Exercises to Eliminate Pathokinematics: Part X

Last week, we continued our discussion on the single limb training.  Although there are a plethora of exercises that could be used, we are just outlining a couple that we find beneficial.  This series, when emphasized during the eccentric phases of the exercise not only aid in improving single limb performance but also aid in building eccentric strength of the hamstrings which is critical to reduce part to reducing hamstring strains/sprains.

Modified Single Leg Dead Lift:

Level I:  Standing on the right foot, with a slight bend in the right knee, flex at the hips while reaching towards the arch of the right foot with your left hand and the outside of the right foot with your right hand.  Once you have obtained the end of your available range, without flexing in the lumbar spine or increasing the flexion in the knee, return to the starting position.  Perform 3 sets of 10-20 reps focusing on 3-4 seconds to lower to the end range and 1-2 seconds for returning to the upright starting position.  Repeat on the left.

Level II:  While holding a dumbbell in each hand and standing on the right foot, with a slight bend in the right knee, flex at the hips while reaching towards the ball of the foot.  Once you have obtained the end of your available range return to the starting position.  Perform 3 sets of 10-20 reps focusing on 3-4 seconds to lower to the end range and 1-2 seconds for returning to the upright starting position .  Repeat on the left.

NOTES: Start with a weight which you can perform this exercise without loss of balance, “cork screwing” at the hip or loss of neutral pelvic positioning.  Once you are able to perform with #25 dumbbells, for 20 reps, progress to Level III.

Level III:  While holding a #45 weight bar in your hands and standing on the right foot, with a slight bend in the right knee, flex at the hips reaching toward the ground in front of your supporting leg.  Once you have obtained the end of your available range, return to the starting position.  Perform 3 sets of 10-20 reps focusing on 3-4 seconds to lower to the end range and 1-2 seconds for returning to the upright starting position.  Repeat on the left.  Progress in weight.

 Level IV:  While standing on the right foot on a foam pad, hold a straight bar in your hands.  With a slight bend in the right knee, flex at the hips while reaching towards the ground in front of the right foot.  Once you have obtained the end of your available range without flexing in the lumbar spine, return to the starting position.  Perform 3 sets of 10-20 reps focusing on 3-4 seconds to lower to the end range and 1-2 seconds for returning to the upright starting position.   Repeat on the left.  Progress in weight

KEYS TO SUCCESS:  Key points with this progression is to keep the non-stance hip in a neutral position (no hip extension or flexion) and the lumbar spine in a neutral position (maintain throughout without allowing spinal flexion or extension).  It is important to maintain “proper positioning” of the hip and knee as well (no adduction at the hip or internal rotation).  Preventing these will strengthen good movement patterns and prevent reinforcement of bad habits.  Only reach as far as you can while maintaining proper positioning at the hip and spine in the neutral position.   In addition, focusing on the eccentric phases allows you to push eccentric strength of the hamstrings.

Dr. Nessler is a practicing physical therapist with over 17 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment.  He is the developer of an athletic biomechanical analysis and author of a college textbook on this subject.  He serves as the National Director of Sports Medicine for Physiotherapy Associates, is Chairman of Medical Services for the International Obstacle Racing Federation and associate editor of the International Journal of Athletic Therapy and Training.