The Influence of Pelvic Position on Lower Extremity Stretching

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The latest webinar recording for Inner Circle members is now available below.

 

The Influence of Pelvic Position of Lower Extremity Stretching

The below webinar will help you understand:

  • Why lower extremity stretching is essentially flawed
  • Why we aren’t always in neutral position or symmetrical
  • The influence of pelvic tilt on pelvic position
  • Simple assessments to see if you are “neutral”
  • How to adjust stretches to assure proper form and alignment
  • How to individualize lower extremity stretching based on pelvic alignement
  • What to avoid while stretching to maximize movement quality

 

To access the webinar, please be sure you are logged in and are a member of the Inner Circle program.  If you are currently logged in, you will see the webinar below.  If not, please log in below and then scroll down to the “webinar archives” section.  If you are not a member, learn more and subscribe to Mike Reinold’s Inner Circle program.

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17 Responses to “The Influence of Pelvic Position on Lower Extremity Stretching”

  1. Work and life keep getting in the way, but I finally had a chance to watch the first Inner Circle webinar. I absolutely love the 3D approach you applied to the standard SLR and Thomas tests. I plan to teach this to 1st year PT students to get so much more out of the typical muscle length tests. I’ve learned a lot from you both as a PT and a teacher. Thank you!

  2. Mikhail Pavlov July 16, 2012 at 12:23 pm

    Great webinar! Makes things clear for me. One question thou, most common opinion is that anterior pelvic tilt drives internal hip rotation. You show external leg rotation on the left anterior tilted side. Is it due to 90 hip flection?

    • When lying on the table with an anterior tilt, your leg is positioned in more ER. Don’t think dynamically about what may happen (that is a different topic), think more alignment.

      If we are thinking in the sagittal plane and “assuming” they are in neutral, but there is an anterior tilt, this will position the acetabulum that results in ER.

      Image the leg staying straight ahead, but the pelvis changing, this creates the change in position in relation to “neutral.”

      Did i explain that better or make it worse????

      • Mikhail Pavlov July 18, 2012 at 8:19 am

        I’m a little bit confused, becouse I’ve read the legs should be more IR with anterior pelvis tilt, not ER. If I squeeze my glutes forcing posterior tilt my thighs will be more ER then.

        • Imagine you lay down on the table and we are looking at you from the top, through your head. If we line you up in “neutral” and just for the sake of this example say your feet are lined up, shoulder width apart, and feet pointing straight up.

          Now, if your pelvis on one side is tipped more anterior, but we still line you up in “neutral,” your hips will be off in the transverse plane. That left hip will be more forward, that hip will be in more ER in this position because the acetabulum moved the position, not the femur.

          Remember, we are talking about stretching on a table, not what happens dynamically with the femur.

          Hope that helps!

  3. Lior Ben alta July 25, 2012 at 9:52 am

    Hi Mike.
    First of all, let me say that I’m enjoying your web site and your articles and proud to be in the “inner circle” :-).
    I am really interesting to know what is your opinion of the theory that stretching magnify ROM by affecting the pain threshold and not because it has an affect on the tissue itself.
    See article that I found:
    http://ptjournal.apta.org/content/90/3/438.full.pdf
    Thanks,
    Lior

    • Lior, I do think this current research and thought process is heading in the right direction. We can have an impact on ROM but I also think we have an impact on the brain ALLOWING more ROM!

      Thanks for being part of the Inner Circle!

  4. Great Webinar Mike, only just joined Inner Circle and already learning lots of great information, and seeing common themes which I regularly see with my patients.

    Do you have any information on how you would rehab a “stable” internal GHJ impingement differently to an external sub-acromial impingment? Or if you could point me in the right direction.

    Many thanks Mike.

    Steve

    • By “stable” I assume you mean they aren’t that symptomatic? By definition, internal impingement involves a certain degree of instability, even if micro. So they may not have gross instability, but they aren’t doing a good job dynamically stabilizing. So, naturally, that is the emphasis of treatment. Read my two part papers in Sports Health or I have a chapter on this in my book The Athlete’s Shoulder

  5. Hi Mike,
    Thanks for all of the great information!! I have a question about the psoas length on the left side when the pelvis is anteriorly tilted on the left. Wouldn’t the contribution of the iliacus make the patient look as if he had more mobility and length of the anterior hip on the left side (since it contributed to the appearance of less mobility of the hamstrings)? Not sure if my reasoning is correct? Also, I had also been taught that the abducted position in the psoas stretch was due to tightness of the ITB, so it’s really interesting to know that this is not always the case. Thanks again!

    • Hi Elizabeth-

      I like your thought process with the hip flexor comment. You are thinking of this stuff very well. If you are just looking at posture and not considering alignment, yes, you could get a false assessment. However, when you carefully scrutinize the hip flexor you will see tightness due to the anterior tilted position. The patient will also have a noticeable side to side difference.

      Essentially our job is to make sure they are in alignment BEFORE we start stretching etc.

      I was taught that too, btw, regarding this ITB but see more psoas involvement than ITB.

  6. Love the webinar Mike. I’ve recommended both sites to my students. Would love to see webinars like this one on the pelvis also including the knee, ankles, hips. Look forward to more great info. Thanks for taking the time to share your knowledge and experience.

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