Congratulations to our last winner Mia Adams!
Welcome to our weekly exercise challenge
The rules are simple:
1) All answers must be posted as a comment on the PTexplosion website
2) All answers are due by Friday October 30th at 9pm
3) The trainer or therapist with the best answer receives a DVD of choice from our products page
Good luck!
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8 Responses to “Corrective Exercise Challenge ll”
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There is lack of glute activation, ITB and Psoas also need balance. Quad and hamstring stretch and strength. Start with TRX assisted one leg squats, spiderman crawls and reverse spiderman crawls for hip movement. I would use kettlebell swings to get more glute and posterior chain activation and stabilisation. I would also use isometric wall pistols(lower position ) and one legged stick hops to build strength and endurance in the calves and quads. Core stabilisation/posterior chain exercises are an important aspect of this regime as well.
During the two movements the knees should remain in line with the second/third metatarsal of the foot.
Overactive areas include:
The compensation consist of the femoral adduction and some tibia abduction as well. The adductor complex, biceps femoris (short head), TFL and lateral gastrocnemius all affect his altered knee position during both transitional movements.
Underactive areas include:
The medial hamstrings, gracilis, popliteus, medial gastrocnemius, and the gluteus medius and maximus as well are the muscles that when underactive will assist in allowing the femur to adduct (internally rotate) and the lower leg to abduct or (externally rotate).
Also during the descent of the squat and hop the foot and ankle complex demonstrated slight pronation.
tight hamstrings, tight external hip rotators and tight hip flexors usually prevent individuals from being able to really “sink their hips” in order to truly work the posterior chain without compromising lumbar stability. A lack of hip mobility will cause the lumbar spine to become abnormally mobile which may lead to low back pain and or injury
he needs to strengthen his quads, glutes, hamstrings, calves and core.
1: warmup: walking leg cradles, backwards lunge rotational reach, lunge matrix w/ ham&psoas, IT band stretch w/ lat lunge, mountain climbers, bird dogs, fire hyrdrants
2: Legs: start with squats (preferably box) with wide stance, toes pointed out to emphasis on glutes, hamstrings and lower back. superset w/ box jumps. end with banded external rotation.
3. Post. chain: GHR superset w/ single leg glute bridges, wide stance good morning
4. Core: hanging scissor kicks, leg lifts, rotational med ball slams
First of all I would like to use the KISS principle.
From all the technicalities we loose the essence of training.
1.Check the client for flat feet deformities i.e. the trouble originates from the first point of contact thus activating different muscles in kinetic chain.Solution-making the proper prosthetic aid for his shoes.
2.Lack of knee stability can best be resolved through balance exercises such as in Yoga-warrior III,tree pose and others,other which I find beneficial is while semi squating on one leg use the other to tap around the clock while maintining the knee of the semisquated leg as fixed as possible on the axiom position between the 2nd and 3rd toe.The other taping leg can have a small ankle weight on it to awaken the gluteus medius.
3.Simple stair walking up and down while emphasising glute activation by using heel thrusts.Use different rhytms from slow to very slow up to normal and when really warmed up some quck changes.
4.Core work which incorporates whole body such as roll up into squat and back
5.Maybe some http://www.kinesiotape.com running down the IT band up into the glute medius and the other part of the Y strip into spina iliaca anterior to activate the psoas.
6.He could also be protecting his groin area from a small hernia by moving in this manner but that is more of a Dr.House realm
To do this exercise:
First , need improve balancing and lower body stretching.
Second, improve the strenght : core, hip flexors, quads, hamstrings, glutes and calfs.
Strenght techniques: i think its easier when you tense all muscles,
tighten your fists, twists your arms outward, tense your lats, brace your abs, grip the floor with your toes.
How to perform : shoulder back and down, chest forward, weight in your heels ( toes up )one leg near straight out in front of you, arms in front of of you for balance, keep shin for perpendicular with the floor.
To ascend: reach forward as far as possible, push from the heels, squeeze your glutes, explode, fast. . Errors to avoid : don´t let your shoulders come up, don´t let your knees come forward, don´t let your knees come in, don´ t sit down , sit back.
Thanks Brian, and sorry for my bad english. I´m trying to improve not only as phisician, but the form to speak english. ( ahahahaha ).
My Best,
Marcia
I know I missed the deadline, but I can’t resist making an attempt at this one. I agree initially with Davor in that it starts with the feet. This man’s arch completely collapses with weight baring, throwing everything north of there off. This dysfunction goes up the chain. While an orthotic may help in the short term, it won’t solve the problem. Increased mobility of the ankle complex via myopfascial release of the plantar surface of the foot (golf ball roll) and the calf (foam roll), plus some static stretching will improve dorsiflexion. Strenghening of the weakened muscles on the bottom of the foot (ie squishing the toes by picking up a towel or marbles, flex/ext with a theraband) should help improve the integrity of his arch. Next, he should be taught the neutral ankle position and practice it in weight baring so he can ‘relearn’ the proper movement pattern. Progression: Neutral ankles in standing to neutral in 1-legged standing balance to controlled pronation in 1-legged reach. As for the rest of the chain, essentially most of the medial side is overactive and tight (since he rolled in) and the lateral side is underactive and weak. Myo release and static stretching on what’s tight and strengthening on what’s weak. Again, strengtheners should be taught with special attention being paid to optimal positioning to create functional movement memory. Even though I couldn’t see it from this camera angle, I know that when the femur medially rotates, the pelvis tilts anteriorly. I did notice he had some hip hike on his left side to balance this. Together these factors lead me to believe he also has tight hip flexors which will make his glutes deactivated and his hamstrings too taught. Combined this all leads to his knee pain even though I believe it stems from his feet. I would not have this client performing single leg squats (other than for assesment purposes) until he demostrated improved alignment in single leg balance. Hams should be released via foam rolling since they’re taught and hip flexors should be lengthened. Glutes and hips should be strengthened with bridge progressions, side-lying clams etc progressing to more multi planar movements as long as the client remains pain free.
I’m not as certain as I sound, but my gut tells me that’s what’s happening here. If he were my client, I would assess him further to confirm my suspicions. I’m still new at this, so I keep looking and looking and looking until I figure it out!
Thanks for the brain teasers!
who won???