Stretching the most commonly forgotten muscles!
When demonstrating a stretch for a student or a patient, I find the most common question is “where should I feel this?”. I always take this opportunity to give a mini anatomy lesson explaining where the muscle we are stretching attaches and thus, where you should feel the stretch. However, at times it is important to think in the opposite direction. By this, I mean taking a look at certain troublesome muscles and ask ourselves “are we effectively stretching these when they are tight?”.
The first commonly forgotten muscle relates to the low back. We often think of psoas as a hip flexor (which it is), but due to its attachment to the front of the lower lumbar vertebrae, it should be on our investigation list in the clinic, and potentially a muscle we should be stretching. To stretch psoas, simply lunge forward on one knee, keeping your front knee over that same side ankle. Keep your torso lifted, and drive forward with the glutes. For an extra stretch, try reaching over head with the same side arm as your back leg. Hold this stretch for about 5 slow yoga breaths, in and out. Focusing on psoas should not only help with some potential hip flexor issues, but also low back pain!
PSOAS
Notice the top muscle (psoas) joins with the lower muscle (iliacus) and atttaches together at the medial, proximal aspect (lesser trochanter) of the femur.
The second muscle I find a lot of patients miss out on, especially those who sit at a computer or on their smart phone all day is Pectoralis Minor. Pec minor attaches to the front of the shoulder blade, extending down into the first few ribs. This muscle is particularly important due to the fact that all of the nerves from the neck to the arm travel underneath this muscle (the brachial plexus). To stretch this muscle, you want to place your forearm on a door frame, elbow above the shoulder, forearm perpendicular to the ground. From here, carefully step forward (be mindful of any past or potential shoulder issues) until you feel a stretch on the upper corner of your chest. Once again, hold for 5 slow yoga breaths and repeat on the other side. This stretch is also great for anyone who does a lot of overhead work like hair stylists and plumbers!
PECTORALIS MINOR
Notice how the attachment sites include the upper ribs as well as part of the scapula (the coracoid process). A tight pec minor can affect both aspects of the shoulder joint and the arm/hand.
The next muscle that can relieve a lot of hip and thigh pain is gluteus medius! This fan shaped muscle not only helps you move your leg sideways away from the midline (abduction) but it also stabilizes the pelvis when standing on one leg, walking, or running! Although we often focus on strengthening our glutes, we also need to know how to stretch tight glutes!
To stretch glute med, try sitting on the ground, and cross one ankle over the other knee. From here, slowly drop that foot towards the floor, pausing when you feel areas of tension. Because this muscle is shaped like a fan, it’s important to add movement so as not to miss any potentially tight fibres within the muscle.
GLUTEUS MEDIUS
Notice how much of the pelvis glute med attaches to as well as where it attaches on the femur (greater trochanter).
Next up is another muscle related to the IT band. Your IT (iliotibial) band runs along the outside of your thigh attaching distally into the lateral (side) aspect of your knee. This is why runners with IT Band Syndrome can feel knee pain when running. The IT Band also attaches at the ilium into a muscle called Tensor Fascia Latae (TFL). No, this is not the latest Starbucks secret menu order, this is a small muscle that not only stabilizes the hip, but also tenses the IT Band (essentially aiding in the biomechanics of hip and knee movement).
To target TFL, you want to go into a lunge on the floor with your knee on the ground. From here, turn your front leg outwards and your back leg inwards until you’ve rotated around 90 degrees and started to feel a stretch in the side of your hip. This one is a bit tricky to get, but it often missed when treating hip and knee pain!
TENSOR FASCIA LATAE
Notice how the attachment of TFL crosses the hip joint (showing its role in stability of the hip) but also how it connects directly into the IT (iliotibial) band relating to biomechanics of the knee.
The last muscle I want to discuss relates to the calf. The most common stretch I see fellow runners and walkers performing is a small lunge with their back knee straight. This will target one of the two muscles that join into your Achilles tendon, Gastrocnemius. Gastroc has fast-twitch fibres, meaning it’s great for power and sprinting. To target the deeper muscle joining into Achilles, you need to bend that back leg during your calf stretch. This will slack Gastroc (due to its attachment above the knee joint) and focus in on Soleus. Soleus is important to include when stretching your calves due to the fact that it’s muscle type makes it more of an endurance/postural/workhorse muscle. So, for those long-distance walkers and runners, make sure you are getting in that very useful Soleus stretch!
SOLEUS
Notice how soleus does not cross the knee joint, but it does feed into the Achilles’ tendon.
As always, consult a licensed healthcare professional before adding any stretches into your care program. Your local Chiropractor should be able to give you a detailed program of stretches that can help you feel great and keep moving! Happy Stretching!
-Dr. Stephen Gray
