Excessive Lordosis

Psoas Release:

The psoas is a very powerful lumbar extensor as well as hip flexor.  When we sit a majority of the day the psoas is put into a shortened position and unless stretched throughout the day will remain shortened or "tight" after work.  In a shortened position it can lock us into lumbar extension which loads the facet joints of the lumbar spine and reduces the space for the nerves exiting the spinal cord in the lower back.  When asymmetrically tight it can cause a lumbar rotation, when coupled with a tight QL it can cause an anterior pelvis rotation.  Both of which lock forces into the low back on the side of the collapse.  

Technique:  The technique to release the psoas can be done through cloths with you laying on your back and the opposite knee bent while you keep the knee on the side your are releasing extended.  It often requires skin to skin contact.  

Medical Consideration: 
Because it crosses multiple lumbar spine segments posteriorly before attaching to the anterior aspect of the hip the psoas is prone to mechanical overload during sports that consist of running and change of direction.

Rotated Pelvis

Quadratus Lomborum (QL):
The QL is one of the most stubborn muscles of the low back. It’s holding pattern is many time the source of low back pain. It get told to tightened when a lumbar spine vertebrae is out of alignment which is a common result of asymmetrical loading through the low back. The SymFit® QL release technique consists of you laying on the side opposite the QL being released with your top hip in neutral and top knee flexed 90 degrees. Your top leg is in neutral and hanging off a treatment table in a position of stretch. 

Technique:  This technique can most often be successfully administered through thin clothing but a myofascial release technique may be required in order to release the holding which requires skin to skin contact. In most case this can be done under clothing.

Medical Consideration: 
Untreated a tight QL can cause joint mis-alignments in the lumbar spine and pelvis that put you at risk for accelerated arthritis and/or a herniated disc.




Lumbar Strain

Thoracolumbar Extensor Release:
When you contract your abdominals they connect your rib cage to pelvis and unload the low back. Unfortunately, most of us go about our daily activities without abdominal contraction and we are loading our low back all day. The muscles in the small of the back are put in a shortened position and remodel around this shortened pattern creating a barrier to neutral spine alignment. 

Technique:  The release technique for restoring neutral resting length of the low back extensors is performed with you laying on your stomach (prone) similar to a traditional massage. A pinch technique may be administered if myofascial adhesions exist between the skin and the lumbar spinous processes.  At times a deep soft tissue release of the lumbar extensors is necessary.

Medical Consideration: 
Prolonged lumbar spine extension can accelerate arthritis in the lumbar spine and put you at risk for a lumbar spine disc bulge or herniation.
Rotated Sacrum

Piriformis Release:
One of the most debilitating low back injuries is sciatica also referred to as piriformis syndrome. This conditions is almost always related to a faulty loading pattern through the low back and mis-alignments in the lumbar spine and/or SI joints.

Technique:  The technique consists of placing a sustained pressure on this muscles trigger point while mobilizing the hip into and out of internal rotation. This technique can often be performed through thin clothing. This treatment may require a myofascial release of the sacrum which does require a skin to skin contact.


Medical Consideration: The sciatic nerve runs underneath this muscle. When the piriformis is mechanically overloaded it goes into protective holding which increased it girth which can compress the sciatic nerve. The best way to release a tight piriformis is to restore neutral positioning of each of the lumbar spine vertebrae pelvic bones and sacrum. Then a soft tissue release of the piriformis itself can be performed in sidelying or prone.

SymFit® Soft Tissue Release Techniques
Lower Body Clearing Videos


Feature content will be pulled up and behind the page header. Be sure to save and refresh your page after adding feature content.
     


Abnormal muscle tension is a common by-product of faulty posture.  Overtime faulty posture causes asymmetrical loading which eventually will result in joint mis-alignment.  Joint mis-alignment in the low back, pelvis, hips, knees and ankles mechanically overloads the soft tissue (muscles and myofascia) in the lower body.  We refer to this as protective holding when referring to the muscle and myofascial restriction when referring to the myofascia.  This is similar to what many would refer to as a "tight" muscles.  

