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Moulton College
Dorsiflexors
Patient lies supine Place towel under knee for comfort Locate Tibialis Anterior Tendon Or site of lesion Lock with Thumb Apply technique Active / passive plantar flex foot Resisted - Client attempts to produce a stretch of the tissue but is resisted by therapist
Achilles tendon
Patient lies prone Bend knee and support Apply Lock using thumbs
Apply technique
Knee Extensors
Patient lies supine Support knee in semi-flex position Re-extend the knee to shorten the musculature Apply lock
Use thumbs to focus on VMO (specific lesion) Broad lock using hand / webbing over distal MT junction
Alternative approaches
In sitting leg over edge of couch Standing move from upright to squat position Specific thumb lock to patella tendon
Hamstrings
Many different approaches to applying STR on Hamstring group Important to adapt to size and condition of the muscle Technique 1 - Passive:
Patient lies prone Broad lock applies across distal Mt junction using palm of hand Passively extend the leg
Hamstring 2 - Active
Patient lies prone Reinforce lock using webbing of both hands of distal MT junction Patient actively extends knee Repeat start position Lock applied using webbing of one hand only Therapist resists patients knee extension
Hamstring 3 Resisted
Technique 4 - Passive
Use other hand to support thigh / knee to prevent further hip flexion Patient actively extends knee
IT band
http://www.youtube.com/watch?v =FUq1Kq0HDT0&feature=related Patient lies side lying Support medial aspect of thigh
Typically requires use of thumbs / elbow for application of lock Whilst applying pressure patient Flex / extends knee joint Can be V.uncomfortable!
Piriformis
Patient lie prone Apply elbow in a longitudinal direction to the piriformis muscle Maintaining lock position apply technique Active assisted patient internally rotates hip Passive therapist internally rotates hip Resisted - therapist resists external rotation
Shoulder Elevators
Patient lies prone Apply lock with thumb from one hand Use other hand on acromion and depress shoulder to lengthen tissue Technique could be applied with active assitance
Infraspinatus
Patient lies prone Treated arm lies over side of couch Palpate area of Infraspinatus muscle to be locked Lengthen muscle by moving into external / medial rotation Can be applied Actively / Passively / Resisted
Latissimus Dorsi
Patient lies side lying Place arm at 90 shoulder flexion Apply lock using hands