this knee joint. 740 00:53:18,139 --> 00:53:20,324 So I'm giving her a cue from both sides. 741 00:53:20,372 --> 00:53:22,560 I'm moving in opposite directions here. 742 00:53:29,419 --> 00:53:31,427 The fist is also another tool here. 743 00:53:31,484 --> 00:53:33,395 If you feel some really fibrous areas, 744 00:53:33,467 --> 00:53:34,324 just sink in, 745 00:53:34,412 --> 00:53:34,963 Wait. 746 00:53:35,092 --> 00:53:36,996 Let that fist stay soft. 747 00:53:37,187 --> 00:53:43,960 You might expedite that softening a little bit by raising the leg and then anchoring and stretching. 748 00:53:46,460 --> 00:53:48,036 If you want a little better stretch, 749 00:53:48,147 --> 00:53:50,560 this would be a good time to move the bolster out. 750 00:53:51,740 --> 00:53:58,819 So I would anchor and stretch here and then lengthen that muscle. 751 00:53:58,900 --> 00:54:00,515 If I felt very, 752 00:54:00,587 --> 00:54:03,075 very isolated little areas of tension, 753 00:54:03,187 --> 00:54:05,354 then I could come in with my fingers. 754 00:54:05,532 --> 00:54:08,849 Wherever I feel adhesions or tenseness, 755 00:54:10,870 --> 00:54:12,409 just come right in there, 756 00:54:13,669 --> 00:54:15,849 anchor and bring it down. 757 00:54:21,829 --> 00:54:26,089 You can see how I'm outlining the biceps femoris or lateral hamstring here. 758 00:54:26,870 --> 00:54:30,206 So what I'm actually doing is defining the border of this muscle, 759 00:54:30,237 --> 00:54:34,579 and I feel a lot of real hard tension in this area. 760 00:54:34,699 --> 00:54:40,755 So I'm actually going to slow down a little bit and show a little bit more like I would normally be working. 761 00:54:40,827 --> 00:54:42,036 When I'm showing a lot of strokes, 762 00:54:42,067 --> 00:54:45,040 I have a tendency to work a little faster than I normally do. 763 00:54:45,420 --> 00:54:46,500 So in an area like this, 764 00:54:46,540 --> 00:54:48,360 you might work just this slowly. 765 00:54:49,740 --> 00:54:51,459 I have her leg elevated. 766 00:54:51,620 --> 00:54:53,220 I can rotate it if I want to, 767 00:54:53,259 --> 00:54:54,516 if I want to find a strain pattern. 768 00:54:54,548 --> 00:54:55,124 But basically, 769 00:54:55,172 --> 00:54:56,995 I just wait for this tissue to melt, 770 00:54:57,028 --> 00:54:58,660 and it's starting to melt right there. 771 00:54:58,779 --> 00:54:59,860 It's a very subtle feeling. 772 00:55:00,240 --> 00:55:01,340 When tissue melts. 773 00:55:03,359 --> 00:55:04,759 But if you move slowly enough, 774 00:55:04,799 --> 00:55:08,259 it makes your work a lot more rewarding and it can tell you when to move on. 775 00:55:16,640 --> 00:55:19,460 I'm coming out and working a little more shallowly now. 776 00:55:33,210 --> 00:55:40,310 This needs about two to three times as much work on the lateral aspect as on the medial. 777 00:55:42,170 --> 00:55:43,746 My fingers start getting tired. 778 00:55:43,857 --> 00:55:45,857 I can use a fairly sharp knuckle. 779 00:55:45,954 --> 00:55:51,270 It's not going to be quite as precise as my fingertips. 780 00:55:59,380 --> 00:56:03,212 I could follow this all the way up to the ischial tuberosity. 781 00:56:03,356 --> 00:56:07,563 I'd be planning ahead of time to soften tissue. 782 00:56:07,611 --> 00:56:13,760 So I'm not diving in that deeply without first softening the external muscles. 783 00:56:14,099 --> 00:56:16,316 So let's go right to the ischial tuberosity. 784 00:56:16,347 --> 00:56:19,524 This is an area that you should be able to find in your sleep. 785 00:56:19,572 --> 00:56:21,700 You don't want to be probing around here, 786 00:56:21,819 --> 00:56:22,548 hit and miss. 787 00:56:22,603 --> 00:56:24,115 To try to find the ischial tuberosity. 788 00:56:24,147 --> 00:56:25,891 You should always be able to find it within, 789 00:56:25,995 --> 00:56:26,212 say, 790 00:56:26,236 --> 00:56:27,891 a quarter of an inch of where it is. 791 00:56:27,995 --> 00:56:36,227 And it's an extremely important landmark for the pelvis because both hamstrings attach at the ischial tuberosities. 792 00:56:36,323 --> 00:56:37,043 If they're tight, 793 00:56:37,091 --> 00:56:39,200 they can be pulling this pelvis under. 794 00:56:39,819 --> 00:56:41,379 If one is tighter than the other, 795 00:56:41,420 --> 00:56:43,840 it can be causing rotational force here. 796 00:56:44,310 --> 00:56:47,790 So it's an excellent area to spend a lot of patient time. 797 00:56:47,829 --> 00:56:51,453 And basically I usually work distal to the ischial tuberosity. 798 00:56:51,501 --> 00:56:54,849 I start with fairly soft fingers. 799 00:56:55,909 --> 00:57:03,646 I can work on the broad facial components and then work myself down deeper to the actual hamstring tendons. 800 00:57:03,757 --> 00:57:05,694 I can do some cross fiber work. 801 00:57:05,781 --> 00:57:12,792 I like to just basically sink here and weight and you'll feel those muscles soften. 802 00:57:12,855 --> 00:57:17,687 And you can save a lot of time by working at the tendonous insertion of the hamstrings, 803 00:57:17,704 --> 00:57:18,903 the Golgi tendon organs, 804 00:57:18,951 --> 00:57:25,180 Things like this will give feedback to these muscles so that they will relax just by working on the tendon. 805 00:57:25,919 --> 00:57:29,816 If you feel your fingers are a little bit too sharp or a little pokey, 806 00:57:29,927 --> 00:57:31,960 then knuckles work very, 807 00:57:32,000 --> 00:57:32,391 very well. 808 00:57:32,415 --> 00:57:35,219 I've got two knuckles with a fairly broad surface here. 809 00:57:43,449 --> 00:57:52,710 The other alternative would be to put your hand here so that it's not going to be sliding around too much and just sink in with your elbow and just wait. 810 00:57:55,930 --> 00:57:58,030 This is very important work. 811 00:58:09,379 --> 00:58:09,740 Again, 812 00:58:09,780 --> 00:58:12,876 there's nothing fancy about working on the hamstrings. 813 00:58:12,907 --> 00:58:15,276 It's just taking your time softening tissue, 814 00:58:15,388 --> 00:58:17,479 lengthening tissue where it needs it. 815 00:58:27,139 --> 00:58:31,479 Let's talk a little more about working on the it band in the prone position. 816 00:58:31,870 --> 00:58:32,421 Now, 817 00:58:32,526 --> 00:58:35,542 if there's too sharp of an edge on the table or they're too sensitive. 818 00:58:35,605 --> 00:58:36,229 Obviously, 819 00:58:36,310 --> 00:58:40,581 you can put a pillow or something else right here to bolster this leg, 820 00:58:40,686 --> 00:58:42,389 Realizing that the higher you lift it, 821 00:58:42,430 --> 00:58:42,870 however, 822 00:58:42,990 --> 00:58:45,093 the more torsion you're going to have on the back. 823 00:58:45,181 --> 00:58:49,157 So unless you feel them recoiling against the pressure you're putting, 824 00:58:49,253 --> 00:58:53,770 you're better off leaving the leg down here and minimizing your rotation in the spine. 825 00:58:55,229 --> 00:59:00,003 Work on the IT band just like you would in any other position that you can access it. 826 00:59:00,102 --> 00:59:01,819 Some nice broad strokes. 827 00:59:04,800 --> 00:59:06,599 I never use anything very sharp here. 828 00:59:06,639 --> 00:59:10,680 I don't use my side of my arm with the ulna. 829 00:59:10,759 --> 00:59:13,671 Anything that's going to be hard and bony is going to be too sensitive there. 830 00:59:13,695 --> 00:59:18,300 So I always rotate my hand so that I'm using the fleshy aspect. 831 00:59:20,959 --> 00:59:33,985 The advantage to working prone on the IT band versus supine is that I'm giving this picture to this femur to drop out of the acetabulum here. 832 00:59:34,057 --> 00:59:35,910 I'm distracting this joint. 833 00:59:36,810 --> 00:59:38,737 And just as any other way, 834 00:59:38,793 --> 00:59:40,545 if I feel particular strain patterns, 835 00:59:40,577 --> 00:59:45,350 I can move to fingers and just work nice and slowly. 836 00:59:46,730 --> 00:59:49,709 I'm lengthening in a very broad sheet here. 837 00:59:50,569 --> 00:59:52,148 If I felt I wanted to. 838 00:59:52,274 --> 00:59:55,839 To outline the IT band here and work on one border. 