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Hip

PROPER TECHNIQUE–HIP HINGE

With their newest release, BODYPUMP is going back to basic, simple, weight training techniques and principles.   New exercises are part of the lunge track, and greater focus on strengthening the gluteals and hamstrings are in the squat and deadlift tracks.  BODYPUMP 85 will kick off in April at Fenton Fitness.

BODYPUMP TECHNIQUE: PROPER HIP HINGE

The hip hinge is a basic movement pattern we all should master.  It keeps stress off the lumbar spine and improves strength in the hamstrings and gluteal muscles.  The BODYPUMP row, deadlift, and clean all require a proper hip hinge.  Many pump participants perform these lifts with way too much spinal motion.  When you hip hinge the spine stays still and you tilt forward at the pelvis.  The pelvis rolls around the femur to create flexion at the hip.  The gluteal muscles and hamstrings create the motion that moves the bar, and the core stabilizers hold the spine stationary.  The best view of your hip hinge performance is from the side.  Practice the drill below to help improve your hip hinge. 

Hip Hinge Stick Drill

You need a mirror and a pvc pipe, golf club, or yardstick.  Stand sideways to the mirror and place the stick along the length of your spine.  The stick should touch your gluteal muscles, thoracic spine, and head.  A space between the stick and your body should be present at the lumbar spine and neck.  Maintain those spaces as you push your bottom back and tilt forward.  The knees should bend a little (20-30 degrees) and you should feel some tension in the back of the thighs.  The motion happens at your hip and the lumbar and thoracic spine stays still.  Use the mirror side view to assess your performance.  The stick acts as feedback mechanism to help you keep the spine stable and initiate the movement at the hips.  Progress to using your BODYPUMP barbell with a proper hip hinge motion. 

Michael S. O’Hara, P.T., OCS, CSCS

 

TEST FOR SUCCESS

Easy Answers With The Y Balance Test

We are always looking for better ways to measure our physical therapy patients’ progress.  You want to know if the treatment you prescribe is producing positive changes in the patients’ pain and functional mobility.  You want to be able to identify weaknesses and focus efforts on the most significant problems.  One of the best functional assessment tools is the Y Balance Test. 

The Y Balance Test is a stance platform with three moveable reach boxes.  Each box travels along a measuring stick.  The patient stands on the platform and with the opposite foot, pushes the reach boxes down the measuring stick.  A successful test involves reaching as far as possible and then successfully returning to a stable single leg stance position. 

Measurements of the distances the patient was able to reach are recorded.  Comparisons are made between the right and left legs.  As the patient moves through therapy, he or she can be reevaluated on the Y Balance Test to measure the success of treatment intervention.  A great effort is made to train away any asymmetry in reach distances between the right and left leg.  Asymmetries in reach scores are correlated with greater incidences of future injury.  

The Y Balance Test is a true measure of how we use our legs.  Most activities of daily living and nearly all sports are all about single leg control.  Unfortunately, most clinical tests look at only one joint segment, in non weight bearing positions.  The Y Balance Test gives the clinician and patient a real world assessment of the interactive function of the foot, ankle, knee, hip, and torso in a standing position. 

Patients like the test because it is easy to understand and gives them a clear training goal.  The Y Balance Test takes minimal time to perform and patients do not have to be strapped into a machine or tethered to a computer.  Patients often report that as their scores improve, they notice a decrease in pain. 

Y BALANCE TEST
Functionally relevant.
Research proven: Repeatable and reliable.
True measure of real world lower extremity function.
Easily understood scoring system.

Michael S. O’Hara, P.T., OCS, CSCS

 

SINGLE LEG STANCE OPPOSITE
 ARM REACH AND ROW

A Long Name For A Great Exercise

In life, most of the challenging tasks happen in either single leg stance or with much more of our weight on one leg.  We must be able to support, decelerate, and change directions with one leg.  Our muscles are aligned so that the hip is mechanically linked to the opposite shoulder.  In physical therapy, we know that having one side of the body function efficiently and the other side falter sets you up for injury.  Your exercise program should revolve around training to meet these physical demands.  One of my favorite life enhancing exercises is the single leg stance opposite arm reach and row.   

Exercise Benefits
Fall preventative activity that helps improves single leg balance.
Sure cure for the epidemic of gluteal amnesia.
Gives athletes the hip to opposite shoulder connection they need for performance.
Identifies any asymmetry in single leg control.
Enhances the single leg deceleration skill necessary for injury prevention.
Makes you stronger when you lift, carry, push, and pull.

Single Leg Stance Opposite Arm Reach and Row
You need a cable column machine or resistance tubing anchored at knee level or lower.  Hold the tubing or cable handle in the right hand and stand on the left leg.  You must be at least five feet away from the attachment point of the tubing or cable.  Initiate the movement simultaneously at the ankle and hip and reach forward with the right hand.  Attempt to get the hand down to knee level.  Return back to standing and pull the handle toward the body in a rowing motion.  Perform five to ten repetitions and then repeat on the other side.

