Self Muscle Massage- pt 16 Forearm/Wrist

This is part sixteen in the Self Muscle Massage Series. In the introduction post to this series we introduced and demonstrated the three muscle release techniques that will be used in this post. If you would like to review them, click here. If you would like to see any other parts of the series, click here.

In this installment of the series we’re going to be moving from the elbow down into the forearm, wrist and hand. Typically, as you move further away from the core of the body, the muscles get smaller and become more prone to injury through repetitive overuse situations. It is also why bony injuries such as fractures and joint dislocations become more common where the muscles are unable to counteract the full load of the body in a fall situation onto the arm. In this area, the most common muscular injuries are lateral and medial epicondylitis (also known as tennis and golfers elbow).

Anatomy

Bony Landmarks

As you may recall from the last post, the elbow moves in four ways- 1) bending (flexion), 2) straightening (extension), 3) pronation (rotating the forearm so that the hand is facing down towards the floor), and 4) supination (rotating the forearm so that the hand is facing up towards the ceiling). With those four motions in mind, an easy way to visualize the elbow joint is to think of it as one bone coming down from the shoulder (this is the humerus). As it’s dangling there, two bones that are already connected to each other (this is the radius and ulna) then literally hook on to that bone. This forms the actual elbow joint and allows you to bend and straighten your arm. Rotation at the elbow actually occurs because of the two lower bones and how they are  connected to each other. The rotation of the forearm occurs because the radius is able to rotate over the ulna (it is connected directly to the humerus and provides the bending/straightening).

In addition to the elbow, we now have to add in movement at the wrist itself. It also moves in four ways. With your palm facing the floor, these movements are: 1) extension (bending the wrist up towards the back your hand), 2) flexion (bending the wrist down towards the palm of your hand), 3) ulnar deviation (bending the wrist towards your pinky finger), and 4) radial deviation (bending the wrist towards your thumb).

elbowbone2

#1 Humerus. The humerus is the long bone of the arm that moves down from the shoulder to the elbow. As it moves down the arm, the narrow bone becomes wider at the elbow. If you cup your hand under your elbow you will feel the two “knobs” on either side. These are called the epicondyles (the medial is on the inside closest to the body, and the lateral is on the outside away from the body). The epicondyles are important! These are the two main attachment points for the most of the muscles in the forearm. The epicondyle closest to your side is the called the medial epicondyle. This is where the wrist flexors attach (meaning the muscles that bend your wrist up towards your palm). Strains/sprains/tendonitis in this area is commonly called golfers elbow or medial epicondylitis. The “knob” on the outside is your lateral epicondyle. This is where the wrist extensors attach (meaning the muscles that bend your wrist up towards the back of your hand). Sprains/strains/tendonitis in this area is commonly called tennis elbow or lateral epicondylitis.

#2 Forearm bones- Radius and Ulna. These two bones connect in two spots (up near the elbow and then again down at the wrist). The ulna actually hooks onto the humerus at the back of the elbow. This part of the ulna is known as the olecranon. The second forearm bone, the radius, then connects to the ulna. Together, these two bones rotate to produce supination and pronation of the arm. Without these you would be unable to turn keys, door knobs etc. An easy way to differentiate which bone is which is to look at your hand. The bone on the side of your thumb is the radius, while the bone on the side of your pinky is the ulna. As you rotate your arm back and forth you can see how the radius rotates over the ulna which is connected to the humerus.

#3 The wrist + hand. Instead of rambling on about all of the tiny bones that makes up the hand and wrist, I’m going to stick with a simple overview. Just below the radius and ulna are the carpal bones. There are eight of them and they are arranged like little rocks between the long bones of  the forearm and those of the fingers and thumb. These small bones allow for wrist movement while the long finger bones allow for grip, pinch, etc. The bones of the fingers and thumb are arranged in segments to allow for increased mobility. In order they are- 1) from the wrist to your knuckles are the metacarpals and 2) from your knuckles to your finger tips are the phalanges. As you look at your fingers, there is a little bone on either side of the creases (where the finger bends). Your index finger for example has two creases and therefore three phalanges while your thumb only as one crease and two phalanges.