839 00:59:55,920 --> 00:59:59,959 Then I turn my hand a little bit different angle and follow just. 840 01:00:00,160 --> 01:00:01,060 Down this way. 841 01:00:07,519 --> 01:00:11,220 The other possibility with the leg in this position, 842 01:00:12,000 --> 01:00:15,460 you can tell about mobilizing the femur here. 843 01:00:17,280 --> 01:00:25,260 So what I'd be doing is just taking both hands like this and pushing this femur down in the joint. 844 01:00:25,850 --> 01:00:28,402 So now I'm working at a ligamentous level. 845 01:00:28,585 --> 01:00:33,270 I can do fairly fast rocking initially to override any holding patterns. 846 01:00:33,689 --> 01:00:36,850 And I'm going to switch to just one hand so you can see a little bit more. 847 01:00:36,890 --> 01:00:38,386 I would have my other hand helping, 848 01:00:38,497 --> 01:00:41,393 but I've just got a nice broad surface all the way around here. 849 01:00:41,481 --> 01:00:45,270 I can also push it down and just wait, 850 01:00:45,850 --> 01:00:48,993 see if those ligaments are going to let go a little bit. 851 01:00:49,082 --> 01:00:51,189 I can work a little bit with rotation, 852 01:00:52,020 --> 01:00:59,200 see if I can find the correct combination of this lock I'm trying to pick to let this femur relax. 853 01:01:01,060 --> 01:01:01,707 Very often. 854 01:01:01,764 --> 01:01:04,715 If I feel I'm not making much progress with this, 855 01:01:04,867 --> 01:01:06,683 it's because I'm pressing too hard, 856 01:01:06,772 --> 01:01:08,828 not because I'm not pressing hard enough. 857 01:01:08,963 --> 01:01:10,859 The body's going to be pushing back against me. 858 01:01:10,900 --> 01:01:13,835 So if you don't feel the movement you're looking for first, 859 01:01:13,908 --> 01:01:18,000 try backing off a little bit and see if you can sweet talk this joint into behaving. 860 01:01:32,010 --> 01:01:36,578 The side lying position is by far the best way to work on the whole medial leg. 861 01:01:36,634 --> 01:01:41,510 From the heel all the way up to the ramus of the ilium. 862 01:01:42,170 --> 01:01:44,629 You can work with the heel itself. 863 01:01:49,079 --> 01:01:53,420 This would be for somebody's heel that was sort of gravitating toward the medial side. 864 01:01:55,239 --> 01:02:06,780 What I'm trying to do is just free this tight area in here so this heel is able to move a little bit laterally and provide a little bit of support on the outside of the foot. 865 01:02:07,480 --> 01:02:09,663 You can work with flexion issues. 866 01:02:09,752 --> 01:02:14,063 A lot of people have had sprained ankles and Achilles damage back here. 867 01:02:14,151 --> 01:02:25,860 This is a excellent access for you to be moving the foot through range of motion as you work on areas more people sprain their feet on the outside. 868 01:02:26,240 --> 01:02:28,135 At the lateral malleolus, 869 01:02:28,247 --> 01:02:36,151 there's a ligament called the anterior talofibular ligament that probably 80 to 90% of the sprains strain. 870 01:02:36,295 --> 01:02:41,949 So you could also work on the above leg in this matter if you wanted to work on that. 871 01:02:42,120 --> 01:02:46,882 So this is also an excellent access point to the soleus. 872 01:02:46,945 --> 01:02:49,346 Instead of trying to work through a very, 873 01:02:49,418 --> 01:02:53,810 very well developed gastroc that some people may have covering the soleus, 874 01:02:53,889 --> 01:02:57,042 all you need to do is get on the medial border, 875 01:02:57,186 --> 01:03:03,550 start working underneath the gastroc and follow the soleus up. 876 01:03:06,250 --> 01:03:09,662 Any kind of work you want to do there you could work from your elbows, 877 01:03:09,825 --> 01:03:10,469 knuckles, 878 01:03:10,550 --> 01:03:16,693 fingers or anything in addition to the soleus. 879 01:03:16,741 --> 01:03:21,650 This is not a bad way to access the posterior tib muscle as well. 880 01:03:22,430 --> 01:03:23,957 And you want to put some stretch. 881 01:03:24,054 --> 01:03:25,889 All you need to do is take your hand, 882 01:03:26,189 --> 01:03:27,889 grab the front part of the foot, 883 01:03:28,509 --> 01:03:32,370 flex it up and you're working there. 884 01:03:39,879 --> 01:03:43,391 From these deep muscles like posterior tib and soleus, 885 01:03:43,455 --> 01:03:47,407 I'm going to move to a much more superficial way of working on the knee itself. 886 01:03:47,503 --> 01:03:49,616 And I just feel how the tissue moves. 887 01:03:49,647 --> 01:03:51,039 Does it move up and down? 888 01:03:51,159 --> 01:03:54,020 Is this knee joint able to slide in this tissue? 889 01:03:54,919 --> 01:04:00,550 And just do some nice broad strokes stretching this tissue here. 890 01:04:00,719 --> 01:04:06,430 If I feel particular fibers of the hamstring or the quadriceps are tight, 891 01:04:06,770 --> 01:04:08,617 I can then do some separation work. 892 01:04:08,674 --> 01:04:09,270 Again, 893 01:04:20,930 --> 01:04:23,065 this is a good way if you want to soften tissue. 894 01:04:23,098 --> 01:04:27,879 You just bend the knee anchor and then straighten, 895 01:04:37,660 --> 01:04:38,579 bend again, 896 01:04:38,699 --> 01:04:39,124 straighten. 897 01:04:39,172 --> 01:04:41,759 You can work it much quicker if you want to, 898 01:04:42,620 --> 01:04:46,291 moving up the leg all the way along the adductors. 899 01:04:46,355 --> 01:04:49,891 This area very often is neglected and massaged. 900 01:04:49,956 --> 01:04:52,228 So certainly do some superficial work, 901 01:04:52,283 --> 01:04:53,519 soften that area. 902 01:04:53,899 --> 01:04:55,540 But you can get much more specific. 903 01:05:00,240 --> 01:05:05,379 If we take a broader view of this and we start looking up the back, 904 01:05:08,720 --> 01:05:11,544 you can see that however you position the knee, 905 01:05:11,592 --> 01:05:14,179 if you move it forward or if you move it back, 906 01:05:15,279 --> 01:05:20,504 you're helping the ability of this leg to almost just drop right out of the pelvis and move independently. 907 01:05:20,632 --> 01:05:21,608 People that are very, 908 01:05:21,664 --> 01:05:24,632 very tight in the upper medial leg here, 909 01:05:24,815 --> 01:05:27,704 when you move the leg back, 910 01:05:27,871 --> 01:05:30,088 it moves the whole pelvis along with it, 911 01:05:30,143 --> 01:05:32,503 and you'll see their spine moving forward here. 912 01:05:32,591 --> 01:05:41,219 So what you're working for is independence of the leg from the attachments of the leg right along this ramus right up here. 913 01:05:41,840 --> 01:05:42,200 Now, 914 01:05:42,240 --> 01:05:42,664 of course, 915 01:05:42,752 --> 01:05:45,927 you're not going to do this the first time you meet somebody at a spa massage. 916 01:05:46,024 --> 01:05:52,088 But if you're working with an athlete or somebody that's got a particular issue with the inside of the legs where they're tight, 917 01:05:52,183 --> 01:05:54,820 all you need to do is be clear about what you're doing, 918 01:05:55,210 --> 01:05:57,281 explain to them why you're working that way, 919 01:05:57,386 --> 01:05:59,265 and it never is a problem. 920 01:05:59,338 --> 01:06:05,986 This is an area in my massage classes that students often have a little bit of trepidation about approaching, 921 01:06:06,177 --> 01:06:08,786 and I've never had any problem. 922 01:06:08,858 --> 01:06:12,418 Everybody is always amazed at how safe it feels in this position. 923 01:06:12,474 --> 01:06:12,721 Of course, 924 01:06:12,745 --> 01:06:14,146 you'd have proper draping, 925 01:06:14,257 --> 01:06:20,069 but I'm not doing that so you can get a sense of the leg placement. 926 01:06:22,739 --> 01:06:38,200 So all I do after I've warmed up with some nice broad strokes here is I make my fingers nice and soft and curved and then just come in right at the upper area and do some spreading work. 927 01:06:38,500 --> 01:06:39,579 I come right up. 928 01:06:39,620 --> 01:06:41,900 I'm just about to the issue of tuberosity right now, 929 01:06:41,939 --> 01:06:45,147 so that'll give you a bit of a landmark. 