Active Exercise After Iliopsoas Release to Improve Anterior Hip Impingement During Squats - Movement Equation #35 -

Last time, I introduced an approach for hypertonicity and adhesions of the iliopsoas muscle.

However, release alone is not enough.

Only by re-educating the released muscle into a "usable muscle" can you lead to an improvement in hip joint function.

This time, I will explain the important active exercises to perform after iliopsoas release for that purpose.

Release alone does not sufficiently improve gliding.

By performing active exercises after release, the muscle glides sufficiently against surrounding tissues, and as a result, gliding is further enhanced and that state is more easily maintained.

It is not "release and finish," but "release and move."

This sequence is extremely important.

So, how should the iliopsoas be moved?

The first thing that comes to mind is probably hip flexion and external rotation.

Of course, that is not wrong.

However, I would like you to be slightly conscious of the femoral neck anteversion angle here.

Flexing the hip in a slightly abducted and externally rotated position is less likely to cause impingement and makes it easier to activate the iliopsoas than flexing it in a neutral position of internal/external rotation.

Place the subject in a side-lying position with the affected side up,

hip extension, adduction, and internal rotation position

from

hip flexion, abduction, and external rotation position

and repeat moving slowly to.

Since they often do not know the correct trajectory at first, the therapist should guide them to help them understand the movement before transitioning to active exercise.

Once they have sufficiently mastered the movement and you have determined that there are no issues with muscle strength, try adding light resistance.

The contraction of the iliopsoas is enhanced, and further improvement in gliding is expected.

However, strong resistance is unnecessary.

Since the iliopsoas is not a muscle that generates high output, excessive resistance easily leads to compensation by the rectus femoris.

Here, we performed a way of using the iliopsoas that involves

moving the lower limbs relative to the trunk

.

Next, conversely, we will perform a way of using it that involves

moving the trunk relative to the lower limbs

.

Sit on the edge of a chair or bed, with the hip and knee joints flexed at approximately 90 degrees.

Correct forward head posture, perform elongation, and guide the spine into extension.

With deep core activity heightened, increase IAP, and while maintaining pelvic and spinal alignment, slowly tilt the pelvis posteriorly.

The most important thing here is to move while maintaining pelvic and spinal alignment.

A state where the deep core is functioning appropriately is a state where movement can be performed without losing posture.

In reality, compensations such as increased lumbar lordosis or, conversely, rounding of the lumbar spine as the upper body leans backward are very frequently observed.

Therefore, therapists should observe closely and have the subject constantly remain conscious of elongation.

In this movement, the iliopsoas performs eccentric contraction.

Because the iliopsoas runs deep from the lumbar vertebrae to the lesser trochanter, it is a muscle that is difficult for subjects to visualize.

Therefore, it is not uncommon for the accuracy of the movement to improve by having them understand the path using anatomical diagrams and performing the movement while visualizing the muscle.

The range for leaning the upper body is the range in which no compensation occurs.

Some people may stop at around 20°, while others may be able to reach around 45°.

The important thing is not the size of the range of motion, but performing it within a range where you can do it correctly.

Once you have leaned your upper body backward, slowly return to the original position.

In this phase, the iliopsoas performs a concentric contraction.

By repeating both eccentric and concentric contractions, the iliopsoas will begin to function in a way that is closer to actual movement.

Because the iliopsoas is a muscle that runs at a very deep level, it often does not function well even if it looks like you are performing the movement correctly.

First, it is important to acquire the 'sensation of using it' under low load while maintaining the correct posture.

By accurately performing active exercise after release in this way, not only the gliding ability of the iliopsoas but also its muscle function will improve, leading to the resolution of anterior hip impingement that occurs during squats and smoother hip flexion movement.

Release is not the goal.

Re-educating the released muscle into a muscle that functions correctly.

I believe that only by going that far can we truly lead to an improvement in hip joint function.

Do not just end with treatment, but go as far as 'changing function' and 'changing movement'.

That is the philosophy I value most at Movement Equation.

Next time, I will explain an easily overlooked muscle that causes anterior impingement during hip flexion.