Get Maximum Benefit From Your Rehab Exercises

by James Dunne

As a follow on from my previous post about Multiplanar Strengthening Exercises, I also want to mention the importance of keeping an eye on the quality of execution of the exercises.

It’s not uncommon for me to meet a frustrated athlete with, for example, anterior knee pain who has been given rehab exercises by their physiotherapist and has been diligently performing them, with no improvement in symptoms. Usually it’s not because the exercises prescribed are wrong, more-so the fact that the exercises are, through no fault of the athlete, being performed incorrectly.

The problem is that unless you’re an elite performer with full time support, nobody is there to watch over you and give feedback on form and quality as you perform the exercises.

A CLASSIC EXAMPLE: THE SINGLE LEG SQUAT

Most people (especially who have a tendency to underuse their glutes and dominate movements with their quads) will perform a single leg squat in such a way that inhibits the glutes from engaging as they should – due to the lack of motion at the hip throughout the exercise. By focussing on sitting back into the squat and loading through the heel, the glutes will be more inclined to engage.

The contrasts in form can be seen in the two stills below. Note how the knee stays behind (or at most inline with) the toes when squatting correctly. As soon as the motion at the hip is lost, the knee pushes forwards of the toes and takes increased load through the quads.

APPLIED TO ALL EXERCISES

This same principal of making sure you are executing your rehab and strengthening exercises well should be used for all exercises you perform. You don’t want to schedule precious time to get your exercises done and then find that you’ve been effectively wasting your time with poor form.

Just like everything else in training, it’s important to train smart with your rehab and strengthening exercises!

You should know which muscle group each exercise is targeting and should be able to feel that muscle group working. If you’re trying to work your hamstrings for example and only feel the exercise in your back – the chances are you’re doing something wrong!

If in doubt, get a professional to take a look at your form and advise appropriate exercises.

Multiplanar Strength Exercises For Triathletes And Runners

We explore the need for triathletes and runners to incorporate multidirectional strength exercises into their regular program, and show you some great exercises to enjoy the benefits of this type of training.

Triathletes and runners spend most of their time engaged in what are primarily “straight line” activities, particularly running and cycling. Certainly most of the load bearing work that most triathletes and runners complete is uni-directional.

Not only are these movement patterns uni-directional (running in a relatively straight line and cycling), they are also very repetitive, repeating the same movement pattern again and again both in training and in competition with very little variety to our movements.

Those of us who do any strengthening work at all on a regular basis to supplement our running, swimming and cycling (definitely the minority!), often fall into the trap of also only doing straight line exercises such as squats, lunges, step-ups and single leg squats.

“So what? Those straight line movements mirror the demands of our sport…”

“Well yes and no…!”

Remember this important fact:

The body is able to move through three planes of motion at one time. And at any given time it’s moving in all three. Just because (using running as an example) the outcome is a uni-directional “one foot in front of the other” movement, it doesn’t mean there isn’t lots of rotation and lateral motion going on behind the scenes to produce that movement!

Lets look into the anatomy of different types of muscle for a second:

Planes of MotionThe big, powerful, two joint muscles which help to drive us forwards (think hamstrings, rectus femoris, quadratus lumborum etc…) all have their fibres aligned longitudinally, making them very good at producing force into flexion and extension in the sagittal plane, and pretty rubbish at controlling rotation and ab/adduction in the transverse and coronal planes respectively.

On the other hand, the muscles which provide stability as we move (think glutes, obliques and adductors etc…) all generally have fibres which lie at more of an oblique angle, making them very good at controlling rotation and ab/adduction in the transverse and coronal planes respectively… but pretty bad in comparison at producing straight line power on their own.

So what happens when we train predominantly the muscles which work to produce straight line, sagittal plane movements? They become the ones which get worked hardest and develop strongest, leaving the muscles which get loaded more effectively through rotation and lateral movement (yet are responsible for providing stability as we run and cycle) to remain weak and deconditioned.

These days, common underlying causes given by medical professionals when assessing the cause of overuse injuries in sports such as ours are “poor stability” somewhere or “weak glutes”, or another diagnosis linked to the conditioning of these stabilizing muscle groups which thrive on rotational and lateral loading to provide stability.

So logic would dictate that to help remain injury free, become more stable and improve functional strength, we need to train these stability muscles. We can do this highly effectively by adding rotational and lateral strengthening work to our weekly schedules.

Below is a video showing just a few examples of such exercises.

It’s no coincidence that triathletes and runners who have more of an all round sporting background, especially those who play(ed) multidirectional sports involving twisting and turning seem to have more resilient bodies when it comes to training. Perhaps because their all-round, multidirectional, multiplanar strength is more advanced than those who just run.

Try some of the exercises in the video for yourself and see how you get on.