930 01:06:45,323 --> 01:06:46,703 And if you want to. 931 01:06:46,852 --> 01:06:51,671 If you want to stretch the anterior portion of the medial muscles, 932 01:06:51,736 --> 01:06:53,379 then you can move the leg back, 933 01:06:53,760 --> 01:06:57,420 and that's going to put more of a stretch up toward the pubic symphysis. 934 01:06:58,319 --> 01:07:00,471 And if they're very tight near the hamstrings, 935 01:07:00,536 --> 01:07:04,019 you just bring the knee forward and work in that way. 936 01:07:09,280 --> 01:07:13,080 You don't need to work nearly that specifically if you don't have an actual purpose. 937 01:07:13,159 --> 01:07:20,080 It still is an excellent way to do some nice energy work and superficial work on the leg. 938 01:07:35,659 --> 01:07:36,867 The side lying position, 939 01:07:36,924 --> 01:07:37,876 as I've mentioned earlier, 940 01:07:37,948 --> 01:07:42,243 I think is by far the best way to work on all aspects of the lateral leg, 941 01:07:42,331 --> 01:07:42,598 all, 942 01:07:42,644 --> 01:07:48,449 all the way down from ankle issues all the way up to the trochanter, 943 01:07:48,530 --> 01:07:51,074 and even above up to the quadratus area. 944 01:07:51,162 --> 01:07:52,481 So let's start down below. 945 01:07:52,586 --> 01:07:55,425 A lot of people have had trauma to the outside of the ankle. 946 01:07:55,538 --> 01:08:04,433 Here's where the talofibular ligament comes down and attaches from the fibula here at the lateral malleolus down to the talus bone here. 947 01:08:04,521 --> 01:08:05,969 And when an ankle is sprained, 948 01:08:06,050 --> 01:08:08,961 generally it's pulled like this and stretched. 949 01:08:09,026 --> 01:08:11,921 And then you get a lot of scarring and fibrous buildup here. 950 01:08:12,026 --> 01:08:13,425 So this is a nice area, 951 01:08:13,497 --> 01:08:15,662 just with n soft fingers. 952 01:08:15,806 --> 01:08:16,894 Soften up this area. 953 01:08:16,981 --> 01:08:19,246 Somebody rather recently sprained their ankle. 954 01:08:19,277 --> 01:08:21,050 This might be all you would do to it. 955 01:08:24,789 --> 01:08:26,205 After a period of time, 956 01:08:26,277 --> 01:08:29,693 if you feel that this ankle really is not working well, 957 01:08:29,782 --> 01:08:34,689 then you would find any fibrous issues and start moving the ankle through its range of motion. 958 01:08:38,229 --> 01:08:39,650 Plantar flexion, 959 01:08:40,000 --> 01:08:41,496 dorsiflexion, 960 01:08:41,687 --> 01:08:43,659 inversion and eversion, 961 01:08:53,919 --> 01:08:55,304 moving up the leg. 962 01:08:55,472 --> 01:08:58,151 It's a perfect way to work on the peroneals, 963 01:08:58,216 --> 01:08:59,032 or the peroneals, 964 01:08:59,096 --> 01:09:00,487 however you want to call them. 965 01:09:00,623 --> 01:09:03,719 And they're involved with anchor inversion and eversion. 966 01:09:03,800 --> 01:09:05,000 And so they can be very, 967 01:09:05,039 --> 01:09:08,280 very tight in holding a foot into the outer position. 968 01:09:08,400 --> 01:09:08,734 So. 969 01:09:08,792 --> 01:09:13,409 So I just feel for any fibrous restraint here, 970 01:09:13,449 --> 01:09:16,161 any hard musculature, 971 01:09:16,225 --> 01:09:17,670 any spasm, 972 01:09:18,329 --> 01:09:19,906 and just wherever I can, 973 01:09:19,978 --> 01:09:22,069 following up these peroneals, 974 01:09:28,089 --> 01:09:29,550 try to soften that. 975 01:09:30,170 --> 01:09:31,937 If I move the foot in, 976 01:09:32,074 --> 01:09:34,110 I'm going to be putting a stretch to it. 977 01:09:37,220 --> 01:09:39,084 I want a little better access, 978 01:09:39,172 --> 01:09:42,252 and I feel that I'm approaching the threshold where it's too sensitive. 979 01:09:42,315 --> 01:09:44,360 I can shorten the muscle to soften it, 980 01:09:45,060 --> 01:09:50,120 lift the foot up and then just keep trying to stretch it here. 981 01:09:53,220 --> 01:09:59,819 This is basically just being specific in your intention instead of just doing repeat strokes to try to soften. 982 01:10:00,160 --> 01:10:01,179 The outer layers. 983 01:10:02,640 --> 01:10:05,860 Certainly the forearm could be fine here. 984 01:10:09,359 --> 01:10:11,539 Fist feels quite nice along here. 985 01:10:12,400 --> 01:10:14,820 Move the foot through any range of motion you want. 986 01:10:20,399 --> 01:10:21,980 Moving up to the knee. 987 01:10:23,039 --> 01:10:25,736 It's essentially the same thing we did on the inside of the knee. 988 01:10:25,768 --> 01:10:27,660 We're going to look for strain patterns. 989 01:10:27,989 --> 01:10:30,910 Sort of move this leg through its range of motion. 990 01:10:30,989 --> 01:10:40,009 Feel is there more strain in the lateral hamstring area or is there torsion in the quadriceps group? 991 01:10:41,829 --> 01:10:43,421 Just feel wherever there's tension. 992 01:10:43,485 --> 01:10:49,677 You might want to be working on the lateral head of the gastroc here and rolling that and stretching. 993 01:10:49,694 --> 01:10:56,229 It could do the same thing on the hamstrings here. 994 01:10:59,009 --> 01:11:02,793 This is by far the best way to work on the IT band, 995 01:11:02,841 --> 01:11:06,469 which I'm accenting right up here as I go up Dina's leg. 996 01:11:07,569 --> 01:11:17,769 If you could picture this IT band lying in between the anterior compartment of the quadriceps and the posterior compartment of the hamstrings. 997 01:11:17,849 --> 01:11:20,219 It's very easy to see the importance of, 998 01:11:20,250 --> 01:11:24,903 of delineating this IT band from each of those groups, 999 01:11:25,031 --> 01:11:29,180 because as you flex and extend the knee, 1000 01:11:29,519 --> 01:11:33,799 you can picture as I flex Dina's knee, 1001 01:11:33,879 --> 01:11:37,591 the quadriceps group must be lengthening and moving this way, 1002 01:11:37,695 --> 01:11:39,000 while at the same time, 1003 01:11:39,120 --> 01:11:41,671 the hamstrings must be shortening and moving this way. 1004 01:11:41,775 --> 01:11:43,608 And as I move into extension, 1005 01:11:43,703 --> 01:11:48,340 hamstrings need to be lengthening and the quadriceps need to be shortening. 1006 01:11:48,760 --> 01:11:53,103 So they need to be sliding along this IT band and have some differentiation. 1007 01:11:53,231 --> 01:11:54,992 So this is just excellent work. 1008 01:11:55,096 --> 01:12:03,299 I actually go to one of my favorite massage therapists and we spend an hour just working on my IT band. 1009 01:12:11,250 --> 01:12:12,602 Take your time on this. 1010 01:12:12,705 --> 01:12:13,737 Work slowly. 1011 01:12:13,834 --> 01:12:16,469 You don't want to have the person sore the next day. 1012 01:12:18,289 --> 01:12:23,882 There are tremendous number of tight knee problems and just malfunctioning knees clicking, 1013 01:12:23,945 --> 01:12:24,762 things like that. 1014 01:12:24,866 --> 01:12:26,586 If you do meticulous, 1015 01:12:26,698 --> 01:12:27,354 slow, 1016 01:12:27,481 --> 01:12:29,949 patient work on the IT band, 1017 01:12:31,969 --> 01:12:33,401 it will pay off. 1018 01:12:33,586 --> 01:12:38,026 The other advantage is it will pay off in your practice and that people will come for spot work. 1019 01:12:38,098 --> 01:12:38,294 You, 1020 01:12:38,322 --> 01:12:44,090 you're not going to be running at breakneck pace all the way through trying to work the entire body. 1021 01:12:48,629 --> 01:12:52,002 It's really a luxury to be able to take your time and spend 15, 1022 01:12:52,088 --> 01:12:59,901 20 minutes or so just on an IT band and its attachments up at the hip on the other side. 1023 01:12:59,925 --> 01:13:02,382 If you're doing a full body massage and you feel this, 1024 01:13:02,485 --> 01:13:04,286 you don't need to be quite as meticulous. 1025 01:13:04,318 --> 01:13:09,099 But I'll just go back to the image of driving a sports car on a curvy mountain road. 1026 01:13:09,139 --> 01:13:11,116 When you come to really curvy and hilly areas. 