STRONGER ANKLES: Simple exercise drills with no fuss!
Trail and hill running as a sport is demanding on our bodies. Common injuries are often as a result of overloading an area of the body not able to meet the demands placed on it, particularly as running is a repetitive, high-impact activity. Here are four minimal equipment/no fuss drills to help improve strength, proprioception and build fatigue resistance to improve your running economy.
Written by Mariam Kilpatrick, Physiotherapist, Trail and ultra Runner
Trail and hill running as a sport is demanding on our bodies. Common injuries are often as a result of overloading an area of the body not able to meet the demands placed on it, particularly as running is a repetitive, high-impact activity. Click on the video below for 4 minimal equipment/no fuss drills to help improve strength, proprioception and build fatigue resistance to improve your running economy.
The Glasgow Running Clinic is part of Physio Effect and we are located in the North of Glasgow. If you would like more information about the Running Clinic and the services we provide, please click on the button below:
The Core
Think your core muscles are just a ‘six pack?’ You’re wrong! Learn more about your core and it’s importance in movement.
Written by Jenny Devlin, MSK Physiotherapist and Specialist Women’s Health Physiotherapist at Physio Effect
The Core
What do you think of when you hear the word ‘core’?
For most people, they think of the rectus abdominis muscles, or the “six pack muscles”, but the core is so much more than that!
The core is actually a full canister that comprises a top, bottom, front and back. Respectively, these are:
The diaphragm
The pelvic floor
The transversus abdominis (deep stomach muscles)
The multifidus (deep back muscles)
Abdominal canister illustration courtesy of ‘The Wellness Blog for Women.’
These muscles work all the time to hold us upright and provide a base from which other muscles can operate. People will often tell us they ‘have no core’ which simply can’t be true or they would be a floppy noodle! What they mean is that they have forgotten how to tune in to activate their core and the good news is that this can be trained.
Our core canister houses our fluid and organs and is responsible for controlling pressure within the system, namely intra-abdominal pressure (IAP). IAP helps our ribs and spine stay in place and is the central mechanism from which we produce strength and stability. Since the muscles surround the canister, they are in prime position to help to control the pressure. IAP changes to match the task we are looking to perform and without a strong inner unit, it is challenging to keep our bodies moving and functioning effectively.
At Physio Effect we can offer you a path back to exercise safely after pregnancy.
Why do i have weakness in my core?
There are many things which can contribute to the core functioning less optimally - it could be the way you train or perform your sport, from being overweight or just a lack of body awareness of how to engage the correct muscles. In particular, pregnancy can lead to dysfunction as the muscles have been stretched out over nine months to accommodate the baby and then afterwards we often just hope they will go back to doing what they did before. Strength and coordination often need to be retrained and, while traditional abdominal exercises are great, it is important to ensure we have the deep core muscles working efficiently before we layer on the larger muscle groups. When we don’t have good core control, it can lead to injuries anywhere in the body such as the low back or the shoulder.
It is normal to have a diastasis rectus abdominus (abdominal separation) following pregnancy but when the pressure is not well controlled, we see doming at the linea alba (midline connective tissue). If we can work to control the IAP with the core muscles, we can minimise this doming and increase overall strength and performance since we are not losing pressure at our core canister.
Illustration of Abdominal Separation courtesy of Cleveland Clinic.
What can I do to strengthen my core?
It is important to spend time connecting to the core and learning how to coordinate the breath, pelvic floor and deep abdominal and low back muscles before adding more challenging exercises to your program. Our physiotherapists can provide you with some targeted core exercises that are specific to your needs. You could also consider our Clinical Pilates, Pregnancy Pilates or Postpartum Pilates Classes to strengthen your core.
To find out more, give us a call or book in online.
Proprioception Drills for Hill Runners
Trail and hill running as a sport is demanding on our bodies. Common injuries are often as a result of overloading an area of the body not able to meet the demands placed on it, particularly as running is a repetitive, high-impact activity. Here are some of our favourite exercises to help improve strength, proprioception and build fatigue resistance to improve your running economy.
written By Mariam Kilpatrick - Physiotherapist and Ultra-runner
Trail and hill running as a sport is demanding on our bodies. Common injuries are often as a result of overloading an area of the body not able to meet the demands placed on it, particularly as running is a repetitive, high-impact activity. Here are four of our favourite exercises to help improve strength, proprioception and build fatigue resistance to improve your running economy.
STEP UP
What you will need…
A Bench or box that is knee height.
Technique Tips
Try NOT to push through your back leg.
Step up with the weight primarily on your heel.
Maintain a knee window i.e. knees on either side of your midline.
Perform 8-12 reps each leg, aim to perform 5-6 sets with a max of 30s rest between each one.
2. SINGLE LEG BALANCE
What you will need…
An unstable surface to balance on i.e. a bosu ball, wobble board or cushion.
Technique Tips
While balancing on one leg try;
Writing the letters of the alphabet with the other.
To draw a clock face.
Closing your eyes.