Common mistakes are bending at the hip only and slouching over at the spine.  The ankle, knee, and hip all move together, and the spine should stay stable.  Holding the handle on the same side instead of the opposite side.  Performing repetitions past the point of technical failure.  If you start wobbling around, stop the exercise.  Getting the arm and legs out of sync.  Do not reach with the arm and then move the legs—the motions should happen together.  Remember to come all the way back up to a tall standing position before starting the next repetition.  Start with light resistance and try to create a steady smooth pattern before adding more resistance.  Watch the video  and give this exercise a try.  

Michael S. O’Hara, P.T., OCS, CSCS

THE WALL SQUAT

Turn Around And Improve Your Squat Performance

For most people, wall squats are an exercise that involves placing your back against the wall (or on a physioball placed against the wall) and performing squats with a supported torso.  The assistance from the wall permits you to stay up taller and shifts much of the workload onto your quadriceps.  While this exercise will make the muscles in the front of your thighs burn, it does little to improve your mobility or strength.  My advice is to turn around and face the wall to develop better squat mechanics, balance, and functional mobility.   

The ability to perform a full squat is an important basic movement pattern.  The overhead squat is one of the seven critical tests in the Functional Movement Screening process used to assess an athlete’s readiness to compete.  Squatting is a basic mobility pattern that is important for long term independent living, a healthy lumbar spine, and a calorie hungry metabolism. The restoration and preservation of the ability to move through a proper squat pattern should be a part of every fitness program.

As infants, we mastered a full, steady squat.  A baby must develop control of the squat in order to progress to the next level of mobility–standing and walking.  Prolonged sitting, weakness in the muscles that stabilize the pelvis, and the lack of basic spinal and hip mobility in daily activity restricts our ability to move into this basic pattern of movement.  Add in some well meaning but mobility reducing fitness activity and you produce an environment that fosters immobility.

Wall Squatting 101
The wall serves as instant feedback to prevent most mistakes.  If you let the knees collapse inward, slouch over at the spine, or lean the head forward ,you hit the wall and are unable to descend any further.   

Face the wall and position the toes twelve inches away from a wall.  The toes should point out no more than thirty degrees.  A mirror that provides a side profile can be helpful for visual feedback on your performance.  The basic wall squat starts with the hands placed across your chest or out to the side of your shoulders.  Push the hips back and lower into the squat.  The wall keeps your posture tall and forces the knees out.  If you find the wall squat difficult, then you need to perform it often and improve you performance.  Start with three or four sets of five to ten repetitions.

As your mobility improves, simply move closer to the wall.  Holding the hands behind the head or holding a band overhead increases activation in the thoracic spine and shoulder girdle muscles.  You can add resistance by holding a kettlebell suspended from both arms.  Watch the video that accompanies this article.  

Michael S. O’Hara, P.T., OCS, CSCS

 

GET IN YOUR CAGE

Stretch Station Mobility Restoration

Invented by Gary Gray, a physical therapist from Adrian Michigan, the Stretch Station has been a primary piece of equipment at all of our facilities.  It enables the physical therapy patient or fitness client the ability to perform three dimensional mobilization of the major peripheral joints and spine. I have not found another piece of exercise equipment that is as beneficial for improving movement as the Stretch Station.

It Has To Happen In Standing
The Stretch Station allows you to mobilize joints and move in the anti-gravity, standing upright position that it functions in every day. Gravity eliminated, floor stretching programs often fail to produce better movement when gravity comes back into play. Any new movement you develop with mobility training is only beneficial if it can occur in a standing position.

A Little Lift Goes a Long Way
Traction force (pulling apart) of a joint is a key component of all manual medicine. It helps relieve pain and makes greater joint mobility easier to achieve. The overhead bars of the Stretch Station enable you to lift up and partially decompress the spine, hips, knees, and even ankles during mobility training.  This low level traction force assists in the development of better mobility. Deconditioned and overweight patients can perform hip and knee mobility training and remain pain free with the assist of the Stretch Station.

One Good Turn…
Most floor mobility training does little to develop better rotation at the joints that are supposed to produce
rotation–thoracic spine, hips, and ankles. The Stretch Station has an angled floor and multiple handle sites that enable users of all sizes to work on improving rotation. Thoracic spine and hip mobility work is particularly beneficial for athletes that must swing a club or throw a ball.

Identification of Asymmetries
Using the Stretch Station, patients and fitness clients can immediately identify when one side of the spine, one hip, or one shoulder is more restricted than the other. Training away asymmetries at a single joint or movement pattern is important for injury prevention and optimal performance.

A Bridge to Better Performance
I have fitness clients perform thirty seconds of mobility training on the Stretch Station followed by a complimentary strengthening exercise. The idea is to neurologically reinforce the new motion achieved with the Stretch Station using an appropriate strengthening activity. This pairing of the Stretch Station work with a strengthening drill has been very effective in restoring movement and decreasing pain.

Michael S. O’Hara, P.T., OCS, CSCS

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