Balanced Body Movement Principles

Balanced Body Movement Principles How the Body Works and How to Train it. Module 3: Lower Body Strength and Power

Developing Strength, Endurance and Power The lower body is our primary source of strength, endurance and power in daily, functional and athletic activities. To be able to use the lower body effectively for daily and athletic activities, training should focus on: Developing optimum alignment Creating appropriate range of motion in all the joints Training sufficient strength to meet the functional or activity goals of the client. Training or cross training specific movements to help clients achieve their goals or recover from imbalanced use. Manual pages 68-70

Module 3: Key Principles Effectively training the lower body involves three primary principles Optimize the alignment of the lower limb. Create balanced range of motion and balanced strength around the hip, knee and ankle. Create strength and endurance for functional activities. Manual pages 68-70

Aligning the Lower Limb Optimum lower limb alignment means the center of the hip, knee and ankle joint are in a line perpendicular to the floor. The femur and tibia are not rotated relative to each other. Hip joint The knees are not hyperextended. Knee joint The tibia is relatively straight. Ankle joint Manual Page 68

Creating Muscular Balance To create muscular balance include focus on range of motion and strength in the following actions. Hip flexion and extension Hip abduction and adduction Hip medial and lateral rotation Knee flexion and extension Ankle dorsiflexion and plantar flexion Manual pages 76-77

Creating Strength and Endurance To create strength and endurance for functional activities focus on: Endurance The ability to remain active for extended periods of time Agility The ability to quickly change body position or direction Balance The ability to stay upright or in control of body movement Coordination The ability to control multiple body parts smoothly and efficiently Functional or sport specific movements Manual page 70

Knee and Ankle (tibiofemoral joint)

Ankle, Foot and Toes (talocrural, talotarsal, midtarsal, tarsometatarsal, metatarsophalangeal and interphalangeal joints)

The Hemipelvis or Hip Bone The Hemi Pelvis or Hip Bone includes three parts Ilium Ischium Pubis ILIUM Iliac crest Posterior superior iliac spine (PSIS) Anterior superior iliac spine (ASIS) Posterior inferior iliac spine (ASIS) Anterior inferior iliac spine (AIIS) Acetabulum All three fuse to form the hip bone and the acetabulum Pubic symphysis ISCHIUM Ischial tuberosity PUBIS Copyright 2017, Balanced Body Education LLC

The Hip Sacroiliac joint Iliac crest Sacrum Acetabulofemoral (hip) joint Femoral head Anterior superior iliac spine (ASIS) Anterior inferior iliac spine (AIIS) Femoral neck Greater trochanter Pubic symphysis Lesser trochanter Femur Anterior view Copyright 2017, Balanced Body Education LLC

The Hip Posterior superior iliac spine (PSIS) Posterior inferior iliac spine (PIIS) Sacroiliac joint Sacrococcygeal joint Acetabulofemoral (hip) joint Lesser trochanter Ischial tuberosities Posterior view Copyright 2017, Balanced Body Education LLC

The Knee Femur Quadriceps Patella Medial collateral (tibial) ligament Lateral collateral (fibular) ligament Menisci Posterior cruciate ligament Anterior cruciate ligament Fibula Tibia Copyright 2017, Balanced Body Education LLC

Synergists Muscles Working Together Coxal (hip joint) Manual pages 78-82

Coxal (hip joint)

Balancing the Hip Flexors For functional activities like walking and running, the hip flexors should track the femur straight forward. If the medial rotators are dominant, the hip flexors will pull the femur across the midline on hip flexion. If the lateral rotators are dominant, the hip flexors will pull the femur away from the midline on hip flexion. Copyright 2017, Balanced Body Education LLC

Balancing the Hip Flexors Focus on alignment in all hip flexor exercises and correct flexibility imbalances to correct hip tracking. Release tension in the hip medial rotators and activate the hip abductors and lateral rotators to correct medial tracking of the femur. Release tension in the hip lateral rotators and activate the hip adductors and medial rotators to correct lateral tracking of the femur. Copyright 2017, Balanced Body Education LLC

