WEBVTT
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Over here I have drawn in
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all of the deep hip external rotators
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starting with the most prominent one out here
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which is the piriformis.
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Now the piriformis attaches from the anterior side,
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or like under from this viewpoint,
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to the side of the sacrum
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and it comes straight out and attaches
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to the tip of the greater trochanter.
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Which is up here, as you can see on this bone.
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The next guys here, these actually splits off into two.
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This blue guy here is the gemellis.
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So you've got a separation between the gemellus inferior
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and you've got the gemellus superior right here.
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Moving on to the red guy.
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This one here is going to be your obturator externus.
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Which if we look on our iliac or iliacus bone,
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we're gonna see this little foramen here.
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And this guy here fills out the outside portion
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of this guy here.
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And then it inserts up close to the greater trochanter,
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right on the inside here,
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where the neck of that femur is.
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Okay, this last little green guy here
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is called the quadratus femoris.
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And that one attaches to the posterior portion
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of the greater trochanter
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and sits into the lateral portion
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of the ischial tuberosity back here.
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So, one thing that's really interesting
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about these deep rotators
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is that they're commonly thought of
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in conjunction with the glute max,
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which is drawn in here.
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But in reality,
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because they all attach superiorly to this hip,
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they all have a moment to actually pull the hip
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into more of a hip flexion.
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So another thing that's very interesting
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about the way that these guys shorten is that
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the way that we typically think about anatomy
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we tend to put it into our planes of motion
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which is the sagittal, frontal, and transverse plane.
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And so when we think about what these functions are
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with regards to external rotation
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that would frequently put us into
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what we would think of as a transverse plane.
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But the body doesn't tend to move that way.
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And in fact, what we would think about
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as just a purely rotational force
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would really look more like,
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if we can get Chelsea to slide
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to the right side of the table,
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the hip as these guys shorten into flexion,
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we would actually get an abduction
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at that top of that hip flexion motion.
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So you can see that when the hip is in this position
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and these guys are all fully shortened
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what actually happens is it takes it out
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of the plane of motion
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that the glute max would actually function in.
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And so once we get the hip all the way out here,
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these are the main guys that are under tension,
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not so much the glute max.
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And so this is what's being trained
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when we do a lot of exercises, like for instance,
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the hip abductor machine
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and also things like lateral band walks
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if they're being done excessively wide, especially.
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Okay, so if we look at this motion
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of what true hip external rotation looks like
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because they're more hip abductors, hip flexors,
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and that combination of motions,
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we end up shortening
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the deep hip external rotators in this position,
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which is basically the knees in hip flexion comes out.
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Then now at this point,
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there's really no more room in the joint
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for any additional external rotation.
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So if we can depart from that thought process
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of looking at the cardinal planes of motion
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as the way that we refer to the body
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we can actually start to open up the possibilities
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for the way that the joints move naturally.
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So this is going to be fully shortened, deep hip rotators,
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which in turn lengthens
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all of these adductor tissues that we see here.
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So conversely, as we move to shorten these guys
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we're also lengthening the hip rotators
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in the posterior side of the hip.
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And that's gonna move us slowly into adduction extension
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and full internal rotation.
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So if Chelsea rotates on the right side
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we can take another look at that angle.
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And as we come down and into this adduction position,
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we're also gonna get into this internal rotation motion
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and we're gonna hit an end range right there.
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And that's gonna put all of the deep external rotators
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under a pretty significant stretch
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which I'm sure she can feel right now.
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So when we look at training application
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for the external and internal rotators
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they aren't really gonna be best trained
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if we isolate that internal/external rotation function
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at a specific plane.
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So like if we were to look at Chelsea and be like,
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"Okay, we're gonna train rotation
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and just keep this fixed hip flex extension position."
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That's really not going to take them through
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a very big range of motion.
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And it's kind of going to be a dysfunctional motion
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because I'm really gonna be limited
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less by that muscles length
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and more by the shape of the joint,
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the structure of the joint, that neck of the femur,
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and the shape of the pelvis
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are really gonna be the things that are just kind of getting
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jammed up and restricted there.
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And so I'm not gonna be training through
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a big range of motion or a functional range of motion.
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So if we're actually looking at
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how these muscles are incorporated,
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they're meant to assist these big prime movers
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that take us through like our major motor patterns, right?
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Which are gonna be our flexion extension pattern.
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So even though if we were to take Chelsea
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up into full hip flexion,
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we technically aren't at end range, external rotation.
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We are at a significant length of these adductors
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and it's significant shortening.
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It's just not quite fully shortened
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but they are gonna be very involved
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in all of these flexion extension motions
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that are gonna move in this plane.
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So integrating these exercises,
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or these muscles are integrated
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into exercises like split squats, step ups,
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even your squats, leg presses,
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anything where we are getting to
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these extreme range of flexion or extension of the hip.
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If we wanted to train them in a more integrated fashion
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we would want to take something
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that was actually getting us into this
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abducted external rotation position.
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And we were able to reverse action that and come closer
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to this internally rotated adducted position.
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So that would be something like a multi hip, right?
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Or some sort of cable exercise
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where we can actually take these muscles
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through that integrated motion
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rather than isolating the internal or external rotation
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or the ab or adducting position or movement, right?
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So just doing this or just doing this
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is gonna be so much less efficient
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than allowing those muscles to be integrated
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into our flexion extension exercises.
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And if we want to train them more directly
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it would be in an integrative movement like so
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either with a cable band resistance
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or better yet a multifunction machine
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where we can take the hip through that actual path
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that goes from multiple end ranges of flexion and abduction
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into extension and adduction.