1027 01:13:11,187 --> 01:13:12,443 You just downshift, 1028 01:13:12,572 --> 01:13:14,039 go slow for a while, 1029 01:13:15,219 --> 01:13:16,879 and then pick up the pace. 1030 01:13:17,460 --> 01:13:20,199 I'll often mention to people I'm working on saying, 1031 01:13:20,900 --> 01:13:22,620 this really feels pretty tight here. 1032 01:13:22,659 --> 01:13:23,819 I'd like to free this up. 1033 01:13:23,860 --> 01:13:25,836 They generally go right along with that and say, 1034 01:13:25,907 --> 01:13:29,948 I'd like to spend a little extra time here and maybe I'll spend a little less time on your arms today, 1035 01:13:30,003 --> 01:13:31,068 or something like that. 1036 01:13:31,204 --> 01:13:41,370 And that's the way to sort of start leading people into realizing how important it is not to be working at just a superficial level and actually do something that's going to last for a while. 1037 01:13:50,469 --> 01:13:59,854 The Tensor Fasciae Latae and the IT band Sometimes just working the tensor fasciae latae will be enough to soften the entire iliotibial tract, 1038 01:13:59,901 --> 01:14:01,330 or IT band. 1039 01:14:02,509 --> 01:14:07,686 The last area of the legs on the sideline I want to cover is the tensor fasciae latae, 1040 01:14:07,717 --> 01:14:09,717 which attaches to the IT band. 1041 01:14:09,894 --> 01:14:12,614 The IT band is also called the fasciae latae, 1042 01:14:12,741 --> 01:14:18,790 so tensor fasciae latae usually should be able to feel the anterior and posterior borders of this. 1043 01:14:18,829 --> 01:14:20,117 If you have any questions, 1044 01:14:20,213 --> 01:14:28,454 all you need to do is have your client just raise their knee and back down and you'll be able to feel that muscle right here. 1045 01:14:28,622 --> 01:14:37,970 So what I try to do with the tensor fasciae latae is to try to determine is it pulled too far forward or is it pulled too far back. 1046 01:14:40,029 --> 01:14:44,838 This means that you have to work with quite a few people so you can develop a norm, 1047 01:14:44,934 --> 01:14:48,009 but you can also just feel if there's more fibrousness. 1048 01:14:48,910 --> 01:14:53,206 Dinas I'm going to work on the anterior border just to sort of show how you can work on this. 1049 01:14:53,278 --> 01:14:56,470 One of the first things you can do is just get on the anterior border, 1050 01:14:56,629 --> 01:14:58,449 pull that muscle back, 1051 01:14:59,629 --> 01:15:02,100 And then start working with your other hand. 1052 01:15:03,600 --> 01:15:05,559 If you want to lengthen this a little bit, 1053 01:15:05,679 --> 01:15:08,900 you just have your client reach down with her leg a little bit. 1054 01:15:10,320 --> 01:15:11,320 There we go. 1055 01:15:11,439 --> 01:15:12,099 Good. 1056 01:15:18,960 --> 01:15:20,839 You can even come in there with your elbow. 1057 01:15:20,920 --> 01:15:24,339 I'm going to continue to pull this whole it band back, 1058 01:15:25,609 --> 01:15:27,190 come in with my elbow, 1059 01:15:28,489 --> 01:15:30,750 and just work along the border here. 1060 01:15:36,570 --> 01:15:37,665 As long as I'm there, 1061 01:15:37,737 --> 01:15:44,390 I'm going to try to get some continuity by carrying down off the tensor fasciae latae down into the IT band. 1062 01:15:45,210 --> 01:15:47,109 Little integration stroke. 1063 01:15:48,969 --> 01:15:56,543 And also you can come right to the trochanter where the femur joins and just do some nice broad work working all along there. 1064 01:15:56,631 --> 01:15:58,368 You can work in any direction you want. 1065 01:15:58,423 --> 01:15:58,752 Basically, 1066 01:15:58,816 --> 01:16:02,179 you're just spreading this tissue all along the acetabulum. 1067 01:16:07,400 --> 01:16:11,920 I'm going to come with my elbow with one other stroke that I haven't shown very much, 1068 01:16:11,959 --> 01:16:14,096 and that's just the waiting stroke. 1069 01:16:14,287 --> 01:16:17,296 So when you feel particular tension in an area, 1070 01:16:17,447 --> 01:16:22,135 sometimes all you need to do is just rest your elbow there. 1071 01:16:22,287 --> 01:16:24,140 Start with minimal pressure. 1072 01:16:24,959 --> 01:16:26,299 Slowly sink. 1073 01:16:27,040 --> 01:16:31,239 Just visualize that your elbow is just sinking into some very, 1074 01:16:31,280 --> 01:16:32,135 very hard butter. 1075 01:16:32,168 --> 01:16:33,176 And it's just got to melt, 1076 01:16:33,207 --> 01:16:34,579 and it's got to let you in. 1077 01:16:39,840 --> 01:16:40,552 Take a breath. 1078 01:16:40,615 --> 01:16:46,353 Remind your client to take a breath and just wait, 1079 01:16:46,402 --> 01:16:47,474 and you'll feel that melt. 1080 01:16:47,522 --> 01:16:50,257 It's such a rewarding feeling when that muscle melts. 1081 01:16:50,353 --> 01:16:55,650 Very often your client will give a sigh or some other sign that they've let loose. 1082 01:16:55,810 --> 01:16:57,058 And when that happens, 1083 01:16:57,153 --> 01:16:57,938 very often, 1084 01:16:58,073 --> 01:17:06,909 I will ease out very slowly and then just let that sink in. 1085 01:17:07,930 --> 01:17:10,114 Sometimes it's a little bit like stirring the jello. 1086 01:17:10,162 --> 01:17:13,122 If you continue to move and move and move on tissue, 1087 01:17:13,265 --> 01:17:17,030 it never has a chance to imprint and leave itself at a deep level. 1088 01:17:17,210 --> 01:17:21,262 So sometimes after a very important stroke where you feel a good change coming in, 1089 01:17:21,366 --> 01:17:23,102 just sit and relax for a little bit. 1090 01:17:23,205 --> 01:17:25,746 Let that take 10, 1091 01:17:25,834 --> 01:17:26,186 15, 1092 01:17:26,274 --> 01:17:30,409 20 seconds or so to be imprinted into the nervous system. 1093 01:17:39,509 --> 01:17:48,201 I'd like to talk a little bit about some of the forces that are exerted upon the pelvis and that can throw the pelvis out of alignment. 1094 01:17:48,346 --> 01:17:54,442 This is something that you can be working on for the next 40 years to try to improve your skills on. 1095 01:17:54,545 --> 01:17:59,481 But it's really fairly simple to understand the major forces acting upon the pelvis. 1096 01:17:59,545 --> 01:18:00,969 And as massage therapists, 1097 01:18:01,050 --> 01:18:03,081 we can give a lot of relief in this, 1098 01:18:03,265 --> 01:18:08,937 particularly when one side of the body is tighter because of an activity or any other reason, 1099 01:18:08,993 --> 01:18:10,698 an injury or something like this. 1100 01:18:10,834 --> 01:18:15,590 Returning proper function to the muscles that are pulling on this Pelvis can be a very, 1101 01:18:15,629 --> 01:18:19,157 very beneficial thing that you can give your client. 1102 01:18:19,253 --> 01:18:23,349 So let's just talk about the pelvis and some of the forces so that when somebody comes in and says, 1103 01:18:23,389 --> 01:18:25,286 my pelvis feels out of balance, 1104 01:18:25,397 --> 01:18:33,157 you can start considering some options for treatment that are more than just giving some nice squeezing of tissue where it hurts. 1105 01:18:33,253 --> 01:18:33,942 Okay, 1106 01:18:34,086 --> 01:18:37,574 so here we have our pelvis made up of the two innominate bones, 1107 01:18:37,701 --> 01:18:39,669 the right and the left here. 1108 01:18:39,789 --> 01:18:41,925 So let's take a look at some of the major landmarks. 1109 01:18:42,038 --> 01:18:47,090 The first would be the pubic symphysis. 1110 01:18:47,509 --> 01:18:50,686 And the major muscle group that attaches at the pubic symphysis, 1111 01:18:50,717 --> 01:18:52,445 particularly right at the middle here, 1112 01:18:52,518 --> 01:18:54,126 would be the rectus abdominis. 1113 01:18:54,157 --> 01:18:56,449 Muscles that are coming from above. 1114 01:18:57,509 --> 01:18:59,949 They go all the way up to the rib cage, 1115 01:19:00,110 --> 01:19:01,389 and they can have a very, 1116 01:19:01,430 --> 01:19:04,110 very important effect upon the pelvis. 1117 01:19:04,189 --> 01:19:05,325 If they're too tight, 1118 01:19:05,437 --> 01:19:07,822 they can be tilting the pelvis back. 1119 01:19:08,006 --> 01:19:09,213 And so that's very important. 1120 01:19:09,301 --> 01:19:12,750 Somebody walking around without any stability of their back because their pelvis is. 1121 01:19:12,789 --> 01:19:13,885 Is bent too far back. 1122 01:19:13,957 --> 01:19:15,806 You may want to add some length there. 