Perform 1 minute each leg, aim to perform 2-3 sets with a max of 30s between each one.
3. POLEQUIN STEP UP
What you will need…
A slant/decline board OR
A small block placed beneath your heel to elevate it, while standing on a step. This puts your foot into a decline position.
Technique Tips
Keep your weight on the block.
Lightly tap your other heel to the floor.
Maintain a knee window i.e. knees on either side of your midline.
Perform 8-12 reps each leg, aim to perform 5-6 sets with a max of 30s rest between each one.
4. TRAMPETTE BALANCE
What you will need…
A trampette
OR
Your child’s back yard trampoline.
Technique Tips
Aim to land on the same spot, don’t bounce all over the place.
Don’t let you knee fold inwards.
Spend a minute on each leg, aim to work 5-6 sets or work to fatigue.
The Glasgow Running Clinic
If you’d like to improve your running technique or are keen to prevent or return from injury, Physio Effect offer a bespoke running analysis service to get you operating at peak performance. Call our reception team on 0141 230 4766 to find out more and schedule your appointment.
Clinical Pilates Classes at Physio Effect
Clinical Pilates uses a number of original and modified Pilates exercises and is given on a prescriptive basis. It is instructed by a qualified physiotherapist after a musculoskeletal or injury assessment. At Physio Effect, we deliver mat work, small equipment and Reformer based Clinical Pilates on a 1:1 basis and small group classes (maximum of 5 participants) as part of your rehabilitation. This may be suggested as the most effective form of treatment and rehabilitation programme for your condition by your physiotherapist on assessment.
What is Clinical Pilates?
Clinical Pilates uses a number of original and modified Pilates exercises and is given on a prescriptive basis. It is instructed by a qualified physiotherapist after a musculoskeletal or injury assessment. At Physio Effect, we deliver mat work, small equipment and Reformer based Clinical Pilates on a 1:1 basis and small group classes (maximum of 5 participants) as part of your rehabilitation. This may be suggested as the most effective form of treatment and rehabilitation programme for your condition by your physiotherapist on assessment.
The difference between Clinical Pilates and the traditional Pilates method is that you will be firstly assessed by a Pilates-trained Physiotherapist and then have a tailored programme of Pilates exercises given to you. During the session, you will be given exercises to do specific to your individual circumstance. This is usually a prehabilitation or rehabilitation programme relevant to an existing injury (e.g. back pain or post-surgical etc) or a specific condition (e.g. ante - post natal, hypermobility, fybromylagia etc) that will be discussed at an initial Physiotherapy Assessment ahead of you starting your block of classes.
New Class Wednesdays 6PM
Due to popular demand, we have opened a new class time on a Wednesday evening at 6PM from 7th October. This is a rolling class and you can start any time from 7th October. There is a “use-by” date when purchasing a block of classes which is:
10 weeks for a 6 x class block
4 months for a 12 x class block
To find out if there is space in this class or any of our other class times, use the button below:
How much does it cost?
Initial 1:1 Physio Assessment: £49
Single class: £25
6 classes: £120 (£20 per class)
12 classes: £220 (£18.3 per class)
“I have been attending Mariam’s Clinical Pilates classes and they are superb. Because the classes are small (max 5 people) Mariam is able to ensure everyone does exercises which are relevant to their individual problems/injuries.”
You are not your MRI: A Rehab Story.
Fiona Callan is a CrossFitter and Ultra-marathoner who injured her back in 2017. She had an MRI which showed an “L5/S1 disc bulge with nerve root irritation”. In this interview we discussed how she chose to avoid surgery and returned to the things she loved doing best.
Written by Mariam Kilpatrick, Physiotherapist and Clinical Pilates Lead at Physio Effect
Fiona Callan is a CrossFitter and Ultra-marathoner who injured her back in 2017. She had an MRI which showed an “L5/S1 disc bulge with nerve root irritation”. In this interview we discussed how she chose to avoid surgery and returned to the things she loved doing best.
Hi Fiona, thank you for taking the time to share your experience with us. Before we begin, tell us a bit about yourself…
I work in the NHS, primarily an office based job. Preceding my injury I was also studying for an MSc so basically spent all day and night sitting at a desk.
I started running in 2008, mainly 5k and 10k distance on roads but I wasn’t very good and didn’t enjoy it so moved to trail and hill running instead when I started gradually to increase my distance. I met some really cool people to run with as well. In 2012, I was talked into a trip to Nepal by a friend but it wasn’t until around 4 weeks to go that I found out he had signed me up to an ultra marathon. I didn’t even know what that was! It was sheer determination that got me through that and I really caught the ultra marathon bug.
In 2014 I started CrossFit as I thought some strength and conditioning type training would help with my running and I had no idea what I was doing in a conventional gym. The coaching and set workout approach has really worked for me and made me use muscles I didn’t know I had.
So the key question… how did you injure your back?
