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Hip Flexor Mobility - PAILs and RAILs

Low back pain cases we treat in our Beaverton clinic, often include soft-tissue release of the psoas muscles, more commonly called the hip flexor. 

As you can see from the above image, the psoas muscle has attachment points on the spine, and as such is often a contributor to low back pain and anterior pelvic rotation. Similar to the shortening that occurs in the shoulders and chest muscles from too much time at the computer, shortening of the hip flexors is very common from extended time spent sitting.

In our Beaverton chiropractic clinic, we employ various methods to release the hip flexors, including Active Release Technique, Graston Technique, cupping, manipulation, and electrical stimulation. Home therapy will include both mobility and strengthening drills. Today we're going to discuss one of our favorite drills to both lengthen a shortened hip flexor, and make it very strong at end range - the range most susceptible to injury. 

Developed by world-renowned musculoskeletal expert and chiropractor, Dr. Andreo Spina as part of the Functional Range Conditioning joint training system,  PAILs  (Progressive Angular Isometric Loading) and RAILs (Regressive Angular Isometric Loading) contractions are used whenever we see limitations in movement.  Limitations in joint movement can happen from disuse, postural demands placed on the body, or due to injury.

These contractions should always be pain free, and can do more harm than good if the tissue is not ready for this level of stress being placed on it. PAILs and RAILs are most appropriate when we find muscular/joint restrictions in an area of the body.

  1. They help teach the body that your end range of motion is safe.  By driving a limb into an object and creating a strong muscular contraction – your nervous system realizes that the position is actually safe to be in.  This then allows your RAILs contraction to allow you pull yourself into a deeper stretch, thus starting to expand your ranges.
  2. The muscle contractions on both sides of the joint help strengthen the end ranges, allowing them to become acquired actively over time.

The following video demonstrates the PAILs and RAILs cycle for the hip flexor. Notes for timing:

1. Enter the stretch and find the greatest line of tension - You will hold this position for 2 minutes. (Use padding under the knee for added comfort)

2. At the end of the 2 minute stretch, activate your core muscles, and begin building a powerful, all-body contraction. Holding this contraction, drive your back knee into the floor with as much force as you can gather for 20 seconds. 

3. After 20 seconds, pull yourself into a deeper stretch while continuing to drive your knee into the ground. Hold for 20 seconds.

4. After 20 seconds, release the contraction and begin a new 2 minute stretch cycle. 

5. Repeat this entire cycle 2-3 times, or as prescribed by your Back In Motion chiropractor.


Back In Motion Chiropractic & Sports Rehab - Serving The Beaverton & Portland Community For Over 30 Years - "Moving Toward Your Finish Line"



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