Lecture Notes on Stretching Series: Part 2 - Stretching of Lower Limbs and Specific Muscles

Summary

This lecture is the second part of a series focusing on stretching techniques, particularly targeting the lower limbs and various specific muscles. It builds on the first part, and details the steps for effective stretching, explaining the physiological reasons behind each step.

Stretching Techniques for Lower Limbs

1. Piriformis Muscle Stretch

• Functions: Abduction, extension, external rotation of hip.
• Stretching Method:
  • Patient position: Supine, hip and knee flexed.
  • Execution: Externally rotate the hip at 90 degrees flexion, then adduct the hip by pushing the knee towards the opposite shoulder.
• Reasoning: After 90 degrees of hip flexion, the piriformis behaves as an internal rotator, hence the need for external rotation and pushing towards the opposite shoulder to effectively stretch the muscle.

2. Hip Adductors Stretch

• Muscles: Adductor Magnus, Minimus, Longus, Brevis, Pectineus, and Gracilis.
• Bilateral Stretch:
  • Patient position: In "crook" line (lying on the back with knees bent and feet flat).
  • Execution: Abduct both limbs simultaneously.
• Unilateral Stretch:
  • Method 1: Use one hand to stabilize the ASIS (anterior superior iliac spine) and the other hand to apply an abducting force.
  • Method 2: Patient holds one leg flexed and the other leg hanging freely off the couch, stretch performed by abducting and extending the hanging leg.
• Duration and Repetitions: Hold each stretch for 15-20 seconds, perform 5-6 repetitions.

3. Sartorius Muscle Stretch

• Functions:
  • At hip joint: Flexion, abduction, external rotation.
  • At knee joint: Flexion, internal rotation.
• Stretching Method:
  • Execution: Adduct the limb, then flex and internally rotate the knee joint to oppose its normal function, stretching the muscle.

4. Calf Muscles Stretch

• Muscles: Gastrocnemius and Soleus.
• Soleus Muscle Stretch:
  • Execution: With knee flexed 20-30 degrees, apply dorsiflexion to the ankle.
• Gastrocnemius Muscle Stretch:
  • Execution: Keep knees extended and dorsiflex the ankle.

5. Tibialis Anterior Stretch

• Function: Dorsiflexion and supination of ankle joint.
• Stretching Method:
  • Execution: With one hand, perform plantar flexion and pronation of the foot while stretching the muscle belly away from its insertion with the other hand.

6. Extensor Digitorum Longus and Extensor Hallucis Longus Stretch

• Functions:
  • Extensor Digitorum Longus: Dorsiflexion of toes and ankle, pronation at the ankle.
  • Extensor Hallucis Longus: Dorsiflexion at big toe, supination at the ankle.
• Stretching Method:
  • For toes: Perform plantar flexion and supination at the ankle while moving the belly of the muscle away from its insertion.
• Note: Ensure involvement of the ankle joint to differentiate stretching of Extensor Digitorum Longus from Bravis.

7. Interossei Muscles Stretch (Dorsalis and Plantaris)

• Functions:
  • Dorsalis Interossei: Abduction of toes, plantar flexion at MTP joint.
  • Plantaris Interossei: Adduction of toes, plantar flexion at MTP joint.
• Stretching Method:
  • Execution: Adduct or abduct the toes and perform dorsiflexion at the MTP joint.

These notes summarize the specific stretching techniques for various muscles in the lower limbs, detailed in the lecture for proper understanding and application in therapeutic or fitness settings.