Human anatomy reference:

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2 Human anatomy reference:

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4 Weak Glut Activation Weak gluteal activation comes from poor biomechanics, poor awareness when training or prolonged exposure in deactivated positions such as sitting. Weak Glut Activation: Quadriceps (all) / Psoas / Hip flexors 2-5 minutes Trigger point ball or stretch TFL 2-5 minutes Trigger point ball Adductors Biceps Femoris (Hamstrings) / Lateral posterior 2-5 minutes Trigger point ball or foam roller Peroneals / Lateral calf 2-5 minutes Trigger point ball Gluteals (all) / hip muscle Semitendinosus (Hamstrings) / Medial posterior 5 x 5 Build up to 5 x 10 5 x 5 Build up to 5 x 10 Piriformis / Posterior hip 5 x 5 Gastrocnemius / Calf 5 x 5 Tip toe and keep ankle in neutral position throughout movement. Transverse abdominis / core Squat / Lunge / Walk / Run 5 x 5 Abdominal bracing / plank mind your mechanics, positioning and control throughout the movement with awareness of squeezing the gluts. Single leg balance 5 x 30 seconds Practise skill and control alignment, ensure activation consciously.

5 Patella Femoral Pain Patella Femoral pain is mainly developed due to overactive quadriceps and potential weakness of supporting muscles. As the quadriceps tendon houses the patella and joins the patella tendon, when the quadriceps are tight, this pulls the patella into closer proximity with the femur, which can lead to some wear and tear of the patella femoral joint. This would result more often from active people who are not compensating their workouts with enough stretching or it would be a result of muscle imbalances causing the mechanics of the foot, hip and knee weight bearing disproportionately or finally it could be due to direct trauma with insufficient recovery or rehab. Patella Femoral Pain: Quadriceps / Anterior Vastus lateralis / Lateral quadiceps / Peroneals / lateral calf 2-5 minutes Trigger point ball Biceps Femoris / Lateral hamstring 2-5 minutes Trigger point ball Adductors Vastus Medialis Oblique / Medial quadriceps / 5 x 5 Build up to 5 x 10 Gluteus medius / Lateral hip muscle 5 x 5 Build up to 5 x 10 Posterior Tibialis / interior calf and Gastrocnemius / Calf 5 x 5 second holds Keep foot in neutral alignment as you go onto tip toe. Don't let heels laterally shift. Single leg balance 5 x 30 seconds Practise skill and control alignment from the foot, knee and hip. Squat / Lunge / Walk / Run mind your knee (and ideally foot and hip) positioning and control of movement. Seeing a running specialist is a good investment if you are a keen runner / sports person.

6 Patella Femoral Mal-tracking Patella Femoral Mal-tracking is mainly developed due to muscle imbalances. This can also be predisposed by foot pronation. Our daily lifestyle sees us a lot of the time sitting down allowing muscles to deactivate whilst others shorten and get tight, which ultimately compromises our mechanics and onset of pain and discomfort. People who are more quadricep dominant and/or have over active gluteals, Tensor fascia latae and a larger Q angle (angle between hips and knees) will potentially develop this more. Patella Femoral Mal-tracking: Quadriceps / Anterior Vastus lateralis / Lateral quadiceps / Peroneals / lateral calf 2-5 minutes Trigger point ball Biceps Femoris / Lateral hamstring 2-5 minutes Trigger point ball Adductors Vastus Medialis Oblique / Medial quadriceps / 5 x 5 Build up to 5 x 10 Gluteus medius / Lateral hip muscle 5 x 5 Build up to 5 x 10 Posterior Tibialis / interior calf and Gastrocnemius / Calf 5 x 5 second holds Keep foot in neutral alignment as you go onto tip toe. Don't let heels laterally shift. Single leg balance 5 x 30 seconds Practise skill and control alignment from the foot, knee and hip. Squat / Lunge / Walk / Run mind your knee (and ideally foot and hip) positioning and control of movement. Seeing a running specialist is a good investment if you are a keen runner / sports person.

