Tag Archive for: injury

The Week in Research Review, etc 11-5-18

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The Week in Research Review, etc 11-5-18 was filled with more informative and eye-opening posts! Lots of visually stimulating posts to help clarify what exactly is going on in the hip joint with PROM. Another post that shows the suction effect from an intact hip labrum… amongst other great posts.  Just some great stuff..hope you enjoy!

 

  1. Manual Forearm Resistance Drills
  2. ACL Graft Healing Times to Maturation
  3. Hip Capsule Stress with PROM External Rotation
  4. Muscle Activation Affected by Hip Thrust Variation
  5. Hip Thrust Form by Bret Contreras
  6. Hip Joint Suction Affected by labral Status

 

 

Manual Resistance Forearm Exercises

In this post, I wanted to show you guys some of the manual resistance drills we use @championptp on our shoulder and elbow clients, especially our baseball players. We love to use these drills because we can control so many variables with each athlete and tailor it for their specific needs.

We can control the speed and tempo, the direction of forces (eccentric, concentric), and the magnitude of the forces. Plus it’s a great way to interact with our clients. It’s also a great way to feel how well they’re progressing in their programs instead of just giving them dumbbells.

I have found these manual resistance drills to be very helpful with my overhead athletes and hope you give them a try on your clients soon! Let me know what you think or tag a friend below who may like to use these drills too.

In my course that I teach around the US, I try to include these concepts so you can practice and be able to utilize these drills for your clients…thanks!

 

ACL Graft Harvesting and Healing times

In this post, I wanted to show some research studies on graft healing times and why we need to respect tissue biology.

The systematic review from AJSM 2011 looked at ‘The ‘‘Ligamentization’’ Process in Anterior Cruciate Ligament Reconstruction.’

They essentially looked at 4 different biopsy studies on BPTB and Hamstring autograft reconstructions. They concluded that maturation of the graft, as determined by mainly vascularity and cellularity, was not complete until 12 months at the earliest. The healing time even extended to 24+ months as well.

The ligamentization endpoint is defined as the time point from which no further changes are witnessed in the remodeled grafts. The surgical procedure is quite involved, as you can see in the video that I took from @drlylecain on #YouTube.

As I’m rehabbing my clients, my decision making and post-op progressions often take into account:

✔️Healing biology

✔️Graft harvesting

✔️Graft Type

✔️Bone bruise presence (often!)

✔️Other concomitant issues (meniscus, articular cartilage).

So, respect the tissue and allow natural healing to occur before you add more exercises or are concerned that they’re not making the gains you’d expect.⠀

 

 

Hip Capsular Closure: A Biomechanical Analysis of Failure Torque

Chahla et al AJSM 2016

Interesting look at tissue failure, albeit in a cadaver graft, that should help to guide the physical therapist or ATC early in the rehab process after a hip scope.

The purpose of this study was to determine the failure torques of 1-, 2-, and 3-suture constructs for hip capsular closure to resist external rotation and extension.

The 3-suture construct withstood a significantly higher torque (91.7 Nm) than the 1-suture construct (67.4 Nm) but no significant difference was found between the 2- and 3- suture construct.

The hip external rotation degree in which the capsule failed was:

✅1-suture construct: 34 degrees

✅2-suture construct: 44.3 degrees

✅3-sutures: 30.3 degrees (yes, smaller than 2-suture construct)

I think as a #PT, we need to keep this study in mind and respect the healing tissues after a hip scope.

Love when we can get this information and put it into practice, similar to RTC repairs, ACL, etc.

Obviously, this was on a cadaver where there’s no guarding, pain or muscle contraction. We still need to know that there MAY be enough tension on the capsule to create potential issues (like tissue failure).

If you treat patients after hip scopes, then I recommend you read this cadaveric study.

 

 

Barbell Hip Thrust Variations Affect Muscle Activation

COLLAZO GARCIA et al JSCR 2018

This study looked at the EMG activity of various lower body muscles while performing the hip thrust in various positions.