Muscles

When it comes to the wrist and hand, an easy way to think of the muscles is to think about what fingers of the hand they control (they are traditionally referred to as digits 1-5 with 1 being the thumb and 5 being the pinky or little finger). With this in mind, the muscles will either control the thumb (digit #1), little finger (digit #5), or the three fingers in between (index, middle, ring or digits 2-4).

wristflexormuscle-1

#1 Wrist Flexors Group. There are three separate muscles in the wrist flexor group and they all start on the medial epicondyle of the humerus before moving down the arm to the wrist. As I stated above, the hand and fingers can be broken down into three segments (thumb, middle fingers, little finger). You can use those segments to follow the muscles. The small blue muscle is the flexor carpi ulnaris and it travels from the epicondyle, over the wrist joint to insert on the 5th digit. The middle red muscle is the palmaris longus and it crosses the wrist joint to insert on digits 2-4. The green muscle is the Flexor carpi radialis and it attaches to the base of digits 2+3. Together all three of these muscles are responsible for bending the wrist down towards the palm of your hand. The green and blue muscles are also able to assist with radial and ulnar deviation (bending the wrist towards the thumb and towards the pinky finger respectively). If you bend your wrist up towards your palm, you will see the three tendons pop up at the wrist.  Likewise, you place your thumb on the medial epicondyle and bend your wrist back and forth, you will be able to feel the common tendon move.

wristextensormuscles

#2 Wrist Extensors Group. Like the flexor group, the extensor group contains multiple individual muscles that all share a common attachment at the elbow. For this group the muscles all begin on the lateral epicondyle and then move down the back of the forearm to cross the wrist joint before inserting on the carpals and metacarpals. In this group you can again use the three segments of thumb, middle fingers and little finger. This gives us the Extensor carpi ulnaris (to the the pinky finger), the extensor digitorum (to digits 2-5) and extensor carpi radialis (to digits 2+3). Due to their attachments on the end, the ECU is able to bend the wrist towards the pinky and the ECR is able to bend the wrist towards the thumb. If you bend your wrist up towards the back of your hand, you will see the three tendons pop up at the wrist.  Likewise, if you place your thumb on the lateral epicondyle and bend your wrist back and forth, you will be able to feel the common tendon move.

Soft Tissue Release

What you’ll need: stick/foam roller and tennis ball

The techniques: click here for an introduction to the techniques and a video demonstration

1) Lengthening/elongation with the foam roller or stick.

2) Cross friction with your hand or tennis ball.

3) Sustained pressure or trigger point release with the tennis ball.

Key Areas to Work On

#1 Foam Roller. When working on the forearm, start by loosening up the larger and more superficial muscles with the foam roller. For this area you’ll want to use a raised surface for a few reasons: 1) the muscles are small and full pressure will likely be uncomfortable due to how superficial the bones are, and 2) this area is super easy to work on- just rotate the palm up or palm down and you’ll quick access to both sides. A bed or table works best (for example- I use my coffee table). Just like the other areas of the body, shoot for 3-5 minutes before moving to the deeper techniques.

#2 Tennis Ball- Cross Friction. The key with cross friction is to remember that you are working perpendicular to the muscle fibers. This means that you will be working in a side to side (horizontal) direction when working on the forearm arm. The movement itself is very small (maybe 1-2 inches). Sink the tennis ball in deep, relax and then maintain that depth as you work. If you feel like the ball or your fingers are rolling or sliding, you’re moving too much. When working on the forearm, the primary locations for cross friction work will be on the common tendons of the flexor and extensor muscle groups where they insert onto the epicondyles. Sitting with the tennis ball will work best for the flexor group. The extensor group is easiest using your fingers/thumb versus the tennis ball. See the video for further details. If you’re still unsure of the cross friction technique and how to properly do it, click here for a review.

wristcrossfriction

wristcfextensors

Key areas- (the purple circles represent the epicondyles in the pictures above!)

