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Welcome to Section 2 of Deep Tissue Massage and Myofascial Release,
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a video guide to techniques.
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My name is Art Riggs for those of you that are just joining us.
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And I am working under the assumption that you have either seen the first section,
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the fundamentals section,
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or that you are experienced therapists who have cultivated your touch.
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So now we will apply those tools that we have learned in the fundamentals section into section 2,
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which is the strategies section.
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So I will remind you that I'm going to be working considerably faster than I normally work in a regular massage.
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And this is because I want to show you many,
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many strokes and options for you to improvise with.
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So please do feel free to alter any of the strokes I'm using.
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If I'm using an elbow and you prefer to use the knuckles or a fist,
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please try that and experiment with what works best for you and works best for your clients.
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We'll begin our foray up the body with the feet.
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I think the feet are tremendously important in many,
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many ways.
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People injure their feet when they're younger,
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develop limping patterns and protective splinting and compensatory patterns.
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And as the foot contacts the earth,
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that strain pattern will continue all the way up the body.
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So it's very important when you're doing structural massage to start thinking about what is actually happening in the ankle joint,
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the foot joint,
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and how strain patterns move all the way up the leg.
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I'm always excited when we move from the fundamentals and theory aspect of deep tissue to actually doing the work.
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I can slow down a little bit.
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I don't have to be showing a bunch of strokes.
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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.
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So if I'm using my fingers and you prefer to use the knuckles,
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or if I'm using my knuckles and you prefer to use the fist or the fingers,
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please feel free to experiment here.
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I will be showing you more strokes than I normally would be working.
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If I work on this body part,
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I want to give you a lot of options to use.
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But remember that just as in poetry or good literature,
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having a large vocabulary is always very handy.
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But sometimes the simplest and most direct way to work is by far the most effective.
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So let's begin with the leg and the foot,
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and a reminder that I'm going to be using very,
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very little lubrication.
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I'm really trying to stretch this tissue.
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I'm also making the assumption throughout these tapes from now on that you have done your backup work,
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you have worked on the outer layers,
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you've softened,
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you've taken your nice broad strokes,
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you've worked at the superficial level.
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So beginning down at the foot,
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one of the most important joints that we can work with is the talotibular joint.
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The talus bone right here articulates with the tibia and as it rotates like this,
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it can impede the function.
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It also rests upon the calcaneus bone.
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So if the calcaneus is too far medial,
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if it's too far lateral,
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then it's not going to be providing support for the talus bone.
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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.
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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,
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the gastroc and soleus that's preventing it.
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The in range feel will tell you a lot.
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If it comes to a sudden halt,
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then probably it's more of a jamming in the front.
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If you keep feeling,
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feeling the posterior compartment getting tighter and tighter as you stretch this foot up,
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then you're going to know that you're going to want to spend more time on the posterior compartment lengthening that.
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So let's just open up the front of this joint right now.
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If you're working with someone else,
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please feel free at any time to stop this tape and work on.
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And work on the small little segments I'm working with.
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I do want to get some continuity here,
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so I'll be working for a longer time period.
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Dina's foot plantar flexes very easily.
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She's a swimmer and her foot is very often in this position.
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So I don't need a lot of work to lengthen this area to enable her foot to come down.
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Other people,
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when they lie on the table,
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their foot may be resting like this.
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In that case,
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then you need to determine where is the shortness here.
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Pull this foot down and you may feel it along the ankle joint,
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you may feel it all the way up to the knee.
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So I'm just going to do some nice warm up strokes in this area and I'm also going to consider,
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do I want to create mobility of the foot to turn in,
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to turn out,
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to rotate in which direction?
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So I'm always moving this foot and feeling where are the restrictions to movement?
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How can I improve function to this foot by doing some strokes?
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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.
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So as we go down the tibia,
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we notice that it articulates in the front right here with a bone called the talus bone,
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which I just mentioned.
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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.
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But the talus bone also sits upon the calcaneus bone right here.
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So if on the outer side of your leg you have a lot of fascial tightness,
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or if you have a compromised ankle from a sprain,
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you can see how the relationship of the calcaneus is going to influence how this talus bone rests and articulates with the tibia.
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So this is just important things to think about when you're working with the feet,
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that you're not just squeezing tissue,
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you're going to work with these bones.
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How do I get better function?
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Is there a lot of fibrous issue in here that's built up that's preventing this from moving?
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These are things we want you to consider.
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And then when you come out to the next bone in front of the calcaneus,
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we've got the cuboid bone,
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somebody that's got a very high arch and this bone is rotated this way,
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you may want to work with noticing that the plane of articulation is right along this way.
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You may want to work by grabbing this bone and rotating it and just freeing it a little bit.
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So do study the bones of the feet and try to have a game plan when you're working on your foot.
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Do we need to provide more mobility for this medial arch in here so that the navicular bone can actually rotate and these bones,
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metatarsals can move in a little bit and have a little lower arch so that we have better balance these.
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These are things that you want to start thinking about with the feet so that you're not just squeezing tissue.
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The ankle retinaculum.
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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.
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So now I'm just going to sink right in to this retinaculum,
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start the foot in a shortened position and do an anchor and stretch.
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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.
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I always try to work across joints.
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This might be enough for somebody right there.