Their results showed that by varying the foot position into more external rotation, you can recruit the glute max and medius more than by the traditional hip thrust.⠀ …”the activity of the gluteus maximus increases significantly reaching up to 90% MVIC with only 40% of 1RM” with this hip ER variation.

Also, ‘when the distance between the feet is increased, the activity of knee flexors increases. Therefore, this is a very recommendable option to increase hamstring: quadriceps co-activation ratio.’

I like this study because it helps guide our rehab if we’re targeting a specific muscle group a bit more because of an injury or surgery.

It’s one of my go exercises for anyone with a lower body injury, especially after an ACL reconstruction. But I do use this exercise for most of my clients rehabbing from any injury, including the upper body.

It’s a great way to recruit the gluteus maximus and medius, which we know are hugely? (is that a word?) important to help produce and dissipate forces during athletic movements.

The exercise was widely researched by @bretcontreras1 and should be a staple in your rehab programs.

Check it out and add this to your go-to exercise list…thanks!

 

Hip Thrust Form

[REPOST] and a great one from @bretcontreras1 talking hip thrust form, which is perfectly coinciding with my post earlier today on variations to the hip thrust and how they affect muscle activation. Check out his original post below…highly recommended!

Teaching optimal hip thrust form is complicated. While the occasional lifter prefers and functions better staying fairly neutral in the head, neck, and spine, the vast majority of lifters do best maintaining a forward head position, which leads to ribs down and a posterior pelvic tilt.

It’s not just the forward eye gaze; the whole head has to maintain its forward position. You’re not hinging around the bench; the body mass above the bench stays relatively put, while the body mass below the bench is where the movement occurs.

The astute science geeks out there will rightfully point out that posterior pelvic tilt is associated with some lumbar flexion, and that lumbar flexion under load can be problematic. However, lumbar flexion is only dangerous when the discs are simultaneously subjected to compressive forces. With this style of hip thrust, the glutes are driving hip extension and posterior pelvic tilt, and erector spinae activation is greatly diminished. Core activation is what creates the bulk of the compressive forces, so with the erectors more “silenced,” the discs aren’t as compressed. This makes the exercise very safe. In fact, it’s safer than the “neutral” technique because as you rep to failure or go a bit too heavy, you will inevitably arch the chest and hyperextend the spine, which can lead to lower back pain. ⁣

We have 200 members at Glute Lab hip thrusting day in and day out, and there have been zero injuries to date. Considering how heavy we go, this is astounding.⠀
⁣⠀
#gluteguy #glutelab #thethrustisamust⠀

 

Hip Joint Suction and Stability

[REPOST] From @chicagosportsdoc and a very cool look at the suction within the hip joint that contributes to its stability. As the video progresses, they have simulated a labral tear that shows how easily the joint can dislocate. Once the labrum is repaired, the suction effect is recreated, and joint stability is re-established.

That’s 2 posts this week on the hip…if you want to see some awesome posts, then follow him. He just got on Instagram but his visual posts really aid in learning the mechanics of the various joints…see below!

An impressive demonstration of the powerful hip suction seal. When the hip labrum is injured, the seal is disrupted which can potentially produce microinstability. A labral reconstruction can restore the suction seal #labrum #sportsmedicine #hip #anatomy#orthopedicsurgery #medicine

 

The Week in Research Review, etc 8-26-18

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Predictors of Pain and Functional Outcomes After the Nonoperative Treatment of Rotator Cuff Tears Jain et al OJSM 2018

Who should have RTC surgery and who may not need RTC surgery? That’s a big question but this study tries to give us a better understanding.

70 patients with rotator cuff tears were diagnosed based on the clinical impression of a sports/shoulder fellowship–trained attending physician and evidence of structural deficits on MRI (when available). In cases where an MRI scan was available, both of these conditions had to be met for a patient to be diagnosed with a rotator cuff tear. If an MRI scan was unavailable (because it was not clinically indicated; n = 14), the diagnosis was based on the clinician’s impression.