1123 01:19:15,957 --> 01:19:21,982 We talk in the tape in various places about how to deal with these specific soft tissue issues. 1124 01:19:22,086 --> 01:19:27,089 But you do want to understand how they can impact the pelvis. 1125 01:19:27,910 --> 01:19:28,446 Obviously, 1126 01:19:28,478 --> 01:19:29,197 if they're very tight, 1127 01:19:29,213 --> 01:19:32,398 they can also be pulling down on the rib cage as well. 1128 01:19:32,533 --> 01:19:35,209 But we're mostly talking about the pelvis here. 1129 01:19:35,509 --> 01:19:39,341 So as we move to the anterior part of the pelvis, 1130 01:19:39,485 --> 01:19:44,769 the anterior superior iliac spine right here is an attachment for sartorius. 1131 01:19:46,519 --> 01:19:52,180 And this muscle is going to come down and cross to the medial side below the knee. 1132 01:19:52,839 --> 01:19:55,584 And it can have all sorts of effects, 1133 01:19:55,632 --> 01:19:57,216 not only on knee rotation, 1134 01:19:57,327 --> 01:19:59,007 but if the knee is fixated, 1135 01:19:59,103 --> 01:19:59,920 it can be pulled. 1136 01:20:00,080 --> 01:20:02,375 Pulling on the pelvis too far anteriorly, 1137 01:20:02,407 --> 01:20:06,040 which would be just the opposite of the muscle coming from above, 1138 01:20:06,200 --> 01:20:07,863 the rectus abdominis. 1139 01:20:07,992 --> 01:20:12,791 One of the other major major vectors pulling on this would be, 1140 01:20:12,816 --> 01:20:13,208 of course, 1141 01:20:13,263 --> 01:20:14,968 the rectus femoris muscle, 1142 01:20:14,984 --> 01:20:19,928 which attaches to the anterior inferior iliac spine. 1143 01:20:20,024 --> 01:20:27,192 And so if a person is doing a particular activity where one quadriceps is doing a lot more work than the other, 1144 01:20:27,376 --> 01:20:29,899 some sort of unilateral sports activity, 1145 01:20:30,789 --> 01:20:35,101 then this is going to be a factor that you're going to want to try to create balance with. 1146 01:20:35,206 --> 01:20:39,250 So you would certainly check one side versus the other and see if it's tighter. 1147 01:20:39,590 --> 01:20:40,253 Of course, 1148 01:20:40,341 --> 01:20:41,405 the psoas muscle, 1149 01:20:41,438 --> 01:20:42,750 or most of us are aware of this, 1150 01:20:42,789 --> 01:20:45,725 attaches to all these lumbar vertebra, 1151 01:20:45,838 --> 01:20:49,853 comes down through the pelvis and attaches to the lesser trochanter here. 1152 01:20:50,021 --> 01:20:52,334 So secondarily, 1153 01:20:52,381 --> 01:20:54,654 this psoas can have all sorts of effects. 1154 01:20:54,701 --> 01:20:59,929 By a tight psoas muscle could be pulling these vertebra forward in one way, 1155 01:21:00,229 --> 01:21:05,230 which would be bringing the pelvis with it into an anterior tilt. 1156 01:21:05,310 --> 01:21:07,486 And if one psoas is tighter than the other, 1157 01:21:07,558 --> 01:21:10,254 then it's going to be putting rotational force on this pelvis. 1158 01:21:10,302 --> 01:21:10,638 So again, 1159 01:21:10,694 --> 01:21:11,150 that's very, 1160 01:21:11,189 --> 01:21:12,010 very important. 1161 01:21:13,670 --> 01:21:18,126 Let's talk about the vectors pulling on the pelvis from behind. 1162 01:21:18,278 --> 01:21:19,453 One of the most important, 1163 01:21:19,542 --> 01:21:19,950 of course, 1164 01:21:19,989 --> 01:21:21,037 is the hamstrings, 1165 01:21:21,054 --> 01:21:23,933 which attach at the ischial tuberosity back here. 1166 01:21:24,102 --> 01:21:25,150 And if they're very, 1167 01:21:25,189 --> 01:21:27,438 very tight on one side, 1168 01:21:27,493 --> 01:21:30,846 they again could be putting torsional force across the pelvis. 1169 01:21:30,957 --> 01:21:32,522 And if they' too tight, 1170 01:21:32,585 --> 01:21:40,629 they could be tilting the pelvis posterior by pulling this issue of tuberosity down. 1171 01:21:42,370 --> 01:21:44,105 So that's one of the major ones right there. 1172 01:21:44,177 --> 01:21:55,194 There's another important ligament we'll talk briefly about called the sacrotuberous ligament that comes from the sacrum down to the ischial tuberosity. 1173 01:21:55,322 --> 01:21:58,201 And we will actually feel this and palpate this. 1174 01:21:58,225 --> 01:21:59,945 And if one side's tighter than the other, 1175 01:22:00,018 --> 01:22:02,968 you can tell even if the pelvis is fairly stable, 1176 01:22:03,063 --> 01:22:07,591 it could have rotational force one way or the other upon the sacrum. 1177 01:22:07,656 --> 01:22:09,096 So that's another factor. 1178 01:22:09,288 --> 01:22:09,800 And then, 1179 01:22:09,840 --> 01:22:10,072 of course, 1180 01:22:10,096 --> 01:22:13,288 we get up to the quadratus lumborum. 1181 01:22:13,383 --> 01:22:14,919 Quadratus lumborum is very, 1182 01:22:14,960 --> 01:22:15,860 very important. 1183 01:22:16,639 --> 01:22:18,295 It affects both the pelvis, 1184 01:22:18,328 --> 01:22:18,855 the ribs, 1185 01:22:18,888 --> 01:22:19,816 and the spine. 1186 01:22:19,927 --> 01:22:21,895 If one side is tighter than the other, 1187 01:22:21,967 --> 01:22:25,496 we're going to get side bending of the spine. 1188 01:22:25,687 --> 01:22:28,063 It can also pull the 12th ribs, 1189 01:22:28,151 --> 01:22:28,960 which are much, 1190 01:22:29,000 --> 01:22:31,776 much lower than here on the skeleton. 1191 01:22:31,888 --> 01:22:34,032 It can pull the 12th ribs way down here, 1192 01:22:34,056 --> 01:22:36,960 and it can compress the spine in this way. 1193 01:22:37,080 --> 01:22:40,431 So knowing how to work on the quadratus lumborum is very, 1194 01:22:40,455 --> 01:22:41,024 very important. 1195 01:22:41,111 --> 01:22:44,560 It's also very important to know which one you want to work on. 1196 01:22:44,599 --> 01:22:47,460 You're not going to work the same on each side if one's tighter. 1197 01:22:48,039 --> 01:22:53,840 And the other issue would be just this whole broad sheet of lumbar fascia, 1198 01:22:53,919 --> 01:22:54,768 if it's very, 1199 01:22:54,824 --> 01:22:58,650 very tight and pulling you into a pronounced lordosis here, 1200 01:22:58,800 --> 01:23:05,717 Stretching this out so that these vertebra can move forward and get a little bit flatter can be very, 1201 01:23:05,774 --> 01:23:06,581 very effective. 1202 01:23:06,645 --> 01:23:10,294 And we'll talk about that and body positioning on how to accomplish that. 1203 01:23:10,382 --> 01:23:11,909 So learn your pelvis. 1204 01:23:11,990 --> 01:23:13,286 It's extremely important. 1205 01:23:13,358 --> 01:23:15,397 It has effects upon the legs going down, 1206 01:23:15,454 --> 01:23:17,669 it has effects upon the spine going up. 1207 01:23:17,789 --> 01:23:23,622 And learning how to work with balance and with specificity on these vectors, 1208 01:23:23,686 --> 01:23:25,734 rather than just working the same on each side, 1209 01:23:25,822 --> 01:23:31,500 will be what moves you into much more expert status in solving problems. 1210 01:23:47,520 --> 01:23:49,912 The sacrum is another important area to. 1211 01:23:49,936 --> 01:23:52,647 Work that's not often taught in early classes. 1212 01:23:52,743 --> 01:23:57,616 The basic thing you want to do with the sacrum is to work obliquely and shallowly. 1213 01:23:57,728 --> 01:24:04,000 We're not going to try to upset the balance of the sacrum as it's articulating with the pelvis here, 1214 01:24:04,120 --> 01:24:04,831 but there. 1215 01:24:04,855 --> 01:24:06,063 Can very often be. 1216 01:24:06,151 --> 01:24:08,927 If you move down to this area and you look, 1217 01:24:08,984 --> 01:24:09,984 you'll feel the tissue. 1218 01:24:10,032 --> 01:24:11,699 Is compressed toward the middle. 1219 01:24:13,080 --> 01:24:13,936 So basically, 1220 01:24:14,048 --> 01:24:19,300 the strokes that I'm doing are spreading from the middle of the sacrum. 1221 01:24:20,439 --> 01:24:22,103 If I outline the sacrum, 1222 01:24:22,192 --> 01:24:25,300 the sacral apex or bottom is right down here. 1223 01:24:25,759 --> 01:24:26,983 The base of the sacrum, 1224 01:24:27,031 --> 01:24:28,184 which is actually the top, 1225 01:24:28,271 --> 01:24:29,620 is right along here. 1226 01:24:31,360 --> 01:24:33,848 So I just feel for areas that. 1227 01:24:33,903 --> 01:24:36,759 Seem to be a little bit more fibrous. 