1) Wrist extensor tendon. Use the palpation guidance above to find the common tendon with your thumb. Then slide your fingers down approx one inch and your index/point finger. From here you can work each of the three bands of the muscle group (ECR, ED, ECU). After you work on all three, then slide down an inch and repeat. This can be done for the entire length of the muscle group. See the video for further details.

2) Wrist flexor tendon. Use the palpation guidance above to find the common tendon and position the tennis ball just below it. From here you can work each of the three bands of the muscle group (FCR, PL, FCU). After you work on all three, then slide down an inch and repeat. This can be done for the entire length of the muscle group. See the video for further details.

#3 Tennis Ball- Trigger Point.

wristtpflexor

wristtpextensor

When moving onto trigger point areas, remember, let the tennis ball sink in nice and deep and just sit on it. If after 2-3 minutes it hasn’t released, move onto the next spot!

Key Areas: The purple circles are the epicondyles!

1) Muscle bellies of the wrist flexors and extensors.  For the extensors, use your thumb and sink right into the thickest part of the muscle. HOLD it there. This can also be done standing up with the ball on the wall. For the flexors, use the tennis ball while sitting. For trigger point, you’ll want to stay closer to the middle of the group due to the small size of the muscles. Trigger point works best on the thicker parts of the muscles (aka the muscle bellies). As you move closer to the wrist, you’ll be working with a smaller and smaller area. With that in mind, stick to the middle and work your way down! See video for further details.

Video

Here is a video demonstration for self muscle release for the forearm and wrist using a foam roller and tennis ball.

References

1) Hammer, Warren. (2007). Functional Soft-Tissue Examination and Treatment by Manual Methods, 3rd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

2) Hyde, Thomas and Gengenbach, Marianne. (2007). Conservative Management of Sports Injuries, 2nd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

3) Moore, Keith and Dalley, Arthur. (1999). Clinically Oriented Anatomy, 4th edition. Lippincott Williams and Wilkins, Baltimore, MD.

4) Muscolino, Joseph. (2009). The Muscle and Bone Palpation Manual. Mosby, Inc, St. Louis, MO.

Wrist Hand

handmusc11The hand consists of the all the little muscles that move the fingers and thumb. This area is commonly injured with muscle injuries, tendinitis and even nerve injuries such as carpal tunnel syndrome. In this section you will find our available treatment plans as well as the different self treatment techniques on this site.

Injury Training Plans for this area:

None yet, but don’t worry. This region is on our list! So far we have carpal tunnel syndrome, wrist sprain/strains, TFCC ligament injuries and DeQuervains on our list. Have something else you want us to cover? Drop us an email or message.
These plans will be part of our “Injury of the Week” blog series. Each post will talk about what the injury is and how it can happen. It will then take you through all five steps of the ATA self treatment system including self massage, mobilizations, kinesiology taping, stretching and strengthening.

 

Individual Parts of Self Treatment System:

Part 1. Self Muscle Massage.

  1. Blog post with anatomy review, video and picture demonstration of self muscle release techniques for the hand using a foam roller and tennis ball. Click here.

Part 2.Mobilizations.

  1. Blog post with video on how to mobilize longer finger tendons, thumb and pinky muscles with a tennis ball. Click here.
  2. Blog post on wrist joint mobilization using resistance band/tubing. Click here.

Part 3. Stretching.

  1. Blog post with video on how to stretch out the long finger tendons, thumb and pinky muscles. Click here.

Part 4. Kinesiology tape

Stay tuned. As we move through our list of injuries, this section will be updated.

Part 5. Strengthening

Right now our strength advice is specific to our “injury of the week” blog series (see top of this page for injuries affecting this area). However, all of our strenghtening videos can be found on our youtube channel (link at top of website).

Stretching pt 17- Hand

In the introduction post to this series, we reviewed and answered some common questions regarding stretching, including why, when, how, etc. Click here to review it.

In this post we will be talking about how to stretch out the hand. This area includes the muscles/tendons of the fingers and thumb and is a common area for overuse injuries such as carpal tunnel syndrome.