The Shoulder Pain and Disability Index (SPADI) was used to determine the level of disability at 3, 6, 12, and 18 months.

✅Being married as compared with being single/divorced/widowed

✅Shorter duration of symptoms

✅Daily shoulder use at work that included light or no manual labor versus moderate or heavy manual labor

✅alcohol use of 1 to 2 times per week or more as compared with 2 to 3 times per month or less

✅Absence of fatty infiltration

✅ College level of education or higher

✅ Partial-thickness tear versus full-thickness tear

Interesting results, especially the alcohol use and being married (kinda surprising but intriguing). Does this help you to guide your future patients if they ask about RTC repair surgery? Tag a friend or colleague who may benefit from this information…thanks!

 

 

Playing video games for more than 3 hours a day is associated with shoulder and elbow pain in elite young male baseball players. Sekiguchi et al JSES 2018

[HOT OFF THE PRESS] in Sept 2018 issue showing the potential effects of playing video games on injury rates in youth baseball players.
200 Japanese ‘elite level’ male baseball players ages 9-12 years old were included in the analysis.

Playing video games for ≥3 hours/day was significantly associated with an elbow or shoulder pain vs. spending <1 hour/day playing video games.

The amount of time spent watching television was not significantly associated with the prevalence of elbow or shoulder pain.

Originally saw this study on Twitter by Dan Lorenz and thought it was interesting, considering @redsox pitcher @davidprice14had a recent injury and attributed it to playing video games.

Not sure how valid the results are but I just wanted to share with my friends and get your opinions. Tag a friend or colleague that may be interested in these results…thanks!⠀

 

 

 

Shoulder Stabilization Drills

More closed chain rhythmic stabilization drills that we like to utilize at @championptp for our upper extremity patients.

A recent study in 2014 Kang et al showed “The EMG activity of the infraspinatus and the ratio of the infraspinatus to the posterior deltoid activities were significantly increased, whereas the posterior deltoid activity was significantly decreased under the CKC condition compared to the OKC condition.”

I prefer to position the patient with an open palm to make it a less stable surface on the ball. Cue them by telling them ‘don’t let me move you’ as I give manual perturbations along the forearm.

To advanced the drill, we can have them perform it with their eyes closed or in a single-legged stance position with their push-off leg on the ground (if they are a pitcher).

You can also advance them in a time-based manner by extending the duration of the exercise to focus on more of the endurance aspect of the rotator cuff.

This is a great drill for those patients with hyperlaxity that need a relatively stable position to perform their exercises in a relatively pain-free fashion.

Do you utilize these drills or know someone that may benefit from them? tag them below so we can discuss them further…thanks!

Credit to @shift_movementscience for the ER wall stabilization drill that he showed us recently. We always performed them IR Wall Stab drill but a quick 180-degree shift and we got a great posterior RTC exercise!⠀

 

 

Lachmans Test for an ACL Tear

Video showing an obviously positive Lachman’s test in a recent @NFLpreseason game.

Check out the anterior translation of the tibia on the femur while the knee is flexed to about 25 degrees.

This is the best way to diagnose an ACL injury and should be the 1st ACL test that you do in your clinical exam.

Remember to rule out the PCL or you may get a false positive if you see excessive anterior translation because the tibia is sitting too far posteriorly.

According to Benjaminse et al 2006, The Lachman test is the most valid test to determine ACL tears, showing a pooled sensitivity of 85% and a specificity of 94%. There are numerous other studies that conclude this as well.

They even discuss the pivot shift as a test to consider but I think the Lachman’s test will be the most valid overall.

Do you agree? What do you think? Tag a friend or colleague who may benefit from this post…thanks!