To be honest I’ve always had a bit of a lower back niggle, probably postural, but thought it would just go away. It was definitely something I started to feel more when I started CrossFit as I really had to use my back and core more than I had been doing running. Slowly I noticed it had started to affect my running, I had pain in my right buttock that shot down my leg now and again and my leg generally felt heavy. If I left it a few days it would go away but it meant I couldn’t really run or CrossFit as much as I wanted to.
It started affecting my job as I couldn’t sit comfortably for any period of time. I was travelling by train to Edinburgh at least twice a week which became difficult. On one journey I had to get off the train and go back to Glasgow as I couldn’t face sitting for an hour.
Then during a workout involving a barbell I cried so much I had to admit that something wasn’t right.
My initial symptoms were primarily in my lower back, there was a build up of pressure around my stomach and back even when I bent over the sink to wash my face. I tried to keep active but really scaled back on what I was doing. I kept up my hill walking as this is an activity I love doing with my nephew – I used poles and made Ewan carry my bag as he’s the young one! I tried running but could only manage 1k before I felt my back stiffen.
One Saturday I went walking with Dad and Ewan in the Lake District. It was an amazing day. The hill wasn’t too hard; we took our time and enjoyed it. It was the shooting pain in my right leg that woke me up early on the Sunday morning. I tried to stand up but my leg just wouldn’t work. I limped to the bathroom hanging onto the wall and at that point I knew there was something seriously wrong. It sounds dramatic but I genuinely felt paralysed down that whole side of my lower body, first thoughts were ‘I’ll never run again!’ and panicked. My boyfriend called NHS24 and a nurse managed to calm me down and suggested I took paracetamol with ibuprofen and try find a comfortable position until a doctor could get to me. A few hours and one injection later the pain had dulled. He said it was my sciatic nerve; I should try to relax and spend less time sitting down!
What treatment did you seek initially?
I got an appointment with Jonny who did some needling on my lower back/ glutes and gave me some exercises to do. I am the most impatient person and after a week of exercises I didn’t feel any different so I saw another physio (sorry!) who basically told me the same thing and gave me the same exercises. I really was in denial about how serious it was. I spoke to coaches in the gym, chatted to other runners and did a lot of Googling but all the answers were the same.
It was the mental part I actually found the toughest to deal with. I have made so many friends through running and CrossFit and my social media is full of it too so I was always seeing and hearing about all these amazing runs and PBs. I just felt stuck and disconnected. I saw my GP as I really felt like I was struggling to cope. People were always asking how I am and telling me I should ‘do this and do that’ and eventually I just got fed up talking about it. My GP didn’t really help me; she referred me to her physio friend but I didn’t go.
At the same time, Jonny had referred me to see Mariam for Clinical Pilates and it was during my consultation that she suggested some short term medication for my nerve problem in my right leg. I went to another GP for this and as well as giving me the medication, he was really keen to get me back running and to the gym so he referred me for an MRI.
What happened after your MRI?
I was really lucky in that I got an MRI pretty quickly. A few weeks after the scan. I received a letter with a hospital appointment but with no other information. Frustrating and worrying. I thought well there must be something not quite right and because of my problem with patience, I called the GP and asked him to give me a brief overview of the scan. He said he could see a disc bulge and I should continue doing my physio exercises until my appointment (with the consultant). I had just started with the Clinical Pilates class so I let Mariam know the issue and she tailored exercises for me until I found out more about the problem.
How did you feel after speaking to the neurosurgeon?
I remember getting a phone call from a surgeon in the spinal unit and it made me feel sick. I actually don’t remember what he said to me as the idea of back surgery just terrified me. I wasn’t exactly in crippling pain so the idea of surgery just felt a bit extreme to me. This was something I definitely wanted to avoid. I just really trusted my physios and they really believed I could get better without it. I didn’t feel that my pain was bad enough for surgery – for me this was the last resort.
At the appointment, the doctor went through my scan which I found fascinating. I actually felt a bit of weight come off my shoulders when I could physically see the issue. It had been hard to accept when I didn’t know for sure what the problem was but there it was clear in front of me. She then told me that they would do surgical intervention if I was getting sharp pains down the top of my leg. I told her I had that a few weeks before but it had been getting much better. We left it at that and I was told to get in touch if anything changed.
I had so many conversations with my boyfriend, my parents (and myself) and decided that it wasn’t the end of the world if I couldn’t run 50 miles or couldn’t deadlift 100kg as long as I could stay active. I would just scale back what I was doing.
You've spent the best part of a year doing some serious rehab with Clinical Pilates. In your own words, what is it and how did it help you?
I had done a bit of Pilates before as I’d read and heard it was good for runners. It was one of those things I struggled to stick to because I never left the class feeling like I’d worked hard and my issue with patience didn’t help. When I told my boyfriend about it he signed me up for 6 weeks because he knew I’d have to go if he paid for it! I noticed a huge difference after these 6 weeks.
