Thursday Thoughts: Cut Me Some Slack! | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

Thursday Thoughts: Cut Me Some Slack!

Stretch, stretch, stretch!

Clinicians, patients, everyone loves to stretch and thinks it is necessary to increase flexibility, symmetry, and decrease pain. In most cases, the perception of tightness is just that, only a perception. Very rarely are muscles "adaptively shortened" as in the case of true contracture. True contracture happens after prolonged immobilization for 4-6 weeks or so.

Unless you have been immobilizing your knees in a near fully flexed position, it's pretty doubtful you have "tight" hamstrings. In most of these cases, you can dramatically improve ROM in something like an active/passive straight leg raise with some
  • motor control
  • bracing
  • pelvic floor activation
  • diaphragmatic breathing

Without aggressive techniques like ART, IASTM done harder than an angry kitten would lick you, ROM dramatically improves in the ASLR.

In cases of pain and strong stretch perception where motor control techniques will not work, you need to give the muscle with high tone some slack. Foam rolling or stretching an already taught cable does not make it stretch more. I was issued a challenge while taking The SFMA 2 to solve every mobility problem by treating it as a tone problem. I shot two videos where I slacked two areas with high tone, one using
  • passive hip flexion and ER to improve anterior impingement with an EDGE Mobility Band to modulate perception of "compression"
  • passive trunk sidebending and light rotation to slack hip flexors and hikers in a high level former gymnast who had trouble with rolling patterns and supine to sit with hips offset

In both cases, an entirely pain free slacking technique did the same thing much more aggressive and uncomfortable stretching technique would do. Videos below

Positional Release for Obliques

Hip Flexor Positional Release

The key parts about positional releases is that they are
  • pain free
  • easy to do
  • enable a patient to modulate stretch perception via tone reduction, thus enabling them to get to end range to perform their own self resets
  • EDGE Mobility Bands work great for extremity modulation and positional release!
Keeping it Eclectic...

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