Exercises to Correct Muscular Imbalances. presented by: Darrell Barnes, LAT, ATC, CSCS

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1 Exercises to Correct Muscular Imbalances presented by: Darrell Barnes, LAT, ATC, CSCS

3 Objectives Review Functional Anatomy Identify physical imbalances that lead to injury and/or decrease performance Learn how to correct imbalances and enhance performance through exercise prescription

4 The body is an incredible machine!

5 Human Movement System Also known as the kinetic chain Involves: The soft tissue system (muscles) The skeletal system (articulations) The nervous system The systems are integrated. Break down in one will cause compensations which can lead to injury or decreased performance.

6 Muscular System The muscular system is divided into the local systems and the global systems. Local or deep system consists of muscles that are primarily involved in stabilization. These muscles are usually located close to a joint. Example: The deep muscles of the core.

7 Global Muscular System The global system is primarily responsible for movement and consists of more superficial musculature. The global muscles have been divided into subsystems that create force couples and work together to produce functional movement.

8 Neuromuscular Considerations Postural dysfunctions and joint/soft tissue restrictions decrease the body s ability to produce efficient movement. Reciprocal inhibition is when a tight muscle decreases the neural firing of its antagonist (ex. psoas and glute) Synergistic dominance is when a synergist compensates for a prime mover to produce force (ex. Weak glute med causes TFL, adductors and quadratus to over compensate.

9 Movement Efficiency The body should develop sound movement patterns before worrying about performance enhancement. Correct movement patterns are difficult in the presence of muscular imbalances, joint restrictions and decreased neuromuscular control.

10 The Goals of Prehabilitation, Rehabilitation and Performance Enhancement are Similar Optimize range of motion and strength Identify and correct compensations Increase neuromuscular control Develop functional strength used in an athletic environment

11 Common Muscular Imbalances Decreased ankle mobility in dorsiflexion due to calf tightness. Front side leg dominance: Quads are overloaded and hamstrings and glutes are weak. Core imbalances: Tight hip flexors/back muscles and weakness of lower abdominals and glutes. in Gymnastics

12 Ankle Pain Anterior ankle pain is common due to decreased dorsi-flexion (tight calf) coupled with repetitive front side loading. This causes the ankle joint to glide poorly and could damage the joint surfaces.

13 Ankle Assessment Assess mobility by: measuring with a goniometer. Dorsifexion should be approximately 15 deg. Watching to see if the athlete can deep squat with the feet forward and heels on the ground.

14 Ankle Assessment Assess strength by: observing calf/toe raises and looking for differences between R and L. Manually testing ankle strength

15 Ankle ROM Joint mobilizations to increase posterior glide of ankle Stretches for gastroc/soleus

16 Ankle Strenthening Strengthening includes: Theraband strengthening Calf raises/ toe raises Jump rope (pulling toes up) Balance exercises Multidirectional hops

17 Acute knee injuries include ACL and meniscal tears. The majority of knee pain is chronic irritation of the patella-femoral joint. Causes include poor mechanics and muscular imbalances. Knee Pain

18 Knee Assessment: Hamstring 90/90 and Thomas Test

19 Knee Assessment Squat test: Excellent for assessing functional control. Have your athlete stand with feet shoulder width apart and arms overhead. Instruct him to squat and look to see if he can maintain upright posture, hip/knee/ankle alignment and feet flat on the floor.

20 Squat Test

21 Squat Imbalances Heels lift off ground: Tightness in gastroc/soleus complex and weakness in glutes and hamstrings. Knees adduct: Tight adductors, It-band and weakness of glutes. Knees abduct: Tight Lat. Ham, psoas, and piriformis. Weak glutes Increased lordosis: Tight psoas/rectus femoris and weak abdominals and glutes

22 Assessment Tools Step-up test: The step-up test is a great test to determine how the lower extremity is functioning at mid-stance. Have the athlete balance on a 6 or 12 box or step and ask him to step down with the uninvolved leg and just touch the ground and go back up. Imbalances: Buckling of the stance leg may indicate glute medius/ quad weakness and/or increased pronation. You can also assess balance and core control with this test.

23 Step-up Test

24 Lower Extremity Strengthening Bridges

25 Lower Extremity Strengthening: Squat Progression

26 Lower Extremity Strengthening: Lunge Progression

27 Lower Extremity Strengthening: Adduction/Abduction

28 Back Pain Studies show that up to 85% of all gymnasts experience back pain. Extreme ROM coupled with poor core control causes pain.

29 Look for pain with movement: extension, flexion and rotation Look for poor glute activation and over activation of back and hamstring. Back Assessment

30 Sacral traction is a great way to decrease back pain and help the lumbar spine to glide better. Place palm on Sacrum and press toward feet and have the athlete presses into extension. Back Assessment

31 Push-up / Plank Test

32 Core Strength Core control is the key to functional strength. It is the bridge that connects the upper and lower body and includes muscles from the hip, pelvis, back, stomach and shoulders. Training begins with teaching spinal stabilization (pelvic bracing or hollowing).

33 Core Strength: Prone Planks and Side-ups Planks: On elbows and Toes with a pelvic brace. Begin with holds and progress to butt-ups and single leg lifts. Side-ups: Lateral hold with forearm and feet stacked. Start with holds and progress to buttups, rotations and single leg lifts.

34 Rotation Exercises

35 Core/Back Strengthening Begin in a prone or quadruped position and progress to a stability ball. Include: opposite arm/leg extension, ipsilateral, lower trunk and upper trunk extension.

36 Core/Back Strengthening

37 Back Strengthening

38 Conclusion In order to maximize your athlete s performance and decrease the chance of injury you need to: Assess your athlete s imbalances. Correct imbalances with body weight exercises and develop correct muscle patterns. Focus on core control. Try to emulate functional activities. Progress to resistance training, power, speed and agility training to maximize skill development.

39 A Body in Balance Creates Champions! 2008 Olympic Silver Medalists

40 Reference Material Boyle, Michael; Functional Training for Sports. Human Kinetics, 2004 Clark, Michael; Integrated Training for the New Millennium. National Academy of Sports Medicine, 2001 Cook, Gray; Athletic Body in Balance. Human Kinetics, 2003 Jemmett, Rick, B.S, PT; Spinal Stabilization: The New Science of Back Pain. RMJ Fitness and Rehabilitation, 2002

41 Useful Links St. Vincent Sports Performance USA Gymnastics and Technique Magazine National Athletic Trainers Association National Strength and Conditioning Association American College of Sports Medicine

42 The Extraordinary Spirit of Sport!

Functional Movement Screen (Cook, 2001)

Functional Movement Screen (Cook, 2001) TEST 1 DEEP SQUAT Purpose - The Deep Squat is used to assess bilateral, symmetrical, mobility of the hips, knees, and ankles. The dowel held overhead assesses bilateral,