It is basically pilates but physio-led so your exercises are all tailored to whatever issue you may have so we’re all doing something different generally. It’s a small class but everyone is in the same boat and really friendly. Mariam checks in with you regularly during the class and pushes you when you’re ready but also changing exercises if something isn’t quite feeling good.
I expected my exercises to all be lower back focused as that’s where my injury was but actually they’ve been full body movements. As well as having a stronger back, I feel stronger and much improved posture. Mariam also spent some time working on my legs, particularly my right leg as the nerve had been affected and I had limited movement and very little strength.
Eventually you returned to CrossFit and trail-running. How long did that take from when you first injured yourself?
I was always doing a scaled back version of CrossFit and a bit of trail running while I was injured but I was mindful of undoing my hard work. It was important to me mentally that I kept in touch with coaches/ friends in the gym and my runner friends.
I accepted my injury in May 2017 and started Clinical Pilates in the October. In May 2018 I was a more confident runner so decided to train for a race following a plan, building up in distance and I finished the Mad Hatters Half Marathon and the Glentress Half Marathon with a PB and no back or leg pain. Not quite back at ultra marathon distance but I’m actually enjoying the shorter runs at the moment. In June 2018 I started back at CrossFit and noticed that I’m better at a lot of the movements as I actually use my back and core as I should. I’m always conscious of loading too much weight on bars and I know certain movements still aggravate my back but I know when to stop and I just need to gradually build my strength back up. I was asked if I’d like to be part of a team from the gym for a CrossFit competition, I said yes why not I can try and we finished in 3rd place with no back pain!
Most people seek the "quick-fix" or miracle cure. What advice would you give them?
Your back is such a major part of your body so decisions on surgery should never be made lightly. Unless a professional is telling you there is no other option, I would encourage people to commit to the exercises and rehab, spend less time being sedentary and stay active by doing anything you find fun.
Working through this injury has taught me so much about my body and my lifestyle as well as making me a better runner and CrossFitter. This is all coming from the most impatient person!
SEEKING GUIDANCE? WE CAN HELP
Our experienced team at Physio Effect Glasgow are specialists in back pain and have helped 1000s of people recover and get back their quality of life. We talk the talk and walk the walk and will combine exercise based rehab such as Clinical Pilates with highly skilled hands on therapies to ensure you get the best possible treatment.
Most importantly we will listen and work with you in partnership to identify your specific issues and formulate an agreed unique treatment plan. We will relieve your back pain and give you long term self management strategies to strengthen your back and reduce the chance of pain relapse.
Please contact us if you have questions about our physiotherapy and Clinical Pilates services. Book an appointment and get your journey to back pain recovery under way.
Animal flows - What, How and Why?
Animal flows are a great addition to any exercise plan, warm up routine or injury prevention plan. Learning to move like a monkey, frog, or bear helps to build full body strength, mobility and motor control which in turn will make you a more awesome human and less prone to injury. This blog with video tutorials will explain what these movements are, how to utilise them and why you should should be doing them
What are Animal Flows?
Animal flows essentially refer to movement and exercise patterns where we imitate different types of animals such as bears, monkeys, frogs or lizards. Moving in these patterns can be very challenging, especially for the stiff & inflexible among us, but can also be really fun & provide significant benefits.
Deep Squat
Practicing animal flows can help improve strength, flexibility, mobility and overall motor control which in turn will help to make you a better functioning human and less at risk of injury. These movements can really challenge us in unconventional ways demanding our joints and muscles learn to control movement in patterns and ranges we would rarely otherwise practice. They can provide a great way to warm the body up in preparation for other forms of exercise or can even act as a stand alone training session. Once you have tried some of these movements for a few minutes you will understand why!
Where do I start?
As with all areas of training and exercise when attempting something new or different our advice is always start slow and work safely within your own levels of capability. Never push through pain or injury and if in doubt about whether this is appropriate for you please seek advice from a qualified professional.
Very few people will be able to perform controlled animal flow movements perfectly or even well at the beginning. When incorporating these kinds of exercises with my patients it’s essential we first establish their base level where they feel safe to practice but also feel that it is challenging. I would advise starting with getting comfortable in the static positions required as the foundation for the movement. In this post we will look at 2 positions - Deep Squat & A-Frame (Downward dog). These are the foundation starting postures for progression onto the animal movements monkey, frog and bear.
Deep Squat
The squat is a great foundation exercise for strength and mobility in the lower limbs and yet for so many people it is a real area of weakness and frustration. A lot of us slowly lose our ability to sit into a deep squat mainly through neglect and lack of practice combined with our static and sedentary western lifestyles. We become weak, stiff and tight and can no longer control the range of motion required to allow a deep squat. We rarely challenge ourselves to sit into a deep squat position let alone spend time exploring and improving on our range and control in this position. So first things first lets get a measure of your baseline squat function - check out this video and see how you get on.
It may take weeks or months of work to improve your squat mobility and that’s okay. For a more detailed look at improving your hip and back mobility please click the links to see our previous blog posts on these areas. You can use these routines alongside your deep squat holds to improve your squat function.