The Rules:

1) Stretching should NEVER hurt. The goal is to only go until you feel a pull in the muscle. It should not be to go until it hurts in one of those “no pain, no gain” efforts. It should be comfortable and repeatable, allowing you to move a little further with each repetition.2) Perform stretches when the muscles are warmed up. This can be following a workout or following work with the foam roller. Click here to review the self massage post for the hand (this includes pictures and video using a foam roller and tennis ball to review 3 self muscle release techniques).

2) Hold for 20-30 seconds and repeat 3-4 times. You can hold longer than the 20 seconds, but the reps are key. You will always get more out of stretching frequently versus one killer session a week.

3) If hurt- be sure to stretch out the surrounding muscle groups first. For the hand, this means stretching out the wrist and forearm. As the injury allows, work you’re way up to stretching the injured muscle out.

Video:

Here is a video demonstrating how to stretch out the hand.

handmusc1

Key points:

1) Keep your hand down on a flat surface. This will keep you from working the wrist more than than the hand itself.

2) There are three different stretches you can do for the hand (the fingers themselves, the thumb, and then the entire palm of your hand). Try to do them in that order to really open up the hand.

Mobilization- wrist

In this post I’m going to show you a mobilization for the wrist. To do it you’re going to need some elastic tubing/resistance band or a strap that someone else can hold for you.

The whole goal of this mob (mobilization) is to use the strap to glide the radius and ulna (forearm bones) so that you can open up the joint space between them and the carpal bones in the wrist.

Key Points:

1) Place your palm on the floor with the resistance band about one inch above the crease of the wrist. You’re going to want a good amount of resistance on the tubing/band (enough that it feels like your arm would be pulled back if you let go). From here, straighten your elbow and then lean forward over your wrist. See the video below for full details and demonstration.

2) Keep your elbow straight at all times.

3) This is not a traditional stretch. No hold time is required. Go for reps instead. 10-20 will do the trick. If you hit a pain point/strong stretch, stop there, hold for 1 second, and then repeat for the remainder of the reps. You don’t need to be a tough guy. You want this stuff to be repeatable.

4) Follow up with ice if you are hitting any sore/painful points. 10-15 minutes is plenty.

Video:

Tennis ball mobilizations- Hand

In this post I’m going to show you how to use the tennis ball to mobilize the muscles in the hand. This includes the the longer finger tendons, as well as, the muscles of the thumb and pinky finger. The goal with this mobilization is to anchor one end of the muscle down and then actively stretch out the rest of the muscle against it.

Key Points

1) Go back and read the massage post specifically on the hand itself to review the body landmarks and muscles in this region. There are three basic regions you will need to be able to locate to perform these mobilization techniques. They are the thenar emimince (these are the muscles for the thumb), the hypothenar eminence (these are the muscles for the pinky finger), and the area in between where the long finger tendons sneak through. In other words, you’re looking for the the 3 yellow X’s in the picture below as the areas you’ll want to work on.

tennisballhand

2) To perform this mobilization, you’re going to need a tennis ball and a table top/raised surface to work on. The basic idea is to apply pressure to the hand on one of the three yellow x’s and to then try to open the hand/fingers up Remember, only go as far as you can comfortably. You’re not trying to force these! If this is too much or the spot is too tender, start with the wrist straight and work your way up to applying more pressure.  See the video below for full details and demonstration.

3) Repeat for 10 reps.

4) Same warm up rules apply. Try to do this either following a workout or warm up the area with the foam roller first. Especially if you’re coming back from an injury or this is a problem area.

Video

Self Muscle Massage- pt 17 Hand

This is part seventeen in the Self Muscle Massage Series. In the introduction post to this series we introduced and demonstrated the three muscle release techniques that will be used in this post. If you would like to review them, click here. If you would like to see any other parts of the series, click here.

In this installment of the series we’re going to be moving from the forearm down into the hand. Typically, as you move further away from the core of the body, the muscles get smaller and become more prone to injury through repetitive overuse situations. It is also why bony injuries such as fractures and joint dislocations become more common where the muscles are unable to counteract the full load of the body in a fall situation onto the arm. In this area, the most common muscular injuries are in the form of compartment overloads such as carpal tunnel syndrome (where nerves get pinched by tight muscles causing pain and numbness in the hand) and tendon injuries (i.e. trigger fingers, etc).

