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I have a client that goes skiing every weekend in the winter and golfs in the summer. In the winter his Quads cause a great deal of pain to him so he gets massages once a week. I've noticed that his Quads are very very tight but the problem seems to be in his IT Band. Its so tight even after i work on it, it hardly seems like I've loosed it. He says it seems more tender around the origination of the IT Band around his hip. He recently just had a hip replacement as well. I was just curious if anyone could give me some tips or other forms of body work to help his Quads and IT Band besides the normal stripping and deep tissue work I've been using.

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Hi Courtney:  I have a sports massage business in Portland, Maine and I had a similar skier/biker/runner client a couple years ago with extremely tight quads. The technique I use on such tight quads while the client is supine is to drop the lower leg off the side of the table so the quads are being stretched (sort of a gentle active release) while I use my forearm to massage from the knee up to the hip. I also use a technique while lying prone, where I bend the knee and move the knee out by the side of the table but still on the table. You may need to use your body to keep the lower leg comfortably on the table. This is almost a sidelying position that give excellent access for your forearm to the ITB & gluteal muscles & hip rotators. And lastly, I make certain the adductors are loose since they are opposing the ITB.

As a stretch to loosen up the quads I teach the half king pigeon yoga position where you reach back for your foot and pull the foot toward your butt. This may be impossible initially with someone with very tight quads, so there is a 3 step variation of half king pigeon pose against a wall that is hard to explain but a local yogi may be able to demonstrate it for you. Or I will give it my best to describe it to you if you can't find anyone who know what I am talking about. Hope this is helpful.

Thanks so much Michael! I will definitely try all these things on him! I was getting frustrated with not being able to do anything to that ITB. I was working the adductors but not too deeply so maybe ill pay more attention to them as well.
With regards to what Michael said, I noticed Courtney mentioned her client had a recent hip replacement. You don't want to do any type of stretches that puts the hip into internal or external rotation when the client has a hip replacement...period. You may find that working the gluts, hamstrings and quads will be more effective than working the ITB itself, which is actually more like a thin tendon that can't really be stretched. And working the glut med/min and TFL will be the most helpful in letting that ITB relax.
...forgot to add, some active engagement or other type of work to help create better movement between the vastus lateralis and distal end of the ITB.

than working the ITB itself, which is actually more like a thin tendon that can't really be stretched.
There is no point beating up on the ITB as Rajam has said, it won't loosen up and actually if you did, laterally stability of his knee would be compromised.

You don't want to do any type of stretches that puts the hip into internal or external rotation when the client has a hip replacement...period.

I second that advice, unless you want to dislodge that implant....

I was working the adductors but not too deeply so maybe ill pay more attention to them as well.

I would address the adductors for two reasons. One, because of the skiing that you mention where the adductors are active in that activity; and two with osteoarthritis of the hip the typical capsular pattern is internal rotation, abduction and flexion of the hip.  Deep transverse friction (no oil) on the adductors and be clear about what you are doing and explain that to the client - you don't want any mis-understanding while working the inner thigh, right?  Sorting out the tension of the adductors will relieve the tension in the gluts.
Hi Courtney - I use a technique called SMRT and with this you can release the IT band, however, the tension in the IT band is generally caused by a misalignment between the hip and knee.  The release for the IT band is simple.  Place your hand on the client's foot.  Use the side of your hand to create a direct line of lateral compression up the leg.  You will do this from the little toe side of the plantar surface of the foot.  Make that compression reach the hip, but no further.  Then very slightly drag the heel laterally toward abduction.  Hold the position for about 30 seconds and recheck.  You can do this multiple times for different areas of the IT band with less/more compression and less/more abduction.  Play with different combos to see what works for him.  I agree that adductor work is really important, particularly at the pubic bone, and especially with a hip replacement.  Again, you can release the adductors fairly easily.  The pubic symphysis is pretty high up in the abdomen on men.

Use the side of your hand and walk you way down the abdomen toward the pubic symphysis (above the sheet).  When the edge of your hand contacts the pubic symphysis, move it gently and slightly toward the side you wish to release and inferior toward the thigh.  Hold that position for about 30 seconds.  It should not only release tension from the upper adductors, but it should also take away tenderness allowing you to go much deeper,  And it is completely safe for hip replacements.

What keeps itb taught? TFL and Glutes of course. Release those. Use little or no oil to access the many layers found here.

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