If you feel up to increasing the mobility challenge of your deep squat lets check out this next video requiring some active hip rotation movements at the bottom of the squat - a great way to improve your range of motion and strength.
I would recommend slowly building these exercises into your routines, aim for 20-30 second rounds initially performed for 3-4 sets thereby accumulating 2-3 minutes in the deep squat. Try this at least 2-3 times per week. Long term the idea is to become comfortable spending longer periods in the deep squat and find it relatively easy to perform movements from this position. Try to build up to 5 minutes total in the deep squat per day of practice over several weeks.
Monkey & Frog Mobility
These animal flow progressions are suitable once you have a comfortable squat allowing you to sit at least to parallel depth without the need of hand support. Don’t worry if you’re not there yet, keep practicing the squat, back and hip mobility exercises and you can move on to these once you feel confident.
These exercises are difficult and physically demanding but the pay off of regular practice will be improved squat mobility, increased lower limb strength and motor control with an associated reduced injury risk in these areas. Give each of these a try and see how you get on.
Add these to your regular practice at least 2-3 times per week initially
Begin with 20-30 second rounds aiming to build up to 1-2 minutes or longer
Look to accumulate time in the positions - Try a 5 minute timer & while stopping for breaks when required, try to spend as much time actively moving in these flows
Ideally we want to develop a relaxed freedom of movement where you can drop comfortably into a deep squat and easily move through monkey and frog patterns. You can mix and match the movements to create variation in the flow and challenge your strength and mobility through mixed planes of movement. Don’t expect overnight success but as with all training with hard work and consistent practice you should be able to improve allowing you to move better and feel better.
A-Frame (Downward Dog)
This stretch position is probably best known in yoga circles, most people will of at least heard of the Downward Dog. Another term we will use is A-Frame which refers literally to the fact we are trying to get our body into a position whereby it looks the a capital letter ‘A’. This position is another staple in many exercise forms and for good reason, it challenges the flexibility and strength of our body in many areas. The shoulders, back, hips, knees and ankle joints will be tested and for many people deficiencies in strength and range of movement will limit the quality and range available in attempting this position.
For many of us just attempting this posture will be tough and tiring. A lot of you will be feeling significant resistance in the backs of the legs (hamstrings and calves) and through the shoulders and upper back. Build slowly and increase the time spent in the stretch as you feel able, again looking to improve on your own current baseline level. Before attempting bear movements from this position we can work on a couple of simple variations which are shown in the video - slow marching on the spot and active shoulder extension pushing the head and shoulders through. Let’s give it a try and see how you get on.
Bear Movement Flows
The bear crawl can be utilised as a full body exercise to develop strength, flexibility and control in many areas. It is challenging and will take time to develop the skill and movement control required to perform it well but as with all these exercises your only goal should be to steadily improve on your own current baseline level. Once you have developed some comfort and control with the A-Frame stretch the first Bear Crawl movement we will try is with straight arms and straight legs as demonstrated in the video below. The key here is control so take your time and just do what you can, even if it’s only a few seconds initially, you can build on that. Let’s give it a go.
In the next video we demonstrate a number of bear crawl variations to give you some more options to explore. Depending on your own levels of mobility and strength you may find some options easier and others harder but it is great to play around and explore a variety of positions to find any weaknesses or restrictions and ensure a variety of stimulus is achieved. The key is to safely work on your own issues and don’t be afraid to explore positions that are challenging as long as you do so gradually.
Add these to your regular practice at least 2-3 times per week initially
Try:
Straight arms & legs
Bent arms, straight legs
Bent arms, bent legs
Straight arms, bent legs
Begin with 20-30 second rounds aiming to build up to 1-2 minutes or longer
Move forwards, backwards and sideways
Look to accumulate time in the positions - Try a 5 minute timer & while stopping for breaks when required, try to spend as much time actively moving in these flows
Summary
In summary adding animal flow movement practice into your regular exercise routines or habits can have significant physical benefits by helping to improve full body strength, mobility and motor control. It is a challenging but fun way to mix up your normal exercise routines and pushes your body to explore a variety of joint postures and positions that are not routinely trained or strengthened. This variety of stimulus will help to ensure strong and healthy muscle and joint function. Enjoy exploring and playing with these movements and ultimately you can learn to move better & feel better.
Thank You
Thanks for taking the time to read this guide, we hope you find it useful. Please share with anyone who might benefit and if you have any questions comment and let us know. Please subscribe to our mailing list to receive more interesting and useful blogs. Good luck and remember to move better & feel better
Stiff achy hips? Tightness or weakness and what can you do about it?
Complete hip mobility routine to increase range of motion, reduce pain and improve function. Explore your own limitations and work to improve them with daily practice of this routine. Rid yourself of stiff achy hips and restore strong, healthy movement while improving athletic ability.
Why are my hips sore?