In the early stages of the SymFit® Healthy Fitness System you will likely need soft-tissue mobilization to prepare for safe manual therapy techniques before access to neutral spine alignment can be restored.  For educational as well as patient comfort purposes we have outlined our most commonly administered techniques below for your review.   They are organized by condition addressed, you will likely not need more than a few of these release techniques during your treatment.  Additionally, you may present with conditions that warrant soft tissue release techniques not outlined below.  These information below is intended to help current clients move through the SymFit® Healthy Fitness System.



Low Back and Pelvis Conditions


 

Low Back Injury Prevention Tips:  The low back is gran central station for all forces through the lower body.  Mis-alignment of the pelvis causes asymmetrical loading through the ankles, knees and hips.  When your lower abdominals are active in suspending your pelvis in neutral you close the gate to faulty loading and open the bridge to healthy loading through the low back.  So apply the 4 principles of neutral spine alignment during all standing activities to best distribute load through your low back, hips, knees and ankles.  

Remember:  You cannot unload the load back without a "Stacked Upper Back"

 


Hip Conditions


 

Hip Flexor Strain

Rectus Femoris Release:
The muscles that flex your hip are put in a shortened position when you sit and when you stand with a bent knee. Some hip flexors originate below the pelvis and affect the knee mostly. The psoas originates in the lumbar spine and when abnormally tight on one side can cause lumbar spine, pelvis and sacral mis-alignments. Most of us are right lumbar loaders and sit shifted to the left and stand with our right knee bent. This puts our right hip flexor in a short position throughout a majority of each day. The SymFit® technique for releasing a tight hip flexor is performed with you laying on your back with the opposite knee flexed 90 degrees. This technique can most often be successfully administered through thin clothing but a myofascial release technique may be required to release the holding which requires skin to skin contact. In most case this can be done under clothing.


Remember: You cannot stack your upper back if you cannot slide your shoulder blades down your rib cage. This is not available if the shoulders are being pulled forward by tight pectorals.

Medical Consideration: A tight hip flexor pulled the pelvis forward which locks the low back into extension on that side. Similar to a car tire being out of alignment this transfers an imbalanced load to the opposite hip.

Hip Drop

Glute Medius Release:
Faulty posture can affect the loading patterns through the hips, knees and ankles. A collapsed pelvis will cause the hip to externally rotate resulting in an imbalance of hip load transfer with the outer hip muscles doing a majority of the work. This SymFit® technique is performed with you laying on your side opposite the hip being mobilized and with the hip flexed 45 degrees and knee flexed 45 degrees with the hip in slight adduction. This technique can most often be successfully administered through thin clothing but a myofascial release technique may be required in order to release the holding which requires skin to skin contact. In most case this can be done under clothing.

Remember: Inward spiral of the hips is a subtle contraction of the hip internal rotators to the degree that allows equal weight bearing through the big toe and little toe. A strengthening program that challenges lower body functional conditioning maintaining an inward spiral can restore the medial/lateral hip imbalance that causes TFL overload.

Medical Consideration: A "lateral loading pattern of the lower extremity puts us as risk for piriformis syndrome, runner knee (IT Band Syndrome), hamstring strains and medial joint injuries.
Adductor Strain

Psoas Release:

The muscles that flex your hip are put in a shortened position when you sit and when you stand with a bent knee. Some hip flexors originate below the pelvis and affect the knee mostly. The psoas originates in the lumbar spine and when abnormally tight on one side can cause lumbar spine, pelvis and sacral mis-alignments. Most of us are right lumbar loaders and sit shifted to the left and stand with our right knee bent. This puts our right hip flexor in a short position throughout a majority of each day. 

Technique:  The technique for releasing a tight hip flexor is performed with you laying on your back with the opposite knee flexed 90 degrees. This technique can most often be successfully administered through thin clothing but a myofascial release technique may be required to release the holding which requires skin to skin contact. In most case this can be done under clothing.

Medical Consideration: 

Because it crosses multiple lumbar spine segments posteriorly before attaching to the anterior aspect of the hip the psoas muscle is prone to mechanical overload during sports that consist of running and change of direction
Hip Injury Prevention Tips:  When your lower abdominals are active in suspending your pelvis in neutral you close the gate to faulty loading and open the bridge to healthy loading through the low back.  Inward spiral of the hips restores neutral position of the femur in the hip socket.  This restores symmetrical loading through the hips, it also facilitates the lower abdominals ability to suspend the pelvis in neutral.  