1228 01:24:36,920 --> 01:24:38,439 And I just try to soften this. 1229 01:24:38,480 --> 01:24:39,800 This is a great area to work. 1230 01:24:39,839 --> 01:24:41,459 For somebody that's coming in. 1231 01:24:42,160 --> 01:24:43,863 They've been held up in traffic. 1232 01:24:43,911 --> 01:24:45,288 They're a little bit nervous. 1233 01:24:45,463 --> 01:24:50,769 They're uptight about getting all their full hour and a quarter or whatever your massage is in. 1234 01:24:50,889 --> 01:24:52,305 And if you come down to the sacrum, 1235 01:24:52,338 --> 01:24:55,189 it has amazingly calming effects. 1236 01:24:55,689 --> 01:24:57,314 I just work very slowly. 1237 01:24:57,362 --> 01:24:59,850 I sink into maybe a quarter of an inch down. 1238 01:25:00,480 --> 01:25:01,576 I try to grab tissue, 1239 01:25:01,608 --> 01:25:03,419 I'm not sliding over tissue. 1240 01:25:05,839 --> 01:25:08,300 Grab that tissue spread. 1241 01:25:10,800 --> 01:25:11,208 Very, 1242 01:25:11,263 --> 01:25:15,368 very calming work while you're here. 1243 01:25:15,503 --> 01:25:18,568 It's often a good time after you've done this preparatory work. 1244 01:25:18,623 --> 01:25:22,660 And you might work two to three times as long as I'm doing here. 1245 01:25:24,960 --> 01:25:26,780 You could also use your knuckles. 1246 01:25:28,109 --> 01:25:30,309 As long as you're not pushing straight down, 1247 01:25:30,350 --> 01:25:32,409 you're taking very oblique strokes. 1248 01:25:33,390 --> 01:25:38,890 It's often a good way to start warming up for your later work on the quadratus lumborum. 1249 01:25:39,549 --> 01:25:42,490 So now I'm going to work along the crest of the ilium, 1250 01:25:44,509 --> 01:25:46,869 both sides and use my fist. 1251 01:25:47,030 --> 01:25:50,850 I stabilize the pelvis with my other hand so I'm not rocking it too much. 1252 01:25:57,000 --> 01:26:00,500 And then once you've moved outside of the sacrum, 1253 01:26:01,159 --> 01:26:02,479 this triangle here, 1254 01:26:02,600 --> 01:26:07,552 then you can start working on some of these attachments for the muscles here. 1255 01:26:07,575 --> 01:26:09,379 I can work a little more deeply. 1256 01:26:13,879 --> 01:26:15,456 I can start broadening, 1257 01:26:15,567 --> 01:26:17,152 moving into gluteus medius, 1258 01:26:17,215 --> 01:26:18,500 gluteus minimus, 1259 01:26:21,849 --> 01:26:27,510 and start working at a little greater angle so that I'm not quite so oblique 1260 01:26:30,250 --> 01:26:32,914 again. I'm spreading tissue away from the sacrum. 1261 01:26:32,962 --> 01:26:43,109 So now I'm just grabbing these gluteal muscles and doing a cross fiber stroke across the gluteals. 1262 01:26:51,989 --> 01:26:58,061 The gluteals are one of the largest muscle groups in the body and all sorts of regular massage, 1263 01:26:58,126 --> 01:26:59,805 kneading work feels excellent. 1264 01:26:59,837 --> 01:27:04,462 Here I'm working across Dina's body so that my body's not in the way and you can see what I'm doing. 1265 01:27:04,566 --> 01:27:05,597 But for sure, 1266 01:27:05,653 --> 01:27:07,069 do all your warm up work. 1267 01:27:07,109 --> 01:27:08,526 Do your work with your thumbs, 1268 01:27:08,557 --> 01:27:09,614 your effleurage, 1269 01:27:09,741 --> 01:27:18,008 Then start doing some work to integrate down the legs along with the hamstring group. 1270 01:27:18,144 --> 01:27:21,000 The gluteals are the major hip extender, 1271 01:27:21,159 --> 01:27:26,551 so it would bring Dina's leg up toward the ceiling if she contracted these. 1272 01:27:26,656 --> 01:27:30,472 And a lot of people hold tremendous energy in their gluteals. 1273 01:27:30,536 --> 01:27:33,752 That's how they keep themselves erect and their pelvis in a neutral position. 1274 01:27:33,855 --> 01:27:36,280 So most people really appreciate the work. 1275 01:27:36,319 --> 01:27:37,080 To the gluteals, 1276 01:27:37,159 --> 01:27:39,240 there's nothing fancy that needs to be done. 1277 01:27:39,360 --> 01:27:45,352 Basically you realize that they're coming down like this and attach to the back of the femur. 1278 01:27:45,415 --> 01:27:46,259 When they contract, 1279 01:27:46,560 --> 01:27:48,967 they extend the hip. 1280 01:27:49,063 --> 01:27:52,855 Also fibers of the gluteal come over and attach on the it band. 1281 01:27:52,888 --> 01:27:53,479 And that's very, 1282 01:27:53,520 --> 01:27:59,000 very important because if someone has tight gluteals and they're pulling the it band posterior, 1283 01:27:59,080 --> 01:28:00,743 then that's going to be strain on the knee. 1284 01:28:00,792 --> 01:28:02,759 So this is another area that you want to look at. 1285 01:28:02,800 --> 01:28:04,776 When somebody talks about knee strain, 1286 01:28:04,888 --> 01:28:07,822 start thinking about those gluteals as a possible cause. 1287 01:28:08,015 --> 01:28:15,442 So we're not even going to take a lot of time here because that kneading work feels so good and you can actually get some nice lengthening. 1288 01:28:15,586 --> 01:28:16,801 But after you've done that, 1289 01:28:16,825 --> 01:28:18,753 if you want to get a little more intense, 1290 01:28:18,882 --> 01:28:21,554 you just let your forearm. 1291 01:28:21,602 --> 01:28:24,641 I think the forearm works excellently on the gluteals. 1292 01:28:24,786 --> 01:28:27,042 Sink into the level at which you want to work. 1293 01:28:27,145 --> 01:28:32,030 You might want to hold up above so you're getting this stretch and just move down the leg. 1294 01:28:47,300 --> 01:28:51,500 Another excellent way to work on the gluteals is to use your fist on this. 1295 01:28:51,539 --> 01:28:52,843 I'd be using on this side, 1296 01:28:52,931 --> 01:29:01,515 so I would just climb up on the table so that my shoulder is nice and relaxed and then just do a stroke down this way so you can work on this side. 1297 01:29:01,668 --> 01:29:04,879 If I were to do it on this side with my fist turned the wrong direction, 1298 01:29:05,219 --> 01:29:06,680 it would look like this. 1299 01:29:07,379 --> 01:29:07,900 You see, 1300 01:29:07,939 --> 01:29:09,451 there's a little strain on my elbow this way, 1301 01:29:09,475 --> 01:29:11,228 but it's actually not too bad a stroke. 1302 01:29:11,324 --> 01:29:14,080 So this would be a cross fiber stroke on the gluteals. 1303 01:29:21,620 --> 01:29:25,480 Four or five minutes on the gluteal should be ample time, 1304 01:29:26,139 --> 01:29:28,148 unless your client is crying for more. 1305 01:29:28,283 --> 01:29:29,267 Most people really, 1306 01:29:29,324 --> 01:29:30,959 really like the gluteal work. 1307 01:29:31,420 --> 01:29:32,579 It's important to remember, 1308 01:29:32,660 --> 01:29:35,235 even though it looks like I'm pushing straight down here, 1309 01:29:35,387 --> 01:29:42,324 we do have the sciatic nerve that travels down through the back of the pelvis here and moves down the leg right here. 1310 01:29:42,411 --> 01:29:46,115 So if I'm pushing straight down against that sciatic nerve, 1311 01:29:46,148 --> 01:29:50,435 I could impinge it and set off a reaction of sciatica or something like that. 1312 01:29:50,507 --> 01:29:52,470 So even though I'm sicking in here, 1313 01:29:52,579 --> 01:29:55,874 my action is cross fiber. 1314 01:29:55,922 --> 01:29:59,410 I am not pushing tissue into the pelvic bones. 1315 01:30:09,679 --> 01:30:11,980 The piriformis and rotator muscles, 1316 01:30:12,640 --> 01:30:20,699 internally rotating the femur during your work is an effective way to stretch all the rotators and effect a release of these muscles. 1317 01:30:22,079 --> 01:30:23,980 Let's move on to the rotators. 1318 01:30:24,640 --> 01:30:26,728 In the first video, 1319 01:30:26,864 --> 01:30:28,568 as a palpation exercise, 1320 01:30:28,664 --> 01:30:31,867 we tried to just feel these rotators underneath the gluteal. 1321 01:30:31,943 --> 01:30:36,799 So let me just sort of emphasize to you again the muscle direction so you can feel these. 1322 01:30:37,100 --> 01:30:39,719 The gluteals would be moving down in this direction. 