3.  Hip Release and Hip Glides:  this is a video demonstrating how to do the self mobilizations to regain normal motion.

The quadricep muscle group is comprised of 4 muscles that all share a similar attachment to the lower leg bone, the tibia. The muscles converge at the knee at the patella (knee cap) and inserts onto the tibial tuberosity.  The muscles are named for their location on the thigh:

• Vastus Lateralis -spans from the outside of the thigh to the tibial tuberosity
• Vastus Intermedius -spans from the center of the thigh to the tibial tuberosity
• Vastus Medialis- spans from the inside of the thigh to the tibial tuberosity
• Rectus Femoris- spans from the front crest (anterior inferior iliac spine) of the pelvis to the tibial tuberosity

The main action of this group is to extend (straighten) the knee and the rectus femoris will also flex the hip.  Quadricep control is important for walking, running, going up and down stairs, lunging, squatting, basically every move we make.  Having supple quadriceps is key not just for healthy knees, but for healthy feet, hips and spine.  Restrictions in the quads will affect proper loading of the foot and knee during gait.  Tightness in the rectus femoris can pull the pelvis forward into anterior rotation which increases lumbar extension and spinal compression, and can limit hip extension (being able to bring the leg behind you).

Let's face it.  Many of us are super tight, and it feels good to pull on the leg as far as you can to get a deep stretch. The stretch always feels good, but the muscles never fully let go and we have to keep stretching forever and ever.  One possible reason why the muscles don't make lasting changes is that we have a stretch reflex within the muscles that serve as a protective mechanism:  if the muscle is stretched too far beyond its limit, it will contract to prevent injury.  During stretch sessions, you may be moving beyond your tissue limit so the muscles never change!  One way to refine and meet your tissues is to scale back and use alignment markers to guide you into your stretch.
Alignment Markers:

• Maintain level shoulders and pelvis
• Keep thigh in line with hip: don't let it move out to the side, or out to the front 

I have been working with a client for a few visits.  His main complaint: L low back pain and L hip pain.  He has made some good progress and will feel good for about a week or so and then the discomfort will come back.  In our last session we found that he couldn't lift his left thigh off of the table when he was on his stomach, and it really hurt his back.  I could see that his back muscles on his left side were really working hard.  I released the back muscles and his discomfort went away, but he still couldn't lift his leg.  His left gluteus maximus was not responding what so ever!
This last weekend I attended a training called  "Finding Center"  by Gary Ward of Anatomy in Motion.  The first day of training we spent 4 hours exploring the 3D movement of 6 key muscles in the body. One of these muscles was the gluteus maximus.  Many of us know the glute max actions: hip extension, hip external rotation and hip abduction.  Typical ways to strengthen this muscle is through concentric contractions as in clam shells, fire hydrants, bridges, lunges and squats.  
According to Gary Ward, the first rule of movement is: "Muscles lengthen before they contract."  His theory is that you want to lengthen the muscle as far as it can go, and it has nothing to do but contract.  I applied this concept when I returned from my training. 
My client came in this week with his left back and hip a little aggravated.  I tested my client again on his stomach.  He could not lift his thigh off of the table, and he had incredible pain in his back.  I had him stand up onto his left leg and move through the single leg squat and 3D reach.  I had him allow his hip and knee to move into flexion, adduction and internal rotation (prior to this training, I would have controlled for knee adduction and internal rotation).  After completing about 10 repetitions he says, "I don't have the pain in my glute anymore."  We moved through a few more patterns, got him back on the table and retested his ability to lift his thigh off the table:  Full lift without any pain!  He was completely amazed, and quite honestly so was I!  He got off of the table, took a walk and didn't have any pain.  Next time you feel like you are stuck in your training, or you have a case of "dead butt", remember: muscles lengthen before they contract.
I have included one of the movement patterns I went over with my client in the video below.  Rather than tapping down with the foot, you can also try reaching your arm out to touch the floor in a clockwise fashion.

If you didn't know already, the squat is hot. Everybody is doing it..... The squat is one of the most effective ways to strengthen your glutes.  But.... not every body is ready to bust the move and go deep into the squat position without losing their balance or hurting their knees.  
This post demonstrates how to perform a double leg squat and a single leg squat with a vertical shin.  A vertical shin helps take the load from the knees and puts the weight back into the posterior chain: hamstrings and glute max.  The single leg squat also engages the gluteus medius, which is important for stabilizing the pelvis.

1.  Take a piece of blank paper.  Stand barefoot on the paper and outline your foot with a pen.  Take this paper to your closet and compare the width of your shoes to the outline.  Don't wear the shoes where you can't fit your toes in the toe box, and the outline extends beyond the shoe.  Notice that the shoe sits inside of the outline in some places; don't wear these shoes!  Find shoes that do not have a heel.  If you are used to wearing a higher heel you will need to gradually transition to lower heels so your tissues have time to adapt (give yourself 4-6 wks before you transition for each .5 to 1 inch).
2.   Learn how to stand in alignment.  See pic above. Or read this blog.
3.   Wear toe spacers.  Yes, you should be able to see space between your toes!  There are many products on the market. These are my favorite: Correct Toes.  Cool thing about these is that you can wear them in your shoes!  Very comfortable (but you have to have a wide enough toe box in your shoe). If you have a bunion you may want to test to see if this will be comfortable for you before purchase: take your big toe and pull it away from your other toes as far as you can, and then lift it up.  If there is discomfort in the joint then your toe is probably compressed, and it would be good for you to see me, or your local PT (or chiro, osteo, etc) to work with you.

