Athletic Medicine: Pelvic Stabilization and Lateral Hip Strengthening Program, Lecture notes of Medicine

Download Athletic Medicine: Pelvic Stabilization and Lateral Hip Strengthening Program and more Lecture notes Medicine in PDF only on Docsity! Athletic Medicine Pelvic Stabilization, Lateral Hip and Gluteal Strengthening Program Dynamic Stability Bridge Series Double Leg Bridge Level 1 Position and Movement: Supine, keep heels close to the glutes. Keep hips level. Abdominals engaged with a neutral pelvis. Focus on stabilizing legs through the glutes instead of the hamstrings. Raise and lower hips slowly and with control. Reps: 8-10 times Single Leg Bridge Level 2 Position and Movement: Same as double leg bridge, but only one leg is fixed on the ground. Other leg remains lifted off the floor ideally 90 degrees. The lifted leg should be straight with a flexed foot. Reps: 8-10 times each side Introduction Numerous lower body problems can be caused by inefficient pelvic and/or hip stabilization. Our body works as whole and when certain regions are not performing optimally, the body will find a way to move using another muscle or joint in a less efficient manner. This program is aimed at addressing the most common weaknesses seen in the lumbo-pelvic-hip complex. Flexibility may also greatly contribute to these issues, and while stretching is not addressed in this program, it can be found in other programs on the UHS website. Please refer to cord flexibility, dynamic flexibility, Pilates flex and stretch and static flexibility programs. Pilate's principles focusing on centering or maintaining the body in a neutral position are foundational concepts in this program. Maintaining "neutral" pelvis versus being tilted forward or backwards allows for proper muscle function. While performing this program, please be aware of good body position, number of repetitions and resistance. Maintaining a controlled, neutral pelvis throughout each exercise is required. Start with small ranges and lower repetitions until you feel comfortable. Slowly increase range or repetitions when you feel you can maintain and control pelvic neutral with ease. When you feel you are ready to progress you can add resistance starting with 1 lb and increase by 1 lb with maximum of 3-5 lbs. The muscles that are primarily responsible for pelvic stabilization include: gluteus medius, gluteus maximus, pirformis and deep core muscles. These exercises are not intended to replace working with an allied health care professional. If you experience pain or discomfort lasting longer than 1 day, please seek assistance from a medical professional. When in doubt see a medical professional. Rotary Stability Clam Level 1 Position and Movement: Sidelying, heels are in line with the gluteals. Make sure hip flexion is only 45 degrees. Knees flexed to 90 degrees. Abdominals engaged with a neutral pelvis. Keep hips stacked, don’t allow them to rock open. Lift the top knee. At peak height, your positioning resembles an open clamshell. Feet remain in contact throughout arc. Reps: 8-10 times each side Clam Level 2 Position and Movement: Advance to level 2 by lifting lower leg up to a 45 degree angle. From this lifted position, lift the top knee. Pause at the top and slowly and with control lower top leg. Feet remain in contact the entire time. Reps: 8-10 times each side Clam Level 2 with Knee Extension Position and Movement: Align the body as for Clam Level 2. Lift top knee. Hold this open clam shell position and add knee extensions. The bottom leg remains lifted the entire time. Reps: 8-10 times each side Clam Level 2 with Small Ball at Feet Position and Movement: Align the body as for Clam Level 2, add small weighted ball between feet. Lift top knee while ball and feet remain in contact. Reps: 8-10 times each side Clam Level 3 Position and Movement: Align the body as for Clam Level 2, then extend the lower leg, keeping the top hip and knee flexed with the foot hooked behind the lower leg. Lift knee. Pause at the top and slowly and with control, lower to start position. Reps: 8-10 times each side Mobility Sidebend Position and Movement: Lie on your side with body propped up on elbow and forearm. Top arm resting on top leg. Lift pelvis off the floor. Simultaneously, reach top arm upwards toward ear and stretch the uppermost side of trunk. Reps: 6-8 times on each side  6) Small Clockwise Circles Repeat exercise #4, except place L Leg in slight hip extension and foot is flexed. While keeping leg at hip height, make small clockwise circles the size of a dinner plate with L leg. 7) Small Counter-clockwise Circles Repeat exercise #6, except make counterclockwise circles. 