Anatomy

Bony Landmarks

handbone

Instead of rambling on about all of the tiny bones that make up the hand and wrist, I’m going to stick with a simple overview. Just below the radius and ulna are the carpal bones. There are eight of them and they are arranged like little rocks between the long bones of  the forearm and those of the fingers and thumb. These small bones allow for wrist movement while the long finger bones allow for grip, pinch, etc. The bones of the fingers and thumb are arranged in segments to allow for increased mobility. In order they are- 1) from the wrist to your knuckles are the metacarpals and 2) from your knuckles to your finger tips are the phalanges. As you look at your fingers, there is a little bone on either side of the creases (where the finger bends). Your index finger for example has two creases and therefore three phalanges while your thumb only as one crease and two phalanges.

Muscles

When it comes to the wrist and hand, an easy way to think of the muscles is to think about what fingers of the hand they control (they are traditionally referred to as digits 1-5 with 1 being the thumb and 5 being the pinky or little finger). With this in mind, the muscles will either control the thumb (digit #1), little finger (digit #5), or the three fingers in between (index, middle, ring or digits 2-4).

There are two muscle groups that provide the “bulk” in your hand- the thenar and hypothenar muscles. Together these two groups provide the padding for activities where you put weight on your hands (ie push up position. The remaining power muscles are tendons with the true muscles located up in the forearm.

handmusc1

Thenar Group + Adductor Pollicus (aka the thumb muscles). The thumb is essential to grip strength and activities and as such, has it’s own little army of muscles to perform these functions. The thenar group actually contains three separate muscles, all of which work to bend the thumb at the first phalange (crease) and move the thumb in relation to the palm of your hand. The adductor pollicus is the largest of the thumb muscles and opposes the thumb (brings it across the palm of your hand towards your pinky). These muscles are easy to find because they are visible. When you look at the palm of your hand you will see all of the normal creases where the hand bends. There is a large semicircle crease that runs from below the index finger all the way around the thumb. Inside that crease are your thumb muscles.

Hypothenar Group. The hypothenar muscles control the small, pinky finger. There are three muscles and together they work to bend the pinky finger and move the finger towards/away from the other fingers. Together with the thenar muscles, these muscles allow you to touch your pinky to your thumb for strong grip tasks. Like the thenar muscles, these muscles are also easy to find by following the creases in your palm. There is a semicircle that runs from below the knuckle of the pinky down to the wrist.

handmusc2

Finger and Long Thumb Flexors. These muscles are visible in the hand only as tendons. The Flexor Digitorum muscle originates in the forearm and splits into four tendons just before the transverse carpal ligament. From there the tendons travel down the carpal bones to the tips of the finger. The Flexor Pollicus Longus also originates in the forearm and travels to the tip of the thumb as a tendon. The reason for including these muscles in this post is to point out that the forearm cannot be overlooked when trying to improve mobility in your fingers and thumb.

Transverse Carpal Ligament. While this is not a muscle, it is important to note. The TCL runs over the carpal bones inserting onto either side. Beneath it run the median nerve and vascular structures to the hand. This is where carpal tunnel can occurr. If the soft tissue structures around the ligament begin to push on it, the nerve and artery/vein can be pinched causing pain and numbness.

Soft Tissue Release

What you’ll need: stick/foam roller and tennis ball

The techniques: click here for an introduction to the techniques and a video demonstration

1) Lengthening/elongation with the foam roller or stick.

2) Cross friction with your hand or tennis ball.

3) Sustained pressure or trigger point release with the tennis ball.

Key Areas to Work On

#1 Foam Roller. To best work on the hand, start off with a foam roller in the forearm and work both sides from mid-forearm down to your wrist. Rotate your hand as you go to cover more area. From there, switch to the tennis ball and work on the palm itself from following the carpal bones. See the video for further details.