7 Quadricep dominance Quadricep (anterior ) dominance is normally a result of mechanical imbalances which may or may not have occurred due to learning a particular sport or hobby at a young age which required more quadricep use, such as ballet. Therefore this is commonly a learnt behaviour, whether aware or not. When quad dominance occurs, theres an imbalance in muscle tensions which can result in straining or weak muscles or the quads themselves from over use. Quadricep dominance: Quadriceps / Anterior Vastus lateralis / Lateral quadiceps / Vastus Medialis Oblique / Medial quadriceps / Psoas / Hip flexors 2-5 minutes Trigger point ball Adductors TFL 2-5 minutes Trigger point ball Gluteals (all) / hip muscle Hamstrings / Posterior 5 x 5 Build up to 5 x 10 5 x 5 Build up to 5 x 10 Squat / Lunge / Walk / Run mind your mechanics, positioning and control throughout the movement. Having this professionally assessed to start with is best practise. Single leg balance 5 x 30 seconds Practise skill and control alignment ensure equal activation consciously.

8 IT Band Syndrome The IlioTibial Band is band of connective tissue that starts at the lateral hip and runs down the lateral / outside of the and attaches across the lateral aspect of the knee. Quite commonly the IT band can be tight and cause complications at the knee. The IT Band can be tight due to the TFL muscle and a lack of stretching / mobility of the hip and quadriceps. IT Band Syndrome: TFL 2-5 minutes Trigger point ball Gluteus maximus / posterior hip muscle 2-5 minutes Trigger point ball or foam roller Vastus Lateralis (Quadricep)/ Biceps Femoris (Hamstrings) / Lateral posterior 2-5 minutes Trigger point ball or foam roller Peroneals / Lateral calf 2-5 minutes Trigger point ball or stretch Adductors Gluteus medius / hip muscle 5 x 5 Build up to 5 x 10 Piriformis / Posterior hip 5 x 5 Semitendinosus (medial Hamstring) / Posterior 5 x 5 Build up to 5 x 10 Psoas / Hip flexor 5 x 5 Build up to 5 x 10 Internal/External Hip rotators 5 x 5 Gastrocnemius / Calf 5 x 5 Tip toe and keep ankle in neutral position throughout movement. Transverse abdominis / core Squat / Lunge / Walk / Run / Stepping 5 x 5 Abdominal bracing / plank mind your mechanics and control throughout the movement with awareness of neutral ankle, knee and hip positioning. Single leg balance 5 x 30 seconds Practise skill and control alignment, ensure activation consciously.

9 Knock / Valgus Knee Knock / Valgus knee, mainly developed due to muscle imbalances. This can also be predisposed by foot pronation. Our daily lifestyle sees us a lot of the time sitting down allowing muscles to deactivate whilst others shorten and get tight, which ultimately compromises our mechanics and onset of pain and discomfort. One thing I notice often with this, as a therapist, is that the adductors get short and tight without the people knowing. It is therefore ideal to work on the inner to stop and prevent the onset of other conditions before recognising you have a problem. Knock / Valgus Knee: Peroneals / lateral calf 2-5 minutes Trigger point ball Biceps Femoris / Lateral hamstring Vastus lateralis / Lateral quadiceps 2-5 minutes Trigger point ball Adductors 5 minutes Foam roller Stretch Psoas / Hip flexor 2-5 minutes Start with 4 x 30 seconds and build up duration Gluteus medius / Lateral hip muscle 5 x 5 Build up to 5 x 10 Posterior Tibialis / interior calf and Gastrocnemius / Calf General supernation / external rotation 5 x 5 second holds Keep foot in neutral alignment as you go onto tip toe. Don't let heels laterally shift. 5 x 10 Band Single leg balance 5 x 30 seconds Practise skill and control weight bearing throughout the foot Squat / Lateral Lunge mind your knee (and ideally foot) positioning and control of movement.