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If there is a limitation in internal rotation of the femur, and there is a leathery end feel, the problem may be with tightness in the piriformis or the other five of the deep six muscles.
To stretch the piriformis, have your client prone with their knee flexed to 90 degrees. Cradle your clients calf with your forearm, with your hand over the medial side of their knee. Take their thigh into medial rotation as far as it goes comfortable by pulling their foot away from the midline. Have your client try to bring their foot back toward the midline (external rotation) against your resistance using only 10% of their strength for 10 seconds. After the 10 seconds have them try to bring their foot away from the midline (internal rotation) and you assist with the stretch at the end. You can do this several times.
Deep Six Stretch
This begins at 1 minute 11 seconds into the video. It is essentially the same as the piriformis stretch, but with the femur abducted 30 degrees.
This work is adapted from the Orthopedic Massage work of James Waslaski. More information may be found at www.orthomassage.net
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