Remember:  You cannot restore symmetrical loading through your hips until you unload your low back by "Connecting Rib Cage to Pelvis" through lower abdominal contraction to position the pelvis in its neutral vertical position.

 


Knee Conditions


 

Hamstring Strain

Hamstring Strain:
The fibers of the hamstrings can build of tension as a result of injury or prolonged asymmetrical loading through the hip and knee. 

Technique: The technique for releasing abnormal tension in hamstring consist of massage to the hamstring fibers while you are laying on your stomach. This technique requires skin to skin contact so please wear clothing that allows exposure of the knee up to mid-thigh.  Palpation of the hamstring near their origin at the pelvis may be required.  

Medical Consideration: If you cannot straighten you knee all the way refrain from all standing exercise until you can restore full terminal knee extension.  If a hamstring strain progress into groin pain please see your physical therapist or physician for further evaluation.
Faulty Patellae Tracking 

Lateral Release:
Faulty tracking of the patellae is usually associated with muscle imbalance of the medial versus lateral quadricep with the lateral quadricep and hip stabilizers over developed as a result lateral loading of the hip through the foot.  The patellae is tilted in the groove of the femur which causes faulty mechanics of knee flexion.  The treatment is to release lateral tension and restore symmetrical loading through the hip and knee when standing, walking and running. 

Technique: The technique for releasing abnormal tension in the lateral hip and quadricep is performed with you laying on you side with the leg hanging off the table to put the lateral hip musculature on tension. This technique requires skin to skin contact so please wear clothing that allows exposure of the knee up to mid-thigh.

Medical Consideration: If your knee starts buckling underneath you in standing, walking or going up and down stairs is a possible indicator of a more severe injury at the knee.  See your physical therapist or physician for further evaluation and put your home program on hold.
Quad Strain

Quad Release:
Faulty loading of the knee can overload the distal quadricep as it converges into the patellar tendon. Abnormal holding of the quadricep can change the resting position of the patellae which can cause faulty tracking of the patellae when the knee if flexed. 

Technique: The technique for releasing abnormal tension in the quad is performed with you laying on you back and the knee flexed 90 degrees. With the quadricep in tension the therapist will mobilize the fibers of the quadricep that are holding abnormal tension.  This technique requires skin to skin contact so please wear clothing that allows exposure of the knee up to mid-thigh.

Medical Consideration: Maintaining flexibility of the quadriceps and hamstrings is critical for healthy ankle, knee and hip mechanics.  If you cannot bend one knee as much as the other it will manifest itself in sport and recreational activities and put you at risk for an overload injury.

Runner's Knee

Tensor Fascia Lata Release:
Because most of us are right lumbar loaders we are prone to having a collapsed right pelvis. When a pelvis collapsed forward on one side the hip is sitting in the way and must rotate outward to get out of the pelvis's way. This results in lateral loading pattern which transfers a lot of load to the outside of the knee and hip. The muscle that takes the brunt of this load is the Tensor Fascia Lata, an outer hip abductor. It has a long tendon (IT band) that attaches to the lateral aspect of the femur near the knee joint.

Technique: The technique for the TFL release consists of you laying on the side opposite the TFL being released. Your top leg is in neutral and hanging off a treatment table in a position of stretch. This technique can most often be successfully administered through thin clothing but a myofascial release technique may be required in order to release the holding which requires skin to skin contact. In most case this can be done under clothing.

Medical Consideration: A "lateral loading pattern of the lower extremity puts us as risk for piriformis syndrome, runner knee (IT Band Syndrome), hamstring strains and medial joint injuries.

Knee Injury Prevention Tips:  The knee is a hinge joint, mechanically a simple joint.  It is vulnerable to injury because its loads are dictated by hip and ankle mobility and stability.  Imbalances at the ankle and hip can transfer unhealthy loads through the knee.    

Remember:  You cannot ensure symmetrical loading through the knee until you restore neutral hip positioning via "Inward Spiral" of the hips which is only available when the pelvis is in its vertical neutral position.