#2 Tennis Ball- Cross Friction. The key with cross friction is to remember that you are working perpendicular to the muscle fibers. This means that you will be working in a side to side (horizontal) direction when working on the hypothenar and finger muscles and up and down (vertical) direction when working on the thumb/thenar muscles. The movement itself is very small (maybe 1-2 inches). Sink the tennis ball in deep, relax and then maintain that depth as you work. If you feel like the ball or your fingers are rolling or sliding, you’re moving too much. When working on the hand, the primary locations for cross friction will be at the common origin of the thenar and hypothenar groups (aka on either side of the transverse ligament). You can also use this technique on individual long flexor tendons. See the video for further details. If you’re still unsure of the cross friction technique and how to properly do it, click here for a review

handcrossfriction

#3 Tennis Ball- Trigger Point. When moving onto trigger point areas, remember, let the tennis ball sink in nice and deep and just sit on it. If after 2-3 minutes it hasn’t released, move onto the next spot!

handtrigger

Video

Here is a video demonstration for self muscle release for the hand using a foam roller and tennis ball.

References

1) Hammer, Warren. (2007). Functional Soft-Tissue Examination and Treatment by Manual Methods, 3rd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

2) Hyde, Thomas and Gengenbach, Marianne. (2007). Conservative Management of Sports Injuries, 2nd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

3) Moore, Keith and Dalley, Arthur. (1999). Clinically Oriented Anatomy, 4th edition. Lippincott Williams and Wilkins, Baltimore, MD.

4) Muscolino, Joseph. (2009). The Muscle and Bone Palpation Manual. Mosby, Inc, St. Louis, MO.

Anterior Hip

anthipmusclesThis region consists of the hip flexors (iliopsoas and illiacus), the rectus femoris (part of the quad muscles), sartorious, and pectineus. In this section you will find our available treatment plans as well as the different self treatment techniques on this site.

Injury Treatment Plans for this area:

(* note. each treatment plan includes a free downloadable PDF. Here’s a post on how to use them.)

1) Hip flexor strain/sprain. Click here.

This is part of our “Injury of the Week” blog series. Each post will talk about what the injury is and how it can happen. It will then take you through all five steps of the ATA self treatment system including self massage, mobilizations, kinesiology taping, stretching and strengthening.

Individual Parts of Self Treatment System:

Part 1. Self Muscle Massage.

  1. Blog post with anatomy review, video and picture demonstration of self muscle release techniques for the front of the hip using a foam roller and tennis ball. Click here.

Part 2. Mobilizations

  1. Blog post on joint mobilization for the front of the hip. Click here.
  2. Blog post on tennis ball/active mobilization for hip flexors/psoas. Click here.
  3. Blog post on mobilization of the adductor muscles up near their insertion at the groin + lateral hip joint mobilization using a resistance band. Click here.

Part 3. Stretching

  1. Blog post on beginner, intermediate and advanced stretches for the front of the hip. Click here.
  2. Hip flexor/quadricep stretch (pictures). Click here. (this is part of a post on Runners Knee)
  3. Hip flexor/quadricep stretch (video). Click here. (this is part of a post on IT Band Syndrome)

Part 4. Kinesiology Taping

Blog post on a taping application to decrease pain/promote recovery following a hip flexor strain. click here.

Part 5. Strengthening

Right now our strength advice is specific to our “injury of the week” blog series (see top of this page for injuries affecting this area). However, all of our strenghtening videos can be found on our youtube channel (link at top of website).

 

Hip Flexors

As you may recall from our intro post on kinesiology taping, we’re going to focus on each muscle group/joint and show you how to use kinesiology tape in three distinct ways:

  1. Immediately after injury  (for swelling and pain)
  2. During the healing process (correction techniques to restore normal position and allow for healing)
  3. Techniques to help improve strength + function

In this post, we’ re going to be talking about a taping application designed to decrease the amount of pull along the front of the hip where the hip flexors are located. This is perfect following an inner thigh/groin strain to provide support and allow for rest so that the injured muscle/tendon can heal.