 

 

Shoulder Drills

[REPOST] from @tony.comellatalking bodyweight drills that you can use as a warm up or even as part of a shoulder rehab program. Take a look below and applaud these movements by Tony! 👏🏼⠀
⠀
BODYWEIGHT SHOULDER DRILLS⠀
—⠀
🙋🏻‍♂️The shoulder can get overly complex, but the goal of this post is to keep it simple. There are a ton of exercises we can perform, utilizing a variety of equipment (bands, weights, barbells, cable, etc), but here are a few drills I like to perform using only bodyweight:

1️⃣ Prone swimmers. This drill can be deceivingly challenging, as we fight against gravity to keep our arms above the ground. Try and keep your arms as high above the ground as you can and elbows straight (think about reaching fingertips away from you). If you have trouble on the ground you can do this on a bench, or if this is too easy, hold some light weights <5lbs. No need to go too heavy here, as your ability to move a lot of weight won’t impress anybody.

2️⃣ Downdog toe tap. We get the shoulder into full flexion overhead (working on serratus) and some thoracic spine movement too. AdAn additionalonus is showing some love to the posterior chain (hamstrings, calves).

3️⃣ Bear roll. You can’t work on overall shoulder health and not include thoracic spine drills. This beautiful dance move targets the thoracic spine and closed chain shoulder stability at the same time.

😎These are 3 great bodyweight exercises to mix into your warm-up or exercise routine for overall shoulder health. Which one is your favorite?

 

The Week in Research Review, etc 8-12-18

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This week’s articles discuss a wide variety of research topics. We discussed:

  1. Risk Factors for ACL tears
  2. Injury after a concussion
  3. EMG of the hip to minimize TFL activity
  4. We made of our posture and applied it to daily tasks
  5. Rhythmic Stabilization drills for the shoulder

Hope you enjoy and make sure to share with your friends and colleagues!

Factors Associated with Non-Contact Anterior Cruciate Ligament Injury: A Systematic Review. Pfeiffer et al IJSPT Aug 2018

This study looks to examine the existing literature for risk factors associated with non-contact anterior cruciate ligament (ACL) injury in both sexes.

A total of 79 full-text articles were reviewed, 55 of which met criteria for inclusion.
✔️Degrading weather conditions⠀
✔️Narrow inter-condylar notch index or width⠀
✔️Increased lateral or posterior tibial plateau slope⠀
✔️Decreased core and hip strength⠀
✔️Potential genetic influence

Individuals with previous ACL injury are at a higher likelihood for injury in the same knee (9.1x risk).

Take a look at this study because they do a good job of breaking down the literature and pointing out some of the common risk factors, both extrinsic and intrinsic.
✅Anatomic factors⠀
✅Neuromuscular Factors⠀
✅Physiologic Factors⠀
✅Biomechanical Factors⠀
✅Genetic Factors

Check out this paper and tag a friend or colleague that may benefit from reading this paper.

 

 

Musculoskeletal Injury Risk After Sport-Related Concussion: A Systematic Review and Meta-analysis – McPherson et al AJSM 2018

This systematic review & meta-analysis looked to determine the odds that athletes will sustain a musculoskeletal injury after a concussion. It was hypothesized that a concussion would increase the risk for MSK injury.

Eight studies met inclusion criteria for meta-analysis reporting 860 male and 163 female athletes with concussion compared with 3719 male and 507 female control athletes without a concussion.

✅Athletes with concussion had 2.11 times greater odds of sustaining a MSK injury compared with control groups and 1.67 times more likely to experience a lower extremity injury.

✅Female athletes with concussion had 2 times greater odds to sustain injury compared with non-concussed female control athletes.

✅Male athletes with concussion similarly demonstrated an increased odds of 2.1x risk for injury compared with non-concussed male control athletes.

Of course, they say further studies are needed to determine the physiological reasoning behind the increased risk for injury after a concussion.