Lower Leg Conditions


 

Anterior Compartment
Syndrome
Rectus Abdominus

Anterior Tibialis Release:
Faulty loading through the ankle and knee can cause mis-alignment of the fibulae and/or overload of the soft tissue of the lower leg which may warrant a release of the anterior tibialis.  

Technique: The technique for releasing abnormal tension in the anterior tibialis is performed with you laying on you back. This technique requires skin to skin contact and may require a release of lateral hip stabilizers so please wear clothing that allows exposure of the knee up to mid-thigh.  The SymFit® Knee Self-correction technique can be performed safely by you if you do not have any sensory or strength deficits in the lower leg, ankle or foot as a way to restore neutral positioning of the fibular head.

Medical Consideration: Trauma to the anterior aspect of the lower leg can result in increased pressure of the anterior aspect of the lower leg, anterior compartment syndrome can develop.  This is a more serious condition that warrants more closely supervise treatment medically.  If you experience loss of sensation or strength in the lower leg, ankle or foot please refrain from your prescribed home and fitness program and see your physical therapist or physician as soon as possible.     
Calf Strain or
Achilles Tendonitis
Internal Obliques

Gastrocnemius Release:
The gastrocnemius is one of the most mechanically loading muscles throughout the day.  Any joint mis-alignment in the lower body or pelvis can stress this muscle during walking, standing, stairs or running.  Mis-alignments and/or mid-foot can cause mechanical overload to the gastrocnemius.  The SymFit® Ankle Self-correction technique will mobilize the ankle in directions that cause faulty loading and mis-alignment of the talus or mid-foot.  

Technique: The technique for releasing abnormal tension in the gastrocnemius is performed with you laying on you stomach. It requires skin to skin contact and may require a release of lateral hip stabilizers so please wear clothing that allows exposure of the knee up to mid-thigh.  

Medical Consideration: If you experience a sharp pain when you squeeze your calf and/or during the push-off when walking consistently in the back of the lower leg hold off on any standing exercises until you see your SymFit® PT or physician as soon as possible.
Plantar Fascitis



Plantar Fascia Release:

How we walk is affected by many things and dictates so many things throughout the musculoskeletal system.  Please watch the Healthy Walking video to refresh yourself on the do's and don'ts of walking.  A common mechanical overload condition of the foot is plantarfascitis.  It almost always is related to mis-alignment in the ankle and/or mid-foot.  Before any joint is mobilized the soft tissue holding abnormal tone around that joint must be released to allow for a sage joint mobilization.  

Technique: The technique for releasing abnormal tension in the plantarfascia is performed with you laying on you back. This technique requires skin to skin contact and is usually painful.  The SymFit® Ankle Self-correction technique can be performed to mobilize the plantarfascia safely.  A home treatment for an inflamed plantarfascia is rolling your foot over a frozen water bottle.  

Medical Consideration: If you cannot tolerate normal weight through the foot as a result of pain at the bottom of the foot and none of the home techniques above bring relief limit your walking and standing until you can see your physical therapist or physician as soon as possible.  Consider using a cane in the opposite hand to help load acceptance.  The cane lands on the floor at the same time as the foot in pain to distribute load off that foot.  

Ankle Injury Prevention Tips:  Mis-alignment in the low back and pelvis can start as a result of a slight asymmetry in loading through the foot and ankle.  NEVER sit in a Slump Sitting posture or stand in with one knee bent.  Here are some other strategies for keeping healthy alignment through the foot and ankle.  
Standing - stand with equal weight through left and right leg as well as equal weight medial versus lateral aspect of foot via inward spiral 
Sitting - sit upright onto your sit bones with hips inward spiral to some degree (do not allow knees to fall away from each other).
Walking - push-off toward the inside of the foot during the stance phase of walking before weight transfer.
Squats/Lifting - even though your hips are externally rotated 45 degrees during a SymFit Squat you still are maintaining an inward spiral of the hips.  Keeping your toes unloaded during a squat will ensure healthy loading through the heel during a squat.
Running - keep your back stacked when running, a collapsed upper back forces a collapsed pelvis which forces lateral loading through the hips, knees, ankles and feet.  This will eventually cause mis-alignment of the joints followed by soft tissue overload.