1323 01:30:40,619 --> 01:30:45,652 And underneath the gluteals you'll have the rotators and the angle of my fingers right here. 1324 01:30:45,756 --> 01:30:53,076 And what you can actually do is you let your hands soften with nice bent fingers. 1325 01:30:53,188 --> 01:30:55,200 We're not going to go straight in like that. 1326 01:30:55,500 --> 01:30:58,179 And you just slowly sink through those gluteals, 1327 01:30:58,259 --> 01:30:59,600 just melt through. 1328 01:31:00,670 --> 01:31:07,861 And then you'll start feeling these fibers underneath and they're running in this direction. 1329 01:31:08,006 --> 01:31:09,846 They're attaching right over here, 1330 01:31:09,918 --> 01:31:10,981 the trochanter. 1331 01:31:11,126 --> 01:31:12,290 And when they contract, 1332 01:31:12,750 --> 01:31:16,230 they pull the leg this way into external rotation. 1333 01:31:16,390 --> 01:31:19,653 So all I'm going to do is come down here, 1334 01:31:19,742 --> 01:31:20,453 feel those, 1335 01:31:20,542 --> 01:31:25,718 and they almost feel like little pencils or peaks and valleys that I can actually, 1336 01:31:25,774 --> 01:31:26,358 with my hand, 1337 01:31:26,414 --> 01:31:28,974 I can go over each one. 1338 01:31:29,141 --> 01:31:31,998 And then you'll feel that some are more strained than others. 1339 01:31:32,054 --> 01:31:32,382 Of course, 1340 01:31:32,406 --> 01:31:35,757 the piriformis is the main one that most people mention. 1341 01:31:35,853 --> 01:31:37,933 The sciatic nerve can run deep to, 1342 01:31:38,022 --> 01:31:39,245 it can run through, 1343 01:31:39,397 --> 01:31:42,718 or it can run superficial to the piriformis. 1344 01:31:42,813 --> 01:31:45,689 So what I first do is I just sink in. 1345 01:31:46,150 --> 01:31:48,221 You're going to have the easiest access, 1346 01:31:48,406 --> 01:31:53,290 a little bit lateral toward the trochanter here. 1347 01:31:56,450 --> 01:32:00,201 And then I can do some very slow cross fiber work. 1348 01:32:00,385 --> 01:32:01,786 And wherever I feel tension, 1349 01:32:01,817 --> 01:32:02,634 I just stop. 1350 01:32:02,721 --> 01:32:03,709 I wait, 1351 01:32:04,290 --> 01:32:12,681 may do some small undulating moving this out and just wait for that to soften there. 1352 01:32:12,705 --> 01:32:14,538 We got a little bit of a melt right there. 1353 01:32:14,674 --> 01:32:16,361 I'm working right through the gluteals. 1354 01:32:16,425 --> 01:32:18,110 I'm not even thinking of the gluteals. 1355 01:32:23,900 --> 01:32:27,879 As we talked about in the fundamentals tape, 1356 01:32:28,219 --> 01:32:30,740 we really want to put muscles on a stretch. 1357 01:32:30,819 --> 01:32:38,276 So the problem with lying face down and having the leg in a neutral position here is basically those rotators are going to be in a neutral position. 1358 01:32:38,348 --> 01:32:40,639 It's going to be hard to stretch them in this position. 1359 01:32:41,020 --> 01:32:46,919 So what I often do for this is I flex the D to about 90 degrees. 1360 01:32:48,180 --> 01:32:56,443 Then I'll sink in until I feel those rotators underneath me again. 1361 01:32:56,611 --> 01:32:58,651 And very often to test myself, 1362 01:32:58,795 --> 01:33:01,840 I will move the leg into internal rotation. 1363 01:33:09,460 --> 01:33:13,759 And that's going to feel like the rotators are put on a stretch, 1364 01:33:17,060 --> 01:33:19,515 and then I'll move the leg into external rotation, 1365 01:33:19,627 --> 01:33:22,000 and you'll feel those rotators soften. 1366 01:33:22,419 --> 01:33:26,572 So you can see that this femur is now rotating externally. 1367 01:33:26,716 --> 01:33:27,915 And these rotators, 1368 01:33:28,027 --> 01:33:33,228 because the acetabulum and the trochanter are moving in this direction, 1369 01:33:33,324 --> 01:33:35,759 are almost like a rubber band that's softening. 1370 01:33:36,819 --> 01:33:42,705 So carrying this farther than we did with the palpation exercise at this time, 1371 01:33:42,777 --> 01:33:48,349 I might want to do some cross fiber work there. 1372 01:33:48,650 --> 01:33:52,258 But when I really feel that I want to put a stretch on there, 1373 01:33:52,313 --> 01:33:54,866 I want to move this leg into internal rotation. 1374 01:33:54,978 --> 01:33:58,110 I'm going to move the foot out. 1375 01:33:58,490 --> 01:34:02,961 That's going to pull the femur along with it, 1376 01:34:02,985 --> 01:34:04,753 and it's going to stretch these rotators. 1377 01:34:04,882 --> 01:34:05,282 So now, 1378 01:34:05,306 --> 01:34:07,349 instead of doing cross fiber strokes, 1379 01:34:07,650 --> 01:34:10,030 doing lengthening strokes on those rotators, 1380 01:34:11,169 --> 01:34:13,830 the fingers work by far the best here. 1381 01:34:15,169 --> 01:34:16,233 If you need to, 1382 01:34:16,322 --> 01:34:18,105 you're not going to have the specificity. 1383 01:34:18,218 --> 01:34:18,649 And again, 1384 01:34:18,689 --> 01:34:21,721 I'd be doing this on the same side rather than reaching over. 1385 01:34:21,826 --> 01:34:24,589 You certainly can go in with an elbow. 1386 01:34:26,769 --> 01:34:28,442 Can you feel that resistance? 1387 01:34:28,586 --> 01:34:30,629 And then stretch a little bit more. 1388 01:34:41,420 --> 01:34:42,771 Nice patient work. 1389 01:34:42,875 --> 01:34:47,396 If you feel them tensing against your work, 1390 01:34:47,468 --> 01:34:50,100 then it doesn't necessarily mean that you have to stop. 1391 01:34:50,220 --> 01:34:51,363 Just slow down, 1392 01:34:51,531 --> 01:34:52,759 let them adjust, 1393 01:34:53,339 --> 01:34:54,540 and then start working again. 1394 01:35:00,960 --> 01:35:01,704 I will mention, 1395 01:35:01,752 --> 01:35:02,120 of course, 1396 01:35:02,160 --> 01:35:03,303 that before doing this, 1397 01:35:03,391 --> 01:35:07,944 you're going to check with them to see about their knee stability and do a few trial runs. 1398 01:35:07,992 --> 01:35:09,304 Ask them if their knee feels stable. 1399 01:35:09,352 --> 01:35:10,167 In this position, 1400 01:35:10,304 --> 01:35:15,416 you're not going to be doing flexion and extension while you're also doing rotation of the knee. 1401 01:35:15,608 --> 01:35:17,751 So once you get the knee into a fixed position, 1402 01:35:17,856 --> 01:35:21,940 that's when you do the lever arm here. 1403 01:35:37,770 --> 01:35:44,497 The sacrotuberous ligament and the coccyx are two areas you probably wouldn't volunteer to work on somebody the first time you meet them. 1404 01:35:44,634 --> 01:35:45,026 However, 1405 01:35:45,097 --> 01:35:47,921 it is an area that for many people has been injured, 1406 01:35:47,985 --> 01:35:50,018 particularly the tailbone or coccyx. 1407 01:35:50,194 --> 01:35:56,514 Many people have taken a fall sometime in their career skiing or with other sports or coming down icy steps or something. 1408 01:35:56,601 --> 01:35:57,381 And the coccyx, 1409 01:35:57,426 --> 01:35:59,405 coccyx can actually be very, 1410 01:35:59,478 --> 01:36:05,085 very fibrous and have a lot of built up tissue from an injury there. 1411 01:36:05,158 --> 01:36:06,397 It can actually be, 1412 01:36:06,453 --> 01:36:08,605 instead of hanging down at an angle like this, 1413 01:36:08,677 --> 01:36:09,469 like it's supposed to, 1414 01:36:09,510 --> 01:36:14,290 it can be bent very far forward so that it's almost at a right angle to the sacrum. 1415 01:36:17,989 --> 01:36:18,989 It can be very, 1416 01:36:19,030 --> 01:36:19,981 very beneficial work. 1417 01:36:20,006 --> 01:36:27,632 If you can look at this coccyx as the very end of the sacrum and you can see if it's pushed to one side and it's exerting force, 1418 01:36:27,695 --> 01:36:30,272 it can actually have large effects, 1419 01:36:30,415 --> 01:36:31,536 relatively large effects, 1420 01:36:31,567 --> 01:36:34,992 at least upon the sacrum's rotation in the pelvis. 1421 01:36:35,135 --> 01:36:39,936 So if the sacrum is pulled over by fibrous material on the left hand side here, 1422 01:36:40,007 --> 01:36:45,359 it's going to be putting strain all the way up the sacrum and then all the way up the spine. 1423 01:36:45,519 --> 01:36:52,500 So I'd like to talk a little bit about the coccyx first and then we'll talk about another strain pattern from the sacrotuberous ligament. 