Anatomy

anthipmuscles

The front of the hip is a busy intersection area (as you can see from the picture above). What we want to focus on is the Psoas/Illiacus muscles (aka the large hip flexor muscles). They insert into the front of the femur and then move up into the abdominal cavity to insert along the front of the lumbar spine. The Illiacus muscle inserts into the inside of the pelvic bone and the psoas move up to insert into the lumbar spine. To find their distal insertion onto the femur, you will need to work your way down the groin line.

palppsoas1

In the picture above, the blue lines represent your two landmarks. The one at midline is your belly button and the other is your ASIS. The red lines represent your abdominal muscles. To find the distal portion of the psoas and illiacus, start on the blue lines and work your fingers in until you find the outer edge of your abs. Move just outside of them (towards the hip) and follow that down to the groin line (this is the green line in the picture). You can confirm that you are on the right area by lifting your knee up towards the ceiling and bending your hip. You should feel the muscles move beneath your finger tips.

You can read more about the anatomy and surrounding muscles in this area here.

What you will need:

1) Roll of kinesiology tape.

2) Sharpest scissors in the house.

Prep work:

1) Clean skin. This means no oils or lotions of any kind. You want your skin to be clean and more importantly dry. Moisture of any kind = tape will fall off or fail to stick altogether.

2) Hair care. Ideally, the less hair the better. Guys, this means that for best results you will need to trim any long leg hair or shave the calf area.

3) If clean, dry, and hairless skin still = no sticking of tape. Time to get some adhesive spray like Tuf Skin.

4) The tape should last 3-5 days. You can get it wet and shower with it on. Just towel dry it after. No hair dryer! The tape is heat activated.

Taping Techniques

1) Standard hip flexor taping application with optional correction strip.

Key Points:

  • Do your homework first. Make sure you can find/palpate the hip flexor using the advice above. 🙂
  • Prep the skin first. For this application you will want to put the hip flexor muscles on stretch. To do this, use a lunge position with the leg you will be taping in the back (knee on the ground) and the other leg in front. Lean into the front leg (which will extend the back hip). Only move as far as you can comfortably. If this is too much, you can also move the hip by laying on your back with your leg hanging off the side of a bed, couch or table. Let the leg relax and drop down towards the floor.
  • The primary strip will be anchored next to the belly button. From here, position your leg to put the muscle on stretch and then apply the tape. The tape works by pulling on itself and you have already put the muscle on stretch to do the work for you. If you are unable to move the muscle into this position, you may add a small amount of stretch to the tape.
  • A secondary correction strip can be applied to any specific sore spots. Cut the tape so that it is long enough to cover the painful area with 1-2″ of tape on either side (these are your anchors and must be applied without stretch). Round the edges, apply 50-75% stretch and place the tape. Then remove the paper backing and lay down the ends. Don’t sweat the 50-75%. Think medium stretch versus maximum “how far can I pull this tape” kind of stretch.
  • In the case of pain in the front of the hip radiating down into the groin, you can combine this application with the adductor taping application. Click here to review.
  • See the video above for full details.

References

1) Capobianco, Dr. Steven and van den Dries, Greg. (2009). Power Taping, 2nd Edition, Rock Tape Inc, Los Gatos, CA.

2) Hammer, Warren. (2007). Functional Soft-Tissue Examination and Treatment by Manual Methods, 3rd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

3) Kase, Kenzo, Wallis, Jim, and Kase, Tsuyoshi. (2003). Clinical Therapeutic Applications of the Kinesio Taping Method.

4) Muscolino, Joseph. (2009). The Muscle and Bone Palpation Manual. Mosby, Inc, St. Louis, MO.

Psoas/Hip Flexor Mobilization

In this post I’m going to show you a mobilization technique specifically for the front of the hip/psoas area. To do it you’re going to need a new tool or to be creative and built your own. My personal favorite is to slice open a tennis ball and stick it on the end of something like a tennis racket. that way you have something soft to apply pressure with and a good handle to hold that pressure throughout the movement.

The whole goal of this mob (mobilization) is to use anchor down the psoas and then stretch the muscle out against it. In other words, we’re trying to actively release the muscle.

Key Points:

1) Do your homework first!! make sure you can find the hip flexor muscle before jabbing something into the “approximate area”. Click here for a full review on where and how to find it.

2) The other leg should be bent and relaxed.

