Posts Tagged ‘lunges’


 

Yes, I said dormant butt syndrome, DBS for short! I see it all the time in the clinic. In athletes and people of all ages. The cause of DBS is usually tight hip flexors, again, which most people have. This is due to repetitive hip flexion from walking, running, sitting, driving and sleeping in the fetal position.  Other causes include injury and inactivity.   If you remember back to previous posts the gluteus maximus generally attaches proximally to the sacruum, and illiac crest and wraps around the hip to distally attach to the greater trochanter (the big bony bump on side of hip).  Although we think of the gluteus maximus as a powerful hip extender it is actually built for rotation.  Just look at the fiber orientation (yes, you may have to crack open the old anatomy book).  So, functionally its main function is to eccentrically control internal rotation of the femur in the transverse plane during the loading phase of gait or running, eccentrically control hip flexion in the sagittal plane and assist the gluteus medius in stabilizing hip adduction in the frontal plane.  The ability to appropriately load enhances their ability to concentrically contract during the unloadong or propulsive phase.  If the gluteus maximus is inhibited (which V. Yanda taught us) from a tight hip flexor, then the hamstrings and erector spinae group  become overactive to compensate.  This leads to the possibility of hamstring strains, low back pain, knee pain and possibly even plantar fascia.  A simple way to check for DBS is to have patient lie prone and ask them to do a leg lift.  Palpate the gluteus and the hamstring and see which contracts first.  Many times I feel the hamstring contract then the gluteus.  It should be gluteus then hamstring.  Sometimes ive seen people have a 5/5 manual muscle test and not even fire the gluteus.  They used all their hamstring and erectors to lift/hold the leg up.  Some general strategies include a basic muscle re-education of laying prone over table or bed and actively squeezing butt then lifting leg.  Sequence can also be done with bridge exercise.  Stretching the tight hip flexor, of course, and functional hip dominant exercise like single leg balance w/ arm reaches, multi planar lunges, sled walks, various step up and downs.  So now get moving and wake that sleepy butt up!

Get Strong! Stay Strong!

Chris

Despite their name, the adductor muscles work primarily as strong sagittal plane hip flexor or extensors. For example, if you are walking (or running) and the right leg is forward, the right adductor works as an extensor and the left as a flexor and then they switch as you alternate legs in the cycle. Have you ever went out and ran or sprinted for the first time? Where did you feel sore? Right, in the groin and inner thighs (as well as the rest of your body if was your first time).
The adductors (generally) attach proximally to the pubic bone and distally attach to the posterior medial aspect of the femur, giving them their mechanical advantage in the sagittal plane. In single leg stance or the single leg phase of gait running or kicking they work with the gluteus medius and the quadratus lumborum to stabilize the pelvis and limb in the frontal plane on the stance side. Now, in activities such as gymnastics, ballet, and karate where the leg is lifted or rapidly “thrown” out to the side the adductors will actually adduct the leg to bring it back into position to hit the ground.

Due to its atachment to the pubic bone, the adductors when activated, can stimulate (turn on) the pelvic floor muscles.  So, squeezing something between the legs while doing a bridge or squat for example can increase pelvic floor activity, which is important for women who have had multiple childbirths and people with core stabilization issues.

Some examples of functional exercises that activate the adductors include:  lunges – forward, lateral and posterior lateral w/ rotation, step up w/ opp. leg hip flexion (w or w/out resistance from cuff or cable), single leg balance w/ opp. leg reaches, and resisted walk, jog or running (cable, bungie, sled).

Once you understand what the bones are doing in all 3 planes (against gravity, ground reaction forces and momentum) and you know where the muscle attaches proximally and distally, you can begin to figure out its true function and design exercises to actually improve the bodies abilitiy to move.  Unfortunately, school doesnt usually teach us that.  Think back to anatomy.  We are taught that the adductors adduct the leg.  Well, now we know that in function they rarely ever do that!  Good luck and have fun!  There is always more to learn!

Get Strong! Stay Strong!