We have two psoas muscles on each side of our body: psoas major and psoas minor.  This blog is specific to our psoas major.  
This summer I took a very cool tele-class from Liz Koch, of Core Awareness.  In this 5 week series we explored the location and function of the psoas and its relationship to the nervous system and our "fight/flight/freeze" response,  to our emotional well-being and to our skeletal support.
The psoas is centrally located: emerging from the midline at thoracic level 12, attaching to every lumbar vertebra and inserting into the inner thigh at the lesser trochanter.  
The psoas allows the lower limb to move and swing a as a pendulum: multidirectional/orbital.  
As a physical therapist I see many people with SI dysfunction, hip and back pain.  In almost all cases, the psoas is the top priority to rehabilitate.   On muscle testing the psoas is usually weak, and the flexibility test is usually tight.  What I have come to understand through this tele-class, through my training as a Restorative Exercise Specialist™ and as an NKT™ practitioner, is that rather than manipulate the psoas through deep tissue work and stretching, the psoas needs to rehydrate and recover from over-exhaustion.
I have compiled my favorite top 10 ways to release, rehydrate and restore the psoas.  It is helpful to perform a release before going onto the movement sequences.  Some of these are from Liz Koch's book, "The Psoas Book" and some are from the Whole Body Alignment Program.

The inner thigh (adductor group) is made up of five muscles:

1. Pectineus
2. Adductor brevis
3. Adductor longus
4. Adductor magnus
5. Gracilis

When the foot is not planted on the ground, the adductors will bring the leg toward the midline, and flex the hip when the thigh is in an extended position as in the swing phase of the gait (walking) cycle.
The adductors play a significant role during walking and are active in all phases of the gait cycle. The adductors are a part of two important functional kinetic chains:

1. Lateral Sling: comprised of the adductors, same side gluteus medius/minimus, opposite side quadratus lumborum.  This chain is responsible for frontal plane stabilization of the lumbo/pelvic/hip complex during single leg stance (stance phase of gait), squatting and lunging.
2. Anterior Oblique Sling: comprised of the adductors, same side internal oblique, opposite side external oblique and hip external rotators.  This chain is responsible for transverse plane stabilization during trunk rotation in gait, throwing, swinging, twisting activities.

Dysfunction within the slings can result in overuse of the adductor group leading to over facilitation,  increased tension and bound up connective tissue, and potentially pain.  Here is a videoblog demonstrating how to release the adductors using a foam roller.

Tension in the piriformis muscle can trigger irritation of surrounding tissues.  The sciatic nerve exits the pelvis just below the piriformis.  When there is dysfunction in the lumbo/pelvic/hip complex, the piriformis often gets overworked, creating compression and friction on the sciatic nerve.  Sciatica is defined as aching/burning/stinging pain along the distribution of the sciatic nerve: buttock, back of the thigh, lower leg and foot.
Stretching the piriformis can be a very effective way of diminishing the compression, and therefore irritation of the nerve.  Pictured to the left is a very common stretch given as treatment to relieve sciatica.

A traditional piriformis stretch, is often done with a tucked pelvis (and/or flexed spine) and can irritate the nerve if the leg is pulled  too aggressively.  Instead, using the wall and props can be an effective way of maintaining a neutral spine and pelvis. By staying in alignment, and by being able to adjust the load by gradually bending the knee to 90 degrees, the tissues will begin to yield and let go, rather than work to hold the body in position.  
Picture on the left: The half cylinder and block supports my shoulders and head to allow me to rest with a neutral spine, with my ribs down and a level pelvis.  Due to my current tension patterns, I also have to support my lumbar area with a rolled yoga mat so I can comfortably attain neutral pelvis (pubis and ASIS level).  
Middle picture:  I place my left leg straight on the wall and cross my right leg over the left, making sure not to tilt the pelvis. Picture on the right:  I begin to slide my heel down the wall and stop when I feel that I am at my resistance barrier, or my pelvis begins to shift.  Hold at least one minute and repeat on the other side.  If you can tolerate the stretch stay longer, up to 5 minutes on each side.

Some people will try to get a deeper stretch by pressing the right knee down.  Make sure that you don't drag your whole pelvis when you do that (as shown in the pic on the left).  The purpose of this refinement is to maintain neutral, and that means a level pelvis (as shown on the right).   
Even if you don't have sciatica, this is a wonderful stretch to open the hips, and allow more freedom to your pelvis!  Enjoy!

Legs on the wall pose is a restorative position that should be a staple for every person that has a pelvis! Traditionally, the pose is taught by placing the butt close to the wall, and then bringing the legs up against the wall so the back of the legs touch, and the soles of the feet are facing the ceiling.  A variation to the pose is to widen the legs into a "V" position to stretch the inner thighs and groin.


Recently I have rediscovered the beauty of this pose by modifying the position to be able to maintain neutral pelvis (pubis and ASIS in line) and rib alignment.  The benefit of maintaining the alignment markers during this pose allows the connective tissue and muscles to fully release.  When the alignment markers are not in place, there is more load to the tissues which can potentially maintain tension, and prevent a full yield ("letting go") of the muscles and fascia.

In order to do this pose in alignment, you may need to get out props.  Due to the tightness of my psoas muscles and the increased kyphosis of my thoracic spine, I have used a thin yoga mat rolled up to maintain neutral pelvis: pubis and ASIS level, and a half cylinder & block to prop up my upper back to get my lower ribs down and flush with my abdomen. In order to get my pelvis level, I needed to scoot away from the wall, get the props set up, and then place my legs on the wall (see pics below).  

Benefits to Legs on the Wall Pose:

• Gently stretches the back of the legs, inner thighs and low back to relieve aches and pains
  
• Improves lymphatic/venous return from the feet and legs 
• Eases stress/anxiety
• Alleviates symptoms of menstrual cramps, PMS and menopause 
• Helps testicular and ovarian problems
• Relieves swollen ankles and varicose veins