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This may have a lot more direction than just squeezing tissue like you would with a beginning mass massage.
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If I feel specific fibrous restrictions in this,
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I can then stand up,
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use my body weight and sink into this area and do much more specific work.
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Again,
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I'm forever trying to find out where's the restriction,
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how can I improve mobility of this foot?
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I can use my fingers to just stroke this way and go cross fiber on this retinaculum.
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Because I do feel some tightness in Dina's calf,
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I'm going to work a little bit on the posterior compartment.
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One of the advantages of working on the calf muscles.
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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.
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Don't be limited to always working on the up surface.
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The down surface is often a very good surface to work on all through the body.
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Those muscles are nice and relaxed.
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You don't have to work very hard because they're just going to provide most of the impetus themselves with their own gravity.
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And as I anchor on any tight places here,
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I'll just push forward.
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Notice that I don't limit myself to just working on the foot.
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Everything is connected.
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Don't feel like you're just going to work on the foot.
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You're done with that foot,
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then you move up the leg,
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try to connect everything.
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Sometimes I'll go clear across the knee joint when I'm working to get this feeling connection all the way up the body.
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The plantar surface of the foot is an excellent area to work for stretching tissue.
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Dina has a rather flat foot,
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so I'm going to be careful that I don't try to stretch along the medial arch here.
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Her foot turns in fairly easily anyway.
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This would be a hypermobility issue,
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and I want to be careful to not accentuate that.
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But these muscles and this fascia will be strained from the everyday standing and walking and athletic activities that she does.
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So I can possibly work a little more cross fiber on these to solve soften that fibrousness.
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But I want to be careful not to lengthen them on the other side with somebody with fairly flat feet.
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If you can mobilize the lateral arch clear here on the outside,
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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.
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So I'm actually going to work on Dina's lateral arch here and get some mobility there.
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Just using a nice soft knuckle for somebody with a very high arch and lack of mobility,
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Then you could do anything you wanted here.
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You could move to the inside and start working with that medial arch.
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You can also increase the function of the transverse arch here.
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All I need to do is put stretch here,
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maybe even stretch the ankle a little bit and work along the transverse arch here.
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I'm showing a lot of strokes here.
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You might actually be working this way,
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although only a fraction of these would be enough to increase the function of the foot.
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And the next time the person comes back,
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you work a little bit differently.
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I very often will take my other hand underneath the calcaneus and try to mobilize it internally or externally or lateral or medial,
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and possibly even stretch it.
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I'm going to show you one other way to work on the bottom of the foot.
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That feels very,
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very good for your client,
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and that is just have them lift their knee up,
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have the foot sitting flat on the table like this,
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and then take your hand underneath and do any kind of strokes you want to do.
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You'll get a nice soft surface with your fingers here.
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At the same time,
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you can be mobilizing the foot one way or another.
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The main thing is you're not just squeezing tissue in the foot.
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You are increasing mobility.
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You're getting all these bones moving.
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I'm very often thinking about the bones in the foot.
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How do they articulate with each other?
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How can I mobilize them?
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So I'm very often moving bones around here.
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I can actually do a snowplow by curving my fingers slightly,
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anchoring the foot and pushing toward the calcaneus here.
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We'll go into more detail on the bottom of the foot when we talk about plantar fasciitis in the injuries.
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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.
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It just feels like it's pretty vulnerable,
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but it's also an area that really gets bound up.
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The fascia here and the superficial muscles can get very,
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very caught up with the tibia here and bound there.
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So I like to do a lot of work on the front of the shin.
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Clients,
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when they stand up,
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can feel a lot of difference.
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So this is a great one to be using nice soft fingers.
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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.
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I can work about this speed.
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You don't have to work quite so slowly there.
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A lot of people after massage have never even been touched on this area.
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If you want to use a nice soft surface,
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you can just get on the inside of your arm here with your hand rotated this way.
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So you're using the fleshy surface and just work on up.
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Of course,
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the tibialis anterior is probably the most important muscle on the front of the shining the tibialis anterior muscle.
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This muscle is often tight and fibrous,
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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.
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When working with dorsiflexes the foot,
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most people know about that.
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So somebody that's foot is needing to often raise up,
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such as a bicyclist or something like this,
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when they're pulling up on the pedal,
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then this muscle can get overworked.
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But the other issue I want to talk about with the tibialis anterior is that as it travels down,
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goes underneath the retinaculum here,
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it actually connects to the medial arch of the foot,
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and it's what holds the stability of this medial arch so that it doesn't rotate too much.
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So somebody with a very,
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very flat foot,
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you,
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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.
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However,
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this muscle may be very,
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very tight.
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So what you would want to do is rather than stretching the muscle,
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work on it in a shortened position instead of pulling the foot down.
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So now let's go back to some of the earlier strokes I've demonstrated and return to lengthening this area.
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So the first stroke might be the anchor and stretch.
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So I'm moving this Tissue in the opposite direction.
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You'll notice some people that really have a lot of problem pulling their foot up.
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And there's sort of a jerkiness there.
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00:17:57,336 --> 00:18:00,415
I mentioned this earlier in the previous fundamentals tapes.
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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,
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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.
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00:18:43,274 --> 00:18:45,337
Let's show some other strokes on the near leg.
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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,
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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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