Chris

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 Will H. Stewart II, FAFS, CMT Fellow of Applied Functional Science

The Scene: 1996 Summer Olympics in Atlanta, Georgia USA

The Event: Womens Gymnastics The Apparatus: The Vault

The Athlete: Kerri Strug

This should start ringing a few bells. The US team needed a score of 9.493 to win the gold medal for the US. Her first attempt received a score of 9.162. It was erroneously thought not to be enough. To make matters worse, she had under-rotated her first fault and injured her ankle, and because of the miscalculations, her coach told her she needed to do it again. On an injured ankle, Kerri Strug sprinted down the runway and nailed her vault receiving a 9.712. Gold! This was truly what Olympic moments are made of. Ms. Strug was later taken to the hospital and treated for a third-degree lateral ankle sprain. This was, of course, after she had stood on the podium to receive her gold medal with Team USA Gymnastics.

Most of our ankle sprains are not as dramatic as Kerri Strug’s; however, they can be just as bad and ugly. The foot/ankle complex is an amazingly beautiful and complicated system of many bones, muscles and connective tissue that give 3-D support. However, this complex system is prone to injury. Eighty-five percent of ankle injuries are sprains and out of those, 85% are lateral ankle sprains. Unfortunately, ankle sprains that are not rehabilitated functionally can cause dysfunction not only at the foot/ankle, but also up the kinetic chain. Functionally, as we look at the foot and ankle, we know that as the foot hits the ground, it causes a chain reaction that takes the calcaneus into eversion. There are numerous muscles, in particular the peroneus longus, which decelerates the eversion along with assistance from the medial deltoid ligaments of the ankle. However, as stated before, most of our ankle sprains are inversion sprains. While we have muscles that decelerate inversion of the foot, along with the three lateral ligaments, it unfortunately is, as in Kerri Strug’s case, not enough. After the ankle is evaluated and diagnosed by a qualified health care provider, functional rehabilitation can commence. Traditionally, depending on the grade of the sprain, the R.I.C.E. method was recommended to control inflammation and ensure no further damage. Guided by Applied Functional Science, we know that there are 12 multi-joint muscles that send their tendons across the ankle and subtalar joints of the foot. We also know that ice reduces swelling.

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Therefore, one of the many strategies for rehabilitating a lateral ankle sprain (right foot, in this case) would be to mobilize the affected region by performing a 3-D lunge progression in cold whirlpool (as well as out of the whirlpool) that will elicit the proper sequence of joint motion and stress the tissues from least to greatest. This will effectively provide an authentic swelling control to “pump out” inflammation, as well as proprioceptively stimulate the ankle/foot complex. A lunge matrix progression for a right stable lateral ankle sprain that goes from least amount of stress to greatest could look like this:

Right Foot Left Lateral Lunge (Least Stress)

Right Foot Anterior Lunge

Right Foot Posterior Lunge

Right Foot Left Rotation Lunge

Right Foot Right Lateral Lunge (Most Stress)

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The Right Foot Right Lateral Lunge is the last lunge in the progression since it will stimulate lateral ankle ligaments more than the others listed above it. Discretion for the lunge progression is paramount so that motion is introduced at the right time and right direction without overstressing the damaged tissues. Gary Gray explains and demonstrates other powerful techniques in the “Ankle Sprains: Chain Reaction Rehab” edition of the Functional Video Digest Series that observe proper biomechanics to facilitate proper joint motion, soft tissue healing and proprioception. Some ankle sprains are bad, some even look pretty ugly; however, if we understand Chain Reaction Biomechanics, we are able to assist the body in healing and returning to GOOD function.

Get Strong! Stay Strong!

Chris

Due to the sedentary nature of many peoples lifestyle, the hip (among other things) gets very tight and restricted.  This leads to compensatory movement and muscle imbalances that effect movement and performance.  So, as they sing in the movie Madagascar…you’ve got  to move it move it!

Here are few examples of hip mobility/strength exercises moving in various planes/directions.

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Ant Lunge w/ Ant Reach                      Single Leg Stance w/ Opp Arm Cross Reach

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Posterior Lateral Lunge w/ Rotation    Single Leg Stance w/ Overhead Post. Reach

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Single Leg Stance w/ opp. Arm OH                  Lateral Lunge

Lateral Reach

After mastering controlled ranges with body weight move to increased ranges of motion, increased speed and / or adding weight.  Also think of the various other planes you can move into and how you can drive the hip more with variations of arm and leg reaches.  These movements are also a great active range of motion series for hip mobility and can be use to to maintain mobility after passive stretching or mobilization techniques.

Get Strong! Stay Strong!

Chris