3) This is not a traditional stretch. No hold time is required. Go for reps instead. 10 will do the trick.  Like I said in the video- you may not be able to straighten the leg all the way or lower it to the floor. You want the move to be slow and controlled. Don’t try to force it. If you hit a pain or stop point, just hold there for second or two and then bring the knee back up to that start position. You can build into the reps as tolerated.

4) Good idea to follow this mob up with some gentle stretching of the area. click here to learn how.

4) Follow up with ice if you are hitting any sore/painful points. 10 minutes right on the front of the hip.

Video:

Stretching- pt 5 Front of hip

In the introduction post to this series, we reviewed and answered some common questions regarding stretching, including why, when, how, etc. Click here to review it.

In this post we will be talking about stretches specifically for the front of the hip. This includes the psoas/hip flexor, illiacus, sartorious and the smaller internal rotator muscles of the hip.

The Rules:

1) Stretching should NEVER hurt. The goal is to only go until you feel a pull in the muscle. It should not be to go until it hurts in one of those “no pain, no gain” efforts. It should be comfortable and repeatable, allowing you to move a little further with each repetition.2) Perform stretches when the muscles are warmed up. This can be following a workout or following work with the foam roller. Click here to review the self massage post for the front of the hip (this includes pictures and video using a foam roller and tennis ball to review 3 self muscle release techniques).

2) Hold for 20-30 seconds and repeat 3-4 times. You can hold longer than the 20 seconds, but the reps are key. You will always get more out of stretching frequently versus one killer session a week.

3) If hurt- be sure to stretch the opposing muscle groups. For the front of the hip, this means the back of the hip (glutes, piriformis, etc), the  inner thigh (adductors), and the outside of the hip (glute med, TFL, and ITB). If it is too painful to stretch out the side of the hip do to injury, focus on these groups instead and work your way up  to stretching the injury itself. Always start at level 1 and work you way up.

The Progression:

Level 1. Half Kneeling

hipflex1

For this stretch, start in a lunge position kneeling on the side you want to stretch with the other leg out in front. From here you’re going to want to lunge forward onto the front leg (aka push your hips forward with your back STRAIGHT- no leaning forward). Keep the side you are stretching completely relaxed. You should feel a stretch right in the front of your hip and may even feel it in the top of your quad (thigh muscle). Hold for 20-30 seconds and switch legs. Repeat 4 times.

Level 2.

hipflex2

Same idea as the first one except this time we’re going to change the upper body position to increase the stretch. As you lunge forward onto the front leg, I’m going to have you lift your arm up overhead and once you have push your hips forward all the way, lean away from the side you are stretching. Try not to lean forward or back at the waist when you do this. Try to stay in the middle and bend to the other side. Hold 20-30 seconds and switch to the other side. repeat 4 times.

Level 3.

quad31

The third stretch is also a progression of the first stretch. Instead of changing the upper body position though, we’re going to use the leg to increase the stretch. In this case, we’re going to increase the bend of the knee. This can be accomplished in a few ways. You can either reach back and pull your foot up towards your butt or you can prop something under your foot. This is also the stretch you may have seen people with their foot on a chair or stability ball dropping down into the lunge. Personally I like to start in the lunge and and make sure I’m set up right before adding in other parts. The ball/chair idea is great, but I tend to cheat when I use them- I don’t push my hips forward enough or my back angle gets all wonky. so instead, I start by pulling up my foot myself. when that isn’t enough and I still want to increase the stretch, I use the wall. I’m still starting in that lunge position, but my back knee is bent and my foot/shin or against the wall. From here, I try to straighten up my back and push my hip forward. It’s a HUGE stretch when you do this so go easy. Same holds. Shoot for that 20-30 seconds and switch legs. Repeat 4 times.

Level 4- Combo stretch and one of my favorites!

This stretch has made a few appearances on this site. It’s easy to do and covers a lot of ground. If you break it up into two parts the first gets the ITB + TFL (the outside of the hip and upper thigh) and the second gets the the hip flexors/quad. Remember, once you’re in position- push that hip up and towards the ceiling until you feel a good stretch. Here’s a video demonstration.