Kinda makes sense, right? Anecdotally I feel like we see this a lot but good to be able to see it in the literature and educate our clients prior to a return to their sport.

 

 

Electromyographic Analysis of Gluteus Maximus, Gluteus Medius, and Tensor Fascia Latae During Therapeutic Exercises With and Without Elastic Resistance. Bishop et al IJSPT 2018

This study looked to determine the gluteal-to-tensor fascia latae muscle activation (GTA index) and to compare electromyographic muscle activation of the GMax, GMed, and TFL while performing 13 commonly prescribed exercises designed to target the GMax and GMed.

Clams with and without resistance, running man gluteus maximus exercise on the stability trainer, and bridge with resistance, generated the highest GTA index respectively.

It seems as if these 3 exercises may give you the biggest bang for your buck when trying to maximize gluteal activity and minimize TFL activity.

Knowing previous research, it seems as if most single-leg-stance exercises are going to give the patient the best gluteal activity per EMG.

Do you guys use any of these exercises? Maybe you need to use them more for your patients looking to improve their hip strength.

Tag a friend who may need bigger 🍑 and may benefit from this research by the esteemed Barton Bishop and his research team! TThanks, carlokoo for modeling!⠀

 

Loss of knee extension after a surgery can greatly impact a patient’s function in the long term.

Although opinions vary greatly in the orthopaedic world, I am a firm believer that regaining symmetrical knee extension is critical for a surgery to be successful.

Shelbourne et al showed that the number one factor in determining long-term satisfaction after a knee surgery was symmetrical knee hyperextension.

Per Benner et al 2016, obtaining full hyperextension that is anatomically normal for most patients does not affect objective stability, ACL graft tear/failure rates, or subjective scores after ACL reconstruction with patellar tendon autograft.

So why do some docs and PT’s still think you only need 0 degrees of knee extension? 🤔⠀

I’m not sure but I’ll tell you it is safe to get hyperextension and here are 3 tools that I use to help regain that last bit of motion.

1. Low load long duration in supine: in my opinion a better position to regain extension and more comfortable than hanging a patient’s leg off of a table. You try doing that and see how you like it!

2. Retro treadmill walking: walking at ~ 1.0 mph on the treadmill has been a great way to get that last bit of motion back and is something they can do at their gym when they’re not with you in PT.

3. Retro cone walking: Again, the goal is to accentuate the end range into hyperextension and it will also challenge their dynamic balance.

So, do you use these techniques with your patients? If not, tag a friend or colleague that may benefit from seeing this post!

 

I love when we can make fun of ourselves & this post nails it! Give @beardthebestyoucanbe a follow!

There is no such thing as good or bad form or posture. There is no right or wrong “exercise”. What does “functional exercise” even mean, & what is this “core” thing everyone keeps talking about whilst planking or crunching?! My newsfeed is blowing up with these so-called “fitness coaches” and “rehab experts” putting all type of crap out there. For 1 of 2 reasons, maybe both⠀
1. Pure ignorance⠀
2. Trying to grow their following by giving people what they think they want⠀
_⠀
The only bad posture is the posture we spend too much time in (shout-out Andreo Spina). Life is not perfect posture & neither is sports⠀
As human beings, our movement capacity should be vast. If we only stay in a small handful of postures we aren’t fulfilling our movement potential and we’re creating more dysfunctions and weaknesses because of it. Your body will devolve rapidly⠀
If you always hammer down the same posture, even if it’s “good posture”, you’re only creating strength and neurological control in that specific posture. So when your body slips out of that particular shape, weakness and injury is the outcome – and that’s not a good sign⠀

There is no such thing as a functional exercise, just functional (or non-functional) joints that can fulfill movement potential. If your joints can’t successfully control a range of motion that is necessary for your daily life, you should probably make that a priority for your training practice⠀

So in conclusion, is it that you need to practice good form (and never lose it, ever)…or practice multiple forms⠀

How do we practice in those ways? Well, it’s going to take a philosophical change first and foremost. Understanding our biology and neurology is important⠀

If you do not know how to train in such ways, find those who do.