Coxal (hip joint)

Balancing the Hip Extensors One way to assess hip extensor balance is to bend the knee and see if the tibia rotates laterally (lateral hamstring dominance or tibial torsion) or medially relative to the tibia. Hip extension can be done from supine (bridging) all fours, or standing and with a bent or straight knee. To target the medial hamstrings focus on medial rotation of the hip. To target lateral hamstrings, focus on lateral rotation of the hip. Copyright 2017, Balanced Body Education LLC

Coxal (hip joint)

Balancing the Hip Abductors The hip abductors can be worked with the legs straight and the hip in neutral or with the hips flexed to any degree. The amount of hip flexion will change the activation of the muscles. Training the abductors in a closed chain position should be included to create functional stability of the hip. Stepping sideways or balancing on one leg are also excellent ways to address the abductors. Copyright 2017, Balanced Body Education LLC

Balancing the Hip Adductors The hip adductors can be worked isometrically by holding something between the legs. Training the adductors in a closed chain position should be included to create functional stability of the hip. Working the adductors in standing helps create stability and balance. Copyright 2017, Balanced Body Education LLC

Knee (tibiofemoral joint)

Synergists Muscles Working Together Ankle (talocrural joint)

Ankle (talocrural joint)

Balancing the Ankles and Feet Its important to work the ankles in six directions: Plantarflexion Dorsiflexion Plantarflexion with inversion and eversion Dorsiflexion with inversion and eversion Heel raises are a functional exercise that creates strong ankles and lower legs and helps develop good balance. Working with footwork or jumping on the Reformer adds an element of dynamic strengthening and agility to the ankles and feet. Copyright 2017, Balanced Body Education LLC

Alignment Anomalies Pelvis and Hips Anterior pelvic tilt When the ASIS is anterior to the pubic bone The ASIS may be lower than the PSIS Posterior pelvic tilt When the ASIS is posterior to the pubic bone The ASIS may be higher than the PSIS Manual pages 14-16

Sagittal System Imbalances Anterior pelvic tilt Hip flexors are short Hamstrings are long Back extensors are short Abdominals are long Posterior pelvic tilt Hip flexors are long Hamstrings are short Back extensors are long Abdominals are short Manual pages 14-16

Alignment Anomalies Pelvis and Hips Pelvic up slip (high hip) One ilium is higher than the other. Assessed by comparing the high point of the iliac crest, the ASIS and the PSIS. All three points are high with an up slip Pelvic down slip (low hip) One ilium is lower than the other All three points are low with a down slip. Manual pages 14-16

Lateral System Imbalances High hip (pelvic up slip) Abductor is long Adductor is short Quadratus lumborum is short Manual pages 14-16 Low hip (pelvic down slip) Abductor is short Adductor is long Quadratus lumborum is long

Alignment Anomalies Pelvis and Hips Pelvic inflare (rotation to the opposite side) When one ASIS is closer to the midline and more anterior than the other one. Pelvic outflare (rotation to the same side) When one ASIS is farther from the midline and more posterior than the other one Both patterns indicate a rotational pattern in the legs, hips and torso. Manual pages 14-16

Rotational System Imbalances Pelvic inflare Rotation to opposite side Right inflare in photo Right femur is laterally rotated Right to left anterior oblique sling (AOS) is short Left to right posterior oblique sling (POS) is short Pelvic outflare Rotation to same side Left outflare in photo Left femur is medially rotated Left to right AOS is long Right to left POS is long Manual pages 14-16

Alignment Anomalies Legs Femoral internal rotation When the femurs angle toward the midline so the patellaslook cross eyed Femoral external rotation When the femurs angle away from the midline. Both patterns indicate an imbalance in hip structure or in the hip internal and external rotators Manual pages 14-16

