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Procedure #2
The Deep Muscle Stimulator (DMS) is a hand held device that provides a useful form of soft tissue manipulation to loosen
up overactive muscles. DMS provides rapid vibration and percussion allowing for contraction and relaxation of blood
vessels, lymph, and tissues, changing the viscosity of the tissues. DMS is an alternative to transverse friction massage.
This will have a beneficial effect in improving the nourishment and oxygen in the cells of the body part being treated. For
areas of past soft-tissue injuries, such as hamstring strains, the DMS device can break down adhesions and promote
absorption. When adhesions are loosened within the muscle, the muscles are lengthened and strengthened.
Bend over and try to place fingers or palms to the floor. Measure the distance the middle fingers are from the floor.
Benchmark is the ability to have palms flat on floor.
Dysfunction: Not able to touch fingers to the floor; you feel discomfort or pain in the low back; or your thoracic spine or
lumbar spine are bowing with the hip hinge wide open.
Solution: Bend over, but this time think of a belt lifting the hips up and elongating the spine. Push your heels down and
push your bottom up. Stretch the hamstrings with the back locked. Practice elongating the distance between the tailbone
and the chin, separating the two points while hinging at the hips.
Assessment 2
Bend over and try to place fingers or palms on the floor.
Dysfunction: The thoracic spine and the hamstrings feel tight.
Solution: Practice bending over at the hip hinge with outstretched arms. Start with both arms over your head, bend over at
the hips so your torso is parallel to the floor, simultaneously, maximally tightening and squeezing the butt and fists while
keeping the arms outstretched. Continue bending over at the hip hinge, fists and butt as tight as you can for 8-10 seconds.
Release the tension but don't come back up yet. Repeat the squeezing of the glutes and fists as tight as you can for 8-10
seconds. Practice this maneuver with your butt against a wall, getting lower and further away from the wall. Try to isolate
the hamstring muscle belly and not the attachments behind the knees. Repeat this maneuver 7-10 times.
It is important to remember that a forward bend, as in the dead lift, does not require straight legs. The key is to aim for a
perfect hinge from your hips no matter how straight you can press your legs. If you can touch the floor but the spine is
bowing to achieve this, you leave the hip hinge open and the stress is carried in the back and knees.
To self-stretch the hamstrings without over loading the low back, use the forward lean or bow maneuver. While the back is
straight (neutral spine), instruct the client to bend or 'bow' forward. The client will not have to bend over very far to feel
the stretch. Ideally, the client should be able to dissociate the lumbar spine from hip flexion. Remind your client to stand
using the 'short foot' or 'tripod' principles to activate the foot arches.
In clients with overactive hamstrings, it is important to check the prone and standing hip extension movement pattern.
Ideally, the lumbopelvic region should maintain a neutral position as the hip actively extends approximately 10 degrees.
Hip extension should be initiated and maintained by the gluteals and requires the participation of the hamstrings. However,
the gluteals should dominate the movement pattern, not the hamstrings.
Summary
One possible corrective exercise program for the client with overactive hamstrings would be:
1) Foam roll over the hamstrings, especially the lateral hamstings, performed daily at home.
2) Use the Deep Muscle Stimulator, especially over the biceps femoris, each client session.
3) Perform the 90/90 active biceps femoris stretch daily at home for 10 reps. Also perform static stretching of the
hamstrings using the Stretch Out Strap or the MB Stretchbands.
4) Kettlebell swings are a great whole body exercise that will help isolate and activate the gluteals and will help retrain the
hamstrings for proper function.
Once your hamstrings are supple and the resulting stress and pressure is relieved from the lumbar region, the overall
workout experience will be enhanced, increasing the body's strength and range of motion.
Dr. Jeffrey H. Tucker is a Diplomate of the American Chiropractic Rehabilitation Board and teaches postgraduate courses in
spinal rehabilitation. He also instructs for the NASM. Dr. Tucker practices in West Los Angeles, Calif. Visit his web site
at DrJeffreyTucker.com.
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