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6.8. IB. Therapy for the iliopsoas. Maximal stretching.

Starting Position: P: Prone; trunk in left lateral flexion; left leg over side of couch with foot on floor; to avoid lumbar lordosis (which may be painful). foot may be moved forward on the floor and stabilized in position by T's left foot; this flexes hip further, flattens the lordosis and prevents P evading the stretching; left foot position regulates lumbar lordosis, important in treating patients with Iow back pain; a cushion may be placed under the abdomen to increase ventral flexion of the lumbar spine (and therefore the effect of the stretching); pelvis stabilized with a belt; right knee flexed with right hip in fuli medial rotation. T: Standing obliąue, facing Ps left side level with P’s thighs.

Grip: T’s right hand grips P's lower leg just above the ankle. After raising lower end of couch (see Procedurę), Ts left hand can be used to stabilize P’s right thigh at the dorsal side just distal to the ischial tuberosity; this increases stretching.

Procedurę: Using this grip, T uses left hand to slowly raise the foot end of the couch, thereby gradually and fully extending medially rotated hip.

Stimulation of Antagonists: T moves right hand to dorsal side of thigh just proximal to knee. T then asks P to move further in the direction of stretching, and resists that movement to stimulate P’s antagonists. To increase contraction when stimulating, T uses left hand to slap P’s right buttock.

Notę: If the belt stabilization fails to hołd P's pelvis in place after the foot end of the couch is raised, T’s left hand can be placed over P’s right thigh to press the pelvis ventrally towards the couch.

Fig. 73 a. Starting Position.

Fig. 73 b. Finał Position.

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