Alignment Anomalies Legs Knock knees (genu valgus) In standing alignment with the legs parallel, the medial knees touch but the medial ankles do not. Increased Q angle Bow legs (genu varum) In standing alignment with the legs parallel when the medial ankles touch but the knees don t. Decreased Q angle. These patterns are generally coming from the bone structure but can be improved with improved alignment. Manual pages 14-16 Knock Knees Bow Legs

Understanding the Q Angle The Q (or quadriceps) angle is the angle formed by the tibia and the femur at the knee joint. Measured by drawing one line from the ASIS to the center of the patella, and another line directly in line with the tibia Women generally have a greater Q angle then men because their hips are usually wider. An increased Q angle can increase pressure on the knee by creating a more lateral pull by the quadriceps on the patella Manual pages 14-16

Alignment Anomalies Legs Knee Hyperextension In standing alignment viewed from the side when the knees are posterior to the plumb line. Hyperextension indicates instability in the knee joint. Stability and correcting alignment can be helpful. Manual pages 14-16

The Lower Leg and Foot Tibial Torsion Internal rotation of the tibia External rotation of the tibia Tibial bowing These patterns are generally coming from the bone structure but can be improved with improved alignment. Manual pages 14-16 Tibial torsion and tibial bowing

Alignment Anomalies Feet Pronation In standing alignment, the arch flattens toward the ground and the Achilles tendon bows toward the medial side of the foot. Supination In standing the arch is lifted and the weight of the foot is carried laterally. Bunions A bunion is a deviation of the toe towards the center of the foot. Bunions usually occur on the big toe. Any of these patterns indicate an imbalance in the muscles of the foot and lower leg. Focusing on correcting gait and weight bearing on the feet can be helpful. Manual pages 14-16

The Knee Dysfunctional patellar tracking When the quadriceps contract, the patella should glide superiorly in a straight line. If the alignment or muscle balance are off, the patella will track laterally. This is usually caused by a tight lateral thigh and a weak vastus medialis or an increased Q angle. This can lead to knee pain. Manual pages 14-16

Hip Flexion Exercises Marching Supine Marching Seated Marching Standing Focus on pelvic stability, balance and working the full range of hip flexion. Progress from gravity assisted to gravity resisted to longer lever by straightening the leg. Manual page 84

Hip Extension Exercises Prone Hip Extension All Fours Hip Extension Standing Hip Extension Focus on minimizing lumbar extension and aligning the leg with the hip. Variations include medial and lateral rotation of the leg. Manual page 85

Hip Abduction Exercises Side Lying Leg Lifts Stepping Out Abduction Standing Leg Lifts Focus on hip abduction rather than a hip lift. Variations: working leg medial, neutral or laterally rotated. Hips neutral or flexed Manual page 86

Hip Adduction Exercises Side Lying Leg Lifts Seated Adduction with the Ring Standing Adduction Focus on pelvic stability, full range of motion, adduction with hip in neutral and flexed, isometric and concentric Manual page 87

Footwork Exercises Supine or Seated Plantarflexion Supine or Seated Dorsiflexion Standing Heel Raise Ankle strength and stability is often neglected. Work the ankle progressively in all ranges of motion including inversion and eversion Manual page 88

Functional Movement Patterns Marching with Arm Swings Knee Bends, narrow or wide Focus on alignment, strength and endurance in these exercises Manual page 89

Functional Movement Patterns Squats, narrow or wide Focus on alignment, strength and endurance in these exercises Manual page 90

Functional Movement Patterns Upright Lunge Tilt Lunge Focus on alignment, balance, strength and endurance in these exercises Manual page 91

Functional Movement Patterns Running in Place Running Jumping This is where the foundation work comes together or new areas to focus on are identified. Alignment, balance and strength are the keys to longevity in functional movement patterns. Manual page 92

Module 3: Key Principles Lower Body Anatomy Leg Alignment Balanced Muscle Development Developing Strength and Endurance