Deep Squat
Chances are if you’re reading this you have at least one hip and at some point it has given you trouble. Hip pain or stiffness has likely gotten in the way of your daily activities or restricted your ability to exercise on more than a few occasions. Our hips are at the centre of our body’s movement, so if they are functioning poorly then our ability to move freely and unrestricted will be compromised. Poor hip function can cause local issues around the hip but often contributes to pain and dysfunction in other areas like the lower back and knees.
The primary reason for developing hip pain for most people is a lack of movement and excessive sedentary behaviour, an all too common theme in our modern lives. You may workout regularly but chances are you still accumulate a lot of static postures through work or leisure and it’s unlikely that your exercise habits routinely explore and work the hip joints and muscles to anywhere near their full range or capacity. Though most hip pain is not serious and can be helped with the right exercise, we recommend consulting a health professional if you are worried or have persistent symptoms.
Modified Pigeon with Active Hip Internal Rotation
Am I Stiff or Weak?
Most likely it’s a combination of both. There is a lot of confusion out there around the terminology of flexibility, mobility and strength. Essentially flexibility can be considered passive and is about the soft tissues (muscles, tendons and ligaments) ability to temporarily elongate to allow movement through a range while mobility centers around our ability to move through a range of motion with control before becoming restricted. Mobility requires strength to control your flexibility.
Take for example someone who can squat 200 kilos to a parallel depth. This would obviously be considered strong in that range. However if the same individual cannot perform a body-weight squat below parallel depth without falling over or requiring support then we could say they have poor squat mobility. Passively if they can still achieve a deep squat position using some support we can say that they have reasonable flexibility in their soft tissues to allow this. Ideally this individual will work to improve their mobility so that they have better strength to control a greater degree of flexibility i.e they can drop comfortably and controlled into a deep body weight squat without assistance.
Should I Stretch or Strengthen
Again for most people the answer here is both but the key is identifying exercises that allow you to improve on both simultaneously whilst also offering functional value. Being inflexible is not great as your natural joint range of motion may be restricted and eventually painful. Inflexibility can lead to struggles with basic everyday activities like bending to pick something up or getting in and out of bed or your car. If you are weak then as discussed before you will not be able to control your flexibility or movement again making you more vulnerable to injury and pain.
This is where we need to be smart and specific in identifying our own needs and training with functional goals and targets in mind. You may have great flexibility and touching your toes is a breeze but when asked to do a basic lunge you lack the strength, balance and co-ordination. Conversely as with our example above you may have great strength for lifting weight but only in a limited range and the idea of touching your toes or sitting in a deep squat seems ridiculous. There is no single one recipe to fix all here but in essence mobility training will work both our strength and flexibility needs, we just need to identify the right exercises.
Try this mobility routine we have created to help identify your own personal problem areas. What to you find most difficult and are you struggling due to tightness, weakness or a combination of both?
Up for a challenge? Try this routine a few times and note the 3 exercises or positions which you find most restricted or difficult to perform. Now practice them consistently at lease 3 times per week for the next 4-6 weeks and see what changes and improvements you can achieve
At the bottom of this blog you can see each of the individual exercises that make up our hip mobility routine. Click the link below to download your FREE PDF copy of these exercises including some key tips .
Challenge to Change
For the vast majority of people our lives and even our exercise or training keep us moving in basic linear patterns (up and down). We don’t often (if ever) challenge our hips with lateral or rotational exercises and most people end up weak and unstable in these positions compromising their hip health and function. That’s why we designed these routines to explore and challenge these less common positions.
This next video demonstrates 3 more advanced hip mobility exercises that you can try. Please only attempt what you feel able and do not work into pain or through injury. Try the exercises in the video below and see how you feel. Chances are you will find this very tough but they are great exercises to improve overall hip mobility and function so if you feel able add them to your regular routine and with consistent practice you should see real improvements.
Exercise 1
Seated hip Internal / External Rotation
Begin in sitting leaning back on straight arms, knees and hips bent and relaxed shoulder width apart with feet flat on floor.
Gently and with control lower both legs to one side trying to touch the outside of one knee and inside of the other knee to the floor. Don’t worry if this range is too much, just work as far as you feel is challenging but comfortable. Return to start and repeat to opposite side.
Perform this movement for 60 seconds
1- Floor Sitting, Lean back on hands, high chest
2- Slowly Rotate Both Legs to one side
Exercise 2
Deep Squat Hip Internal / External Rotation (Advanced Option)
Begin in a deep squat. Ensure heels remain in contact with the floor
Slowly rotate one knee across mid-line aiming to touch knee to floor in front of opposite foot which should remain flat with heel on floor. Allow moving leg to rotate up onto toes. Static leg should remain open and avoid any inward collapse of knee/hip position.
Return leg to starting deep squat position and repeat with opposite leg.
Repeat with alternate legs for 60 seconds
1- Deep Squat, Heels on floor
2- Deep Squat- Active Hip Rotations
Exercise 3
Modified Pigeon
Begin in 90/90 hip and knee position. Gently rotate and square hips up facing forwards
Gently lean chest forwards through your hips and rotate slowly leaning over the forward knee
Option to gently contract front leg pushing knee into floor, hold 5-10 seconds and release. Repeat 5-10 times.