 

I use Rhythmic Stabilization drills daily in my practice for most of my upper body patients.

I think they are critical to use to help the patient regain neuromuscular control, a sense of their joint and it’s a great way for the PT to get a sense of how the patient is doing overall.

The hands-on strength training (trying not to trigger dependency by the patient, so relax!) is a great way to gauge a patient’s progress.

Various tools can be used to progress and regress these exercises. I hope these few basic RS drills can give you a basic understanding of what we do @championptp

I hope to get more of these videos out in the future.

Share with your friends and colleagues so they can see these valuable drills for the shoulder joint!

 

 

 

The Week in Research Review, etc 7-22-18

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The Week in Research Review, etc 7-22-18

I’m trying out this new concept of publishing my social media posts into a nice package for a weekly delivery to my subscribers.

  1. Knee Case Study
  2. Contralateral ACL Strengthening
  3. Shoulder Static Stabilizers
  4. Weighted Ball Research
  5. Glute Activation


This kid came to me the other day with L knee swelling after sliding headfirst into 2nd base during a baseball game.⠀

Continued to play in the game and even pitched the next day, all without pain or loss of motion.⠀

As you can see from the video, he has a bunch of fluid in his knee, medial ecchymosis (bruising) but full pain-free ROM.

Ligamentous tests appear negative and he has absolutely no pain or stiffness with anything.

I took this video to show what appears to be a bursal sac disruption from the impact of his knee into the ground as he was sliding.

The mechanism fits the presentation and clinical exam.

I advised him to monitor his swelling, wear a knee sleeve and continue his activities per his tolerance.

He is going to touch base with me next week to make sure the fluid is dissipating (and not worsening) and he remains asymptomatic.

What do you think? Am I missing anything? What’s your diagnosis? Tag a friend who may be interested in this case.

Cross-education improves quadriceps strength recovery after ACL reconstruction: a randomized controlled trial. Harput et al Knee Surg Sports Traumatol Arthrosc. 2018

This study looked at a group of ACL reconstructed patients that were divided into 3 groups.

All 3 groups performed the same standardized ACL rehab, but one group was the control group that performed the standardized rehab only.

The other 2 groups did either 3x per week extra concentric knee extensions on their uninjured leg for 2 months (beginning at 1-month post-op through 3-months post-op) or additional eccentric knee extensions on their uninjured leg 3x per week for 2 months between months 1-3 post-op.
💪🏼
They found that the quads strength for the concentric group was 28% greater compared to the control group. 💪🏼
The eccentric group was 31% greater when compared to the control group.

Conclusion: Concentric and eccentric quadriceps strengthening of healthy limbs in early phases of ACL rehabilitation improved post-surgical quadriceps strength recovery of the reconstructed limb.

Pretty crazy stuff and one more reason to work on bilateral strengthening with most of our patients, especially when they’re post-op ACL reconstruction.

Do you work on bilateral strengthening? if not, why? If you do, what other studies have you seen that show similar results?
Tag a friend who may benefit from this study or let’s discuss in the comments section!

This picture shows a simplified view of the static stabilizers of the shoulder joint. I highly recommend reading a classic paper by Wilk et al 1997 JOSPT that talks about this and cites a paper from Bowen et al Clin Sports Med 1991 @wilk_kevin

When one is picturing these stabilizers, the superior glenohumeral ligament (SGHL) is most taut when the shoulder is externally rotated at 0 degrees of abduction.

As we progress to 45 degrees of GH abduction, we stress the middle glenohumeral ligament (MGHL) as we externally rotate the humerus.

Finally, at 90 degrees of GH abduction, we stress the inferior glenohumeral ligament (IGHL) as we externally rotate. More specifically, the anterior band of the IGHL.

