Friday, September 21, 2007

Fast Fitness - Better Posterior Hip, Iliotibial, and Piriform Stretch

Here is Friday Fast Fitness - Quickly improve a common stretch for the back and side of the hip.

Note step 2 and 3 which slides the supporting leg sideways. That change makes it different from the usual ankle over knee stretch:
  1. Lie face up. Bend one knee to put one foot on the floor or bed, comfortably close to your backside. Other ankle crosses knee.
  2. Notice which direction the raised foot is facing. Slide the other foot (the one on the floor or bed) and knee in that direction. Reader David demonstrates. In the left photo, the raised foot faces left. Move the whole leg on the floor to the left. Feel the stretch increase in the raised leg.
  3. Switch sides. Right photo shows raised foot facing right. Slide supporting foot and knee sideways to the right.
The way this stretch is usually done, without moving the bottom foot, does not stretch the piriform (or pyriformis) muscles much, even though it is often called a piraform stretch. The piriform muscles are external rotators (turn the leg outward). Adding more external rotation with the usual "ankle over knee" does not stretch the piraforms. Changing the bottom foot position with this different stretch adds adduction, which means "moving toward from midline." A second movement action of the pyriform muscles is abduction (moving away from midline), so this new method lengthens it, and can truthfully be called a piraform stretch. Future articles will cover more on piriform.

Don't make this stretch hurt or send pain down the leg. The point is to relax and loosen the area, not tighten, constrict, and impinge. Breathe.

This is another 'ooh' stretch. As soon as you do it right, it feels good and you say ooh.

Thank you to David's wife for photos

5 comments:

  1. When you move the foot on the floor, are you supposed to move the knee it is attached to as well?

    Is the ankle of the raised leg supposed to move to the side, move down, or both?

    When I try it I don't get any stretching feeling, so I suspect I'm not doing it properly

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  2. Good questions,
    1. When you move the foot on the floor, slide the whole leg sideways. The knee will then point diagonally to the side instead of forward. If you don't move the knee too, you will have a 'knee-in" position and no change in the stretch.
    2. When you move the foot on the floor, slide it and the other ankle it is holding up. That increases the stretch in the other leg.
    3. The ankle of the raised leg moves to the side, not down.
    When you immediately feel the stretch increase in a good way, you know you have it. Thank you for helping clarify this for other readers. Let me know.

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  3. After Back surgery in March I went to a physical therapist. This was the first Strech I did

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  4. Thanks, now I can feel the stretch.

    I have a request - as a motorcycle and recumbent bicycle rider as well as someone who makes their living at a computer, my hip flexors get quite tight. The usual stretch for them - similar to a lunge - I find very difficult to do without arching the back. Is there another way to stretch them that makes it a bit easier to keep the hip tucked?

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  5. Anonymous, sorry for delay. Good thinking - the tight hip flexor is a main factoring pulling the lower back into too much arch in lunge and other upright positions. This translates into painful overarching when walking and running. The remedy is precisely what you already are attempting to do - make sure the lower back doesn't arch when doing a standing lunge - which will provide the very stretch it needs - Strengthen Legs Without Knee Pain - Standing Lunge. Start small. Start with one foot far in front of the other and tilt the hip (without leaning the upper body back). If you do it right, you will instantly feel the stretch. To increase the stretch, lower a bit. Straight down, not tilting or leaning forward.

    I will post more on anterior hip stretches since they are so neglected and needed. Until then, use the standing lunge position with hip tuck to neutral. For an idea, look at the upper body stretch in Quick, Feel-Good Upper Back and Chest Stretch and use the same idea but move the pillow under the hip (not lower back).For many more, my book Fix Your Own Pain Without Drugs or Surgery has a chapter devoted to hip that gives several easy effective anterior hip stretches. My book Stretching Smarter Stretching Healthier is another good source for many hip stretches and changing common stretches to make them more fun and healthful. Take photos of your progress and let us know as it gets better, which it will.

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