Work into and explore stretch for at least 60 seconds
1- Modified Pigeon 90/90 Sitting
2- Modified Pigeon- forward lean & rotate over front knee
Exercise 4
Modified Pigeon Active Hip Internal Rotation Lift
Begin in the modified pigeon 90/90 sit with slight forward lean supporting weight on hands
Gently lift back foot off the floor. Squeeze and hold for 5 seconds. Repeat for at least 5 contractions
You will repeat this exercise for the opposite side once you’ve completed the routine on one side
1- Modified Pigeon Forward Lean on Hands
2- Modified Pigeon Active Hip Internal Rotation
Exercise 5
Modified Pigeon Hip Active External Rotation
Begin in the modified pigeon 90/90 sit with torso rotated facing forward leaning weight back with hands behind you
Gently lift the knee (with inside touching floor) & rotate outward through hip. Squeeze and hold for 5 seconds. Repeat for at least 5 contractions. Ensure opposite leg remains still with outside knee resting on floor
You will repeat this exercise for the opposite side once you’ve completed the routine on one side
1- Modified Pigeon Chest Open
2- Modified Pigeon Active Hip External Rotation
Exercise 6
90/90 Sitting Lift to High Kneeling
Begin in approximate 90/90 sitting as shown, use hands to maintain balance without leaning on floor
Gently lift through the hips into controlled high kneel. Squeeze the buttocks and hold for a few seconds. Return to start position and repeat 30-60 seconds
Switch legs so back leg begins as forward leg and vice versa. Repeat active sitting movement 30-60 seconds.
1 - 90/90 Sitting on floor (no hand support)
2 - High Kneeling
Exercise 7
Frogger
Begin in all 4s, forearms on floor. Walk knees open keeping insteps of feet and inside shins rotated inward in contact with floor
Gently rock back through hips/pelvis as if taking bum closer to heels, squeeze knees into the floor and hold/release for 5-10 second repetitions.
Gently work into and explore stretch for at least 60 seconds
1 - Frogger Start Position
2 - Frogger Rock Back Position
Exercise 8
Deep Lunge Hip Opener with Arm Rotations
Begin in lunge position, extend out back leg as far as is comfortable. Lean forward and try to come to rest on forearms. Actively drive open front knee/hip rotating out onto outside border of foot.
Take inside arm next to front leg and rotate upwards to ceiling with a straight arm. Stretch open through shoulder, chest and spine. Hold for 5 seconds at top position, return to start driving elbow back to the floor and repeat for 10 repetitions.
Switch legs front to back and vice versa. Repeat process.
1 - Deep Lunge, Forearms to floor, drive front knee open
2 - Deep Lunge Arm Rotations
Thank You
Thanks for taking the time to read this guide, we hope you find it useful. Please share with anyone else who might benefit and if you have any questions comment and let us know. Don’t forget to download your free hip mobility cheatsheet. Good luck and enjoy your improved hip health.
Deep Lunge with Arm Rotation
Tight shoulders? This routine will fix you up
5 step shoulder stretch routine to relieve stiffness and tension. Discover a new range of motion and rid yourself of nagging tightness in your shoulders and upper back
Why are my shoulders so tight?
Familiar Hunchback Posture?
Shoulders are a big sticking point for many of us. We constantly assess and help people with long histories of stiff, tight, achy shoulders and upper backs. More often than not there is no significant injury history but very commonly there is a base of sedentary behaviour, such as office work and driving, and a significant lack of any structured stretching or mobility exercise. Welcome to our modern lives!
Most shoulder pain can be fixed without the need for invasive surgery but it can take time to undo a lifetime of poor habits which have lead to soft tissue adaptations with weakness in some areas and tightness or stiffness in others.
1/2 Crucifix Chest Stretch
Shoulders are very mobile and we put them through a lot over our lifetime with an expectation they will be fine with no real consideration given to tuning or maintenance work. Tightness and pain can easily creep in and often presents initially as discomfort reaching overhead, pain opening a door, or a struggle to weight bear through our arms. This can develop to more constant nagging pain and stiffness and a reduced ability to perform daily tasks or enjoy physical exercise or activities.
Many people just put up with having a dodgy shoulder and accept it as a new norm but with the right guidance and exercises most situations can be at least significantly improved if not completely fixed. Like everything in life though you won’t get something for nothing and commitment to changes in habit and daily routines will be required. A balance of stretching and strengthening exercises is normally key and we have provided a great starting point here with our 5 point stretching routine.
Let’s get started!
We must bear in mind that every body is different as is each individuals unique history and circumstances so please use this routine as a guide to start improving your shoulder health and flexibility but do so carefully. Start slowly and gently and never push in to pain. Work to better your own range of motion but do not compare yourself to the video or anyone else. Practice daily and be patient but also persistent. If you can only do part of the movement or a modified / reduced range that is fine, just do what you can. Of course as with all advice please consult with a health professional if you have significant pain or loss of normal function.