1424 01:36:53,900 --> 01:36:54,579 Generally, 1425 01:36:54,659 --> 01:36:56,340 people will be coming to you saying, 1426 01:36:56,379 --> 01:36:57,924 I have injured my coccyx. 1427 01:36:57,971 --> 01:37:00,371 I have a lot of problem down there. 1428 01:37:00,475 --> 01:37:03,459 And you're probably not going to be exploring around there, 1429 01:37:03,500 --> 01:37:05,091 trying to hunt for gold there, 1430 01:37:05,115 --> 01:37:06,563 unless they've told you about that. 1431 01:37:06,652 --> 01:37:12,756 So the key on the coccyx is to keep your hands soft and use the fleshy part of your fingers. 1432 01:37:12,788 --> 01:37:13,443 So in this, 1433 01:37:13,532 --> 01:37:19,651 I always work on the opposite side of the coccyx because if I work on the near side, 1434 01:37:19,756 --> 01:37:24,836 my fingernails are going to be much harder and give a much more unpleasant sensation there. 1435 01:37:24,987 --> 01:37:28,467 So all I do is I come from above rather than below. 1436 01:37:28,524 --> 01:37:31,860 It's much easier to follow the sacrum down and then when it starts tapering, 1437 01:37:31,939 --> 01:37:34,355 you're going to know that you're nearing the coccyx. 1438 01:37:34,467 --> 01:37:35,379 And then I just, 1439 01:37:35,419 --> 01:37:36,756 with soft fingers, 1440 01:37:36,867 --> 01:37:51,409 I just roll right around that edge. 1441 01:37:52,069 --> 01:37:54,330 Sometimes I'll take my other hand right here. 1442 01:37:54,870 --> 01:37:56,830 And it's a little difficult to see right here, 1443 01:37:56,870 --> 01:37:57,614 of course, 1444 01:37:57,782 --> 01:38:01,533 because you're never going to be working on the coccyx without a drape. 1445 01:38:01,581 --> 01:38:03,133 And here we have the bathing suit on. 1446 01:38:03,222 --> 01:38:06,370 And all I do is I wait for that tissue to soften. 1447 01:38:08,310 --> 01:38:09,550 It may take a minute, 1448 01:38:09,629 --> 01:38:10,930 may take two minutes. 1449 01:38:20,500 --> 01:38:28,319 You can just picture these fingers starting to grab and feel that bony outline of the coccyx. 1450 01:38:28,979 --> 01:38:31,580 I'm just providing a little stability with my left hand. 1451 01:38:31,699 --> 01:38:33,084 And then you can start feeling, 1452 01:38:33,132 --> 01:38:34,747 is it pulled to the left? 1453 01:38:34,804 --> 01:38:35,915 Is it pulled to the right? 1454 01:38:35,987 --> 01:38:37,039 And if need be, 1455 01:38:37,139 --> 01:38:37,943 you can actually, 1456 01:38:38,032 --> 01:38:40,728 in addition to softening tissue with very, 1457 01:38:40,783 --> 01:38:42,824 very steady and not forcing it, 1458 01:38:42,912 --> 01:38:46,632 you can also work to actually turn this coccyx a little bit. 1459 01:38:46,656 --> 01:38:47,848 So I'm exaggerating a little bit. 1460 01:38:47,903 --> 01:38:53,860 What I'd be doing is moving it counterclockwise here if it were pulled to the left hand side. 1461 01:38:56,800 --> 01:38:59,304 That's about all that would be expected of you in a massage. 1462 01:38:59,352 --> 01:39:01,256 But a lot of people come in with problems there, 1463 01:39:01,328 --> 01:39:04,503 and it's nice to be working in a medicinal way. 1464 01:39:04,671 --> 01:39:16,386 In addition to all the nurture that you're giving people when you leave, 1465 01:39:16,418 --> 01:39:18,629 you want to leave gracefully and slowly. 1466 01:39:20,410 --> 01:39:21,041 I would then, 1467 01:39:21,065 --> 01:39:21,649 of course, 1468 01:39:21,769 --> 01:39:22,146 always, 1469 01:39:22,218 --> 01:39:22,817 no matter what, 1470 01:39:22,874 --> 01:39:27,105 go over to the other side and work it to try to create balance. 1471 01:39:27,218 --> 01:39:27,601 And then, 1472 01:39:27,625 --> 01:39:28,161 if need be, 1473 01:39:28,185 --> 01:39:30,930 if I felt that the second side I worked on was much, 1474 01:39:30,970 --> 01:39:32,305 much softer than the first, 1475 01:39:32,377 --> 01:39:34,233 I might even go back to the first side. 1476 01:39:34,362 --> 01:39:35,978 You're not going to work exactly the same. 1477 01:39:36,033 --> 01:39:38,470 You're going to feel differences from side to side. 1478 01:39:39,649 --> 01:39:42,430 So let's talk about the sacrotuberous ligament. 1479 01:39:43,170 --> 01:39:45,834 Here I have the bottom of the sacrum, 1480 01:39:45,961 --> 01:39:48,589 and here I have the ischial tuberosity. 1481 01:39:49,089 --> 01:39:59,689 So from my thumb to my fingers here is a very important ligament that runs in a straight line between these two points and acts to stabilize. 1482 01:40:00,400 --> 01:40:01,080 This clockwise, 1483 01:40:01,112 --> 01:40:03,608 counterclockwise rotation of the pelvis. 1484 01:40:03,783 --> 01:40:12,071 And what you'll find with people is that sometimes that sacrotuberous ligament is going to be a half an inch higher on one side or the other. 1485 01:40:12,176 --> 01:40:17,367 And this can be causing or it can be a result of pelvic torsional patterns. 1486 01:40:17,544 --> 01:40:17,928 Actually, 1487 01:40:17,984 --> 01:40:21,239 when I feel Dina's sacrotuberous ligaments, 1488 01:40:21,320 --> 01:40:26,649 her right sacrotuberous ligament is probably a third of an inch or even more up, 1489 01:40:26,690 --> 01:40:27,722 more toward the ceiling. 1490 01:40:27,786 --> 01:40:29,929 So there's a bit of a rotation going on here. 1491 01:40:30,050 --> 01:40:31,097 So the easiest way, 1492 01:40:31,153 --> 01:40:31,786 as I've mentioned, 1493 01:40:31,818 --> 01:40:37,658 you should always be able to find that landmark of the ischial tuberosity is just put your thumbs on the ischial tuberosity, 1494 01:40:37,753 --> 01:40:38,473 roll over, 1495 01:40:38,561 --> 01:40:41,097 and you're going to be on that sacrotuberous ligament. 1496 01:40:41,194 --> 01:40:42,314 And then when you're there, 1497 01:40:42,402 --> 01:40:45,590 you can either use your fingers to just soften it, 1498 01:40:46,689 --> 01:40:52,750 visualize a little bit of a shearing motion to maybe even push that ischial tuberosity straight down toward the table. 1499 01:40:54,119 --> 01:40:55,008 If that's enough. 1500 01:40:55,064 --> 01:40:56,607 If you feel some softening there, 1501 01:40:56,664 --> 01:40:58,219 that's all you need to do. 1502 01:40:59,079 --> 01:41:01,539 If you feel you need a little more direct pressure, 1503 01:41:02,280 --> 01:41:05,487 then the elbow is a very good way to do this. 1504 01:41:05,543 --> 01:41:08,512 You want to stabilize it with your hands so it's not rocking too much, 1505 01:41:08,615 --> 01:41:09,855 and you just lean in. 1506 01:41:09,927 --> 01:41:14,703 I'm probably putting about 4 to 5 pounds of pressure right now. 1507 01:41:14,792 --> 01:41:22,599 You don't want to put too much more pressure because you could disrupt the balance of the to innominate bones here in the pelvis. 1508 01:41:22,680 --> 01:41:25,463 But if you can put enough very specific pressure, 1509 01:41:25,512 --> 01:41:28,024 this is why you're going to use the sharper part of your elbow, 1510 01:41:28,152 --> 01:41:31,575 because you don't want to be putting broad force and disrupting the pelvis. 1511 01:41:31,768 --> 01:41:33,980 You sometimes will feel that soften. 1512 01:41:45,120 --> 01:41:46,060 Okay. 1513 01:41:46,620 --> 01:41:49,956 This is something that you're probably not going to do in a generic massage. 1514 01:41:50,067 --> 01:41:52,932 But when somebody comes in that you've seen on a regular basis, 1515 01:41:52,995 --> 01:41:58,084 this is a kind of sophisticated work that can really add a whole new dimension to your work. 1516 01:41:58,171 --> 01:42:00,879 So if you need to practice with your friends, 1517 01:42:01,340 --> 01:42:03,668 find these landmarks so that you feel confident, 1518 01:42:03,763 --> 01:42:06,963 because you're not going to be poking around and experimenting with this. 1519 01:42:07,052 --> 01:42:08,740 But once you get these landmarks down, 1520 01:42:08,780 --> 01:42:09,795 it's very easy work, 1521 01:42:09,867 --> 01:42:10,580 and it's very, 1522 01:42:10,620 --> 01:42:11,204 very important. 138626

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