As we internally rotate at 90 degrees of abduction, we stress the posterior band of the IGHL.

These concepts have rehab implications and should be kept in mind when we’re rehabbing people after an injury or surgery.

For example, if someone has an anterior Bankart lesion (front labral repair), then we need to progress them slowly into external rotation, especially at 45 and 90 degrees of abduction.

Another example would be a rotator cuff repair, like the supraspinatus. We would want to progress them slowly at lower degrees of abduction 0-45 degrees but maybe we can progress them a bit quicker at 90 degrees of abduction.

Hope these concepts make sense because they are very important to understand for many patients with shoulder injuries.

Does this make sense? Have you heard this info before? Tag a friend who may benefit from this post!

Effect of a 6-Week Weighted Baseball Throwing Program on Pitch Velocity, Pitching Arm Biomechanics, Passive Range of Motion, and Injury Rates. Reinold et al Sports Health Jul-Aug 2018. @mikereinold⠀

Our 1st of potentially 3 research articles looking at the effects of weighted balls on youth baseball pitchers.

High school baseball pitchers performed a 6-week weighted ball training program.

Players gradually ramped up over the 6 weeks to include kneeling, rocker, and run-and-gun throws with balls ranging from 2oz to 32 oz.

🤔After 6 weeks, the weighted ball group did increase velocity by 3.3%, 8% showed no change, and 12% demonstrated a decrease in pitch velocity. Also of note, 67% of the control group also showed an increase in pitch velocity.⠀

The weighted ball group had a 24% injury rate although half of the injuries occurred during the study, and the other half occurred the next season. There were no injuries observed in the control group during the study period or in the following season.

The weighted ball group showed almost a 5-degree increase in passive shoulder external rotation, also known biomechanically as the late cocking position or layback position.

There were no statistically significant differences between pre- and post-testing valgus stress or angular velocity in either group.

✅Our conclusion: Although weighted-ball training may increase pitch velocity, caution is warranted because of the notable increase in injuries and physical changes observed in this cohort.

Some great Glute 🍑thoughts buy the @theprehabguys. Check out their videos and content for some great ideas that you can add to your practice!⠀
👇🏼⠀
___________________________________________________________________⠀
Episode 705: “Hip Prep for Glute Activation”⠀
.⠀
Tag a friend looking for a glute🍑 killer!⠀
Hip prep is a series of 6 exercises I’ve adopted from my girlfriend @smenzz and her clinic @eliteorthosport. I use it with my patients to prime the glutes and lower body in general before getting into more dynamic and plyometric activities. I will make the statement right now: if done RIGHT, it’s an absolute glute killer & I promise you that you will feel your glutes!⠀
.⠀
I like these 6 exercises in particular for a variety of reasons.⠀
✅They challenge the glutes in all 3 planes of motion.⠀
✅They hit all types of muscle contractions: isometric, concentric, and eccentric⠀
✅They are performed upright in a functional position⠀
✅There is a variety of double leg, single leg, and split stance variations⠀
✅They train proper lower extremity alignment in a variety of hip and trunk flexed/neutral/extended positions⠀
.⠀
The 6 exercises are:⠀
1️⃣3 way clams: 5 per leg per position⠀
2️⃣Side steps: Alternating steps to the left and right starting with 1 step all the way to 5 steps⠀
3️⃣Monster Walks: 10 steps forward, 10 steps backwards⠀
4️⃣W’s: 10 steps to the left, 10 steps to the right⠀
5️⃣Squats: 10 squats⠀
6️⃣Single leg fire hydrants: 30s per side⠀
.⠀
💡Understand that you first need to teach these exercises in isolation first, before throwing someone all 6 at once⠀
.⠀
Have fun!⠀

Hope this helps you keep up to date and fulfill my goal of this website…simplify the literature and bring great content to you so you can apply it 1st thing Monday morning! Happy Reading! 👊🏼

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