Mobility Flow Video:
Exercise 1
Shoulder rolls / Scapular circles
Begin in all 4s position.Hands fixed under shoulders shrug shoulders to ears thenslide back and down and release. Then spread shoulder blades apart stretching across upper back, relax and allow shoulders and back to hollow.
Try to perform this as a slow circular rolling motion working in various directions
Perform this movement for 60 seconds
1- Shoulder shrug
2- Shoulder spread
Exercise 2
Elevated Arms to Partial Childs Pose / Prayer Stretch
Begin in all 4s position with arms straight out elevated on flat surface. Gently sit bottom back towards heels and let weight drop down between shoulder blades and through upper back
When in position try gently squeezing shoulders together and releasing and light pressing through the hands with slight twist/rotation movement
Try breathing in deeply and coming out of the stretch slightly then breathing out slowly and dropping deeper into stretch
Explore the stretch position with subtle movements and breathing for 60 seconds +
1- 4 point kneel arms elevated
2- Sit weight back and down between shoulders
Prayer Stretch (Option 2)
Perform stretch as above but move to have elbows resting on flat surface with arms positioned in ‘Prayer’ posture
Sit weight gently back and down relaxing between shoulder blades and across upper back. Try to let head bypass the bench (surface)
Try breathing in deeply and coming out of the stretch slightly then breathing out slowly and dropping deeper into stretch
Explore the stretch position with subtle movements and breathing for 60 seconds +
Prayer Stretch Start Posture
Prayer Stretch - Sit back position
Exercise 3
Shoulder Dislocates (Stick or Band)
Begin in high kneeling or standing - Holding a stick or band keep arms straight and core tight, slowly bring arms straight overhead and around down towards lower back. Allow shoulder blades to gently shrug then rotate and slide down as you circle arms overhead
Return to start point slowly ensuring not to over-arch through lower back
Repeat for 10-15 repetitions
1- Shoulder Dislocates - Stick (Overhead)
2- Shoulder Dislocates Stick (behind back)
Exercise 4
‘L’ Position Prone Shoulder Stretch
Begin lying on your front. Gently reach with shoulder to be stretched under and across your body at shoulder height with palm facing up. Allow other arm to stretch straight overhead forming an ‘L’ shape with your arms
Gently rotate into the stretch as if trying to square up shoulder blades increasing the pull/stretch felt in back of the shoulder reaching across body. Hold and release this motion for several repetitions
Work in this position for 60 seconds + on each arm
1- ‘L’ Position Shoulder Stretch Part 1
2- ‘L’ Position Shoulder Stretch Part 2
Exercise 5
1/2 Crucifix Chest Stretch
Start face down with side to be stretched arm extended fully out at shoulder height palm down. Opposite arm is bent at 90 degrees at elbow hand at shoulder height ready to push into stretch
Gently push with bent arm while rolling weight of legs over to create a strong opening stretch of the chest of the straight arm
Gently push in and out of the stretch holding for a few seconds then releasing and repeat
Explore this stretch for 60 seconds + on each arm
1- 1/2 Cucifix Start Posture
2- 1/2 Crucifix Chest Opening
Thanks for taking the time to read this guide, we hope you find it useful. Please share with anyone else who might benefit and if you have any questions comment and let us know. Don’t forget to download your free mobility cheatsheet. Good luck and enjoy your improved shoulder health.
‘L’ Position Prone Posterior Shoulder Stretch
Case Study: Ankle Sprain Rehab - Part 3
This concludes our 3-part series following Mariam’s ankle rehab programme after a bad sprain two weeks before her first trail marathon and then her first trail ultra-marathon five weeks after that.
Phase 1 (first 2-3 days after injury):
Ice, Elevation, Compression
Crutches
Avoidance of non-steroidal anti-inflammatories (i.e. ibuprofen)
Phase 2:
Non-weight-bearing exercises
Training modification
Progression to weight-bearing and single leg exercises
Phase 3:
Training modification
Running technique modification
Progression to plyometrics and impact loading
Case Study: Ankle Sprain Rehab - Part 2
Part 2 of our ankle rehab case-study following Mariam's injury two weeks before a trail marathon.
Part 2 of our ankle rehab case-study following Mariam's injury two weeks before a trail marathon. This is a sports physiotherapy approach to the treatment and management of an injury leading up to a specific event. In this episode, we looked at progressing her exercises and training modification leading up to the run.
Case Study: Ankle Sprain Rehab: Part 1
We all know injuries happen and, in most unfortunate instances, they can happen before a sporting event you have been training for months. It can be disheartening when you’ve spent countless hours training for such an event with the prospect of having to pull out. In this month’s case study, we will be looking at managing an ankle injury coming from a personal experience from one of our own physios, Mariam. We will be demonstrating a sports physiotherapist’s approach to dealing with an injury leading up to an event over a 3-part series. Part 1 is below: