ASLR Exercise or How to Improve Hip Hinging | Modern Manual Therapy Blog

ASLR Exercise or How to Improve Hip Hinging



Does your patient feel like they have "tight" hamstrings? Have you performed some STM, or a party trick like the Mulligan Traction SLR? How do you keep the rapid improvements?

The more I practice, the less I see "tight" hamstrings. Here is one of my favorite exercises that a patient can do to quickly improve their ASLR.


Pt:

  • Supine
  • UEs overhead one hand over the other
  • both ankles dorsiflexed
Cues:
  • push your top hand into your bottom hand, but don't let it move (isometric resistance) 
  • tense your belly like someone was going to punch you or drop a heavy weight on it
  • point your toes up toward your head and lift one leg up, keeping your knee straight
  • push your other leg down into the table, keeping your toes pointing toward the ceiling (no hip ER)
  • repeat several times on each side (they may or may not alternate), 3-4 times/day
  • self audit - checking ASLR before and after, or forward bending in standing (assuming there is no posterior derangement)
Indications:
  • limited ASLR that improves easily with passive SLR (indicating a motor control/stability issue)
  • difficulty with hip hinging
  • ASLR rapid improvement with the actual exercise
Precautions:
  • very painful neurodynamic dysfunction
  • peripheralization of complaints that persists
If the exercise does not change the ASLR or SLR rapidly, there may be true dysfunction that requires more extensive manual work.





2 comments:

  1. Neat technique, Erson. That gives me a good idea for a person I'm treating with bilateral limitations following bilateral THR's.

    ReplyDelete
  2. Thanks Kent, it works with all populations. Indications, hips and limited movement! Let me know how it works out

    ReplyDelete