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Anti Extension Progression

An interconnected team of muscles holds our spinal column stable.  If you wish to be strong in all endeavors, you need to develop isometric (no movement) torso strength that resists flexion, resists extension, and resists rotational forces.  Most people have poor anti extension torso strength, and many of them show up in the physical therapy clinic with lower back, hip, and neck pain.  Presented below is a time-tested progression of training activities that will improve anti extension torso strength.  Watch the video and make these exercises a part of your training program.

Anti Extension Torso Strength Program

  1. Wall Planks
  2. Bench Planks
  3. Push up Position Planks
  4. Push up Position Planks feet elevated
  5. Ball Roll Outs
  6. Ab Wheel Roll Outs

Initial anti extension exercises are all a version of planks that are scaled from easiest to hardest–wall, bench, push up position, and then push up position feet elevated.

Weaker people require more practice to develop the neural connections that improve strength.  They need two sessions a day to drive a reboot of their neural system.   Start with the wall planks for two holds of twenty seconds.  Gradually increase the time you hold the wall planks from twenty seconds to forty seconds.  When forty seconds gets easy, move to the next progression–bench planks.  Return to twenty second holds for two planks after each progression.

Once you can perform forty seconds of the push up position plank with feet elevated, move to the ball roll out exercise for five repetitions.  As your strength improves, gradually increase the repetitions until you can complete fifteen repetitions of the ball roll out.  The final progression is the ab wheel roll out–start with five and work up to fifteen repetitions.

View video of these exercises: here

Michael S. O’Hara, PT, OCS, CSCS

Modern medicine has lengthened our lives, but unfortunately, many older people physically deteriorate to a level that makes them vulnerable to minor health setbacks.  Frailty is a syndrome marked by weakness, poor mobility, a slow gait, and excessive fatigue.  Frail individuals are unable to adequately recover from physical activity or a challenge to their health.  Minor illnesses send them to the hospital, nursing home, or assisted living center.  Frail individuals are often unable to tolerate beneficial medical procedures and must live with pain and physical restrictions.  Frailty is a problem that responds very well to treatment.

In the 65 year old plus population, frailty syndrome is common.  Fifteen percent of the non-nursing home population is frail and forty five percent is pre-frail.  Frail individuals are far more likely to fall.  Forty percent of the frail and twenty two percent of the pre-frail individuals are hospitalized every year.  Frailty is a marker for adverse health outcomes and a means of identifying opportunities for intervention in patient care.

Physical activity has been shown to be the best preventative and treatment for frailty.  Patients bounce back from surgery much better if they under take a program of prehabilitation exercise prior to surgery.  Research on rehabilitation has demonstrated the benefits of exercise to restore strength and mobility in the frail population.  Take the time to read, One Last Question Before the Operation: Just How Frail Are You? by Paula Span in the October 27, 2017 issue of the New York Times.  Read the article here: https://www.nytimes.com/2017/10/27/health/elderly-surgery-frailty.html

In the senior population, fitness activities must focus on training that maintains functional mobility and an independent lifestyle.  You need to stand up and train to be a more graceful and competent walker.  Practice drills that improve your capacity to transfer from the floor to standing.  Always include balance and reaction exercises that keep you free from falls.  Foremost are strengthening activities that maintain bone density and restore capacity to lift, carry, push, and pull.

Michael S. O’Hara, PT, OCS, CSCS

* New York Times, One Last Question Before the Operation: Just How Frail Are You? Paula Span, October 27, 2017

PDFEver wonder how many sets and repetitions of an exercise you should perform? Mike O’Hara, PT helps answer this question in his article “Old School Effective”. Jeff Tirrell discusses the importance of changing only one element of your fitness program at a time in order to determine its effective in “Be The Tortoise”. Exercise description and demonstration of single leg hip hinges are included in “One Leg At A Time”. Don’t forget to check out the youtube video that goes with the article.


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