8) Toe Taps Top foot is pointed entire time, tap foot in front of bottom leg and then behind bottom leg. Circuit B: Equipment: Box (At least 6 inches in height) and Small Cuff Weight (2.5 lb) Start Position: Place cuff weight on R ankle. Step onto the edge of the box and balance on L leg. It is important to stand up straight, keep the torso still and engage abdominals throughout all exercises. L shoulder must be kept stacked directly over L hip. The R leg does not rest in between movements nor does it touch the box. After completing entire series, switch, and place cuff weight on L ankle and reference starting position of stance leg. You will perform a prep exercise for circuit B called a pelvic drop to ensure proper form during circuit B. Reps: Start with 5 reps for each exercise. Do each rep slowly and controlled. Continuously flow from one exercise to the next without resting. Progress up to a maximum of 12 reps. Prep Exercise for Circuit B: Pelvic Drop Step onto the edge of the box and balance on L leg. Place hands on hips. Stand tall with abdominals engaged. The R hip should be lower than L hip at start position. Then lift R hip on stance leg up to level of L hip. Be sure not to hip hike L hip, as the focus is on the R hip. Fatigue should be felt in the R hip and gluteal.       Exercises: 1) Hip Flexion: Lift leg in front of you. Foot is flexed the entire time. Return to start position. 2) Abduction: Lift leg out to the side only as far as you can control and maintain your center (small movement). Foot is flexed entire time. Return to start position and repeat. Keep leg in line with body throughout exercise. 3) Abduction with Internal Rotation: Repeat exercise #2, except foot is pointed down and in. 4) Abduction with Hip Extension: Lift straight leg diagonally, out and behind at a 45 degree angle. Foot is pointed entire time. Minimize lumbar extension. 5) Hip Extension: Lift straight leg behind you. Foot is pointed entire time. Return to start position and repeat. Minimize/avoid lumbar extension. 6) Large Clockwise Circles: Move straight leg in large clockwise circles. Foot is pointed entire time. Circles are as a large as you can control while maintaining while centered.  7) Large Counterclockwise Circles: Repeat exercise #6, except make counterclockwise circles. 8) Single Leg Box Squat: Bend knee of stance leg until opposite heel touches floor lightly. Straighten stance leg back to start position. Keep pelvis level throughout exercise. As you squat, avoid bending knee over toe. Foot with cuff weight is flexed the entire time. Sit back, engage gluts. Advanced Lateral Hip and Gluteal Strengthening Exercises Fire Hydrants Position and Movement: On all fours, hands directly under shoulders and knees over hips. Abdominals are engaged. Lift leg up and out maintaining 90 degrees of hip flexion and knee flexion. Avoid rotating hips or arching back as you lift the leg. Goal is to lift thigh to level of torso. Foot is flexed the entire time. Reps: 8-10 lifts Sets: 2-3 on each side Physioball Sidelying Pelvis Static Holds: Position and Movement: Physioball placed between legs at the ankle. Begin with smaller physioball. Elbow under shoulder. Body in neutral alignment. Top hand on hip, do not use it lift the body off the floor. Squeeze Physioball between legs while lifting pelvis off the floor. Lift until only foot is touching the floor. Reps: 4: hold for 10-15 seconds, alternate sides to avoid overload to upper extremity Sets: 2-4 on each side. Physioball Sidelying Pelvis Raises and Lowers: Position and Movement: Physioball placed between legs at the ankle. Begin with smaller physioball. Elbow under shoulder. Body in neutral alignment. Top hand on hip, do not use it lift the body off the floor. Squeeze Physioball between legs while lifting pelvis off the floor. Lift until only foot is touching the floor. Lower pelvis back towards the mat until it is 1 inch above the mat. Reps: 4 to 6 raises and lowers. Alternate sides to avoid overload to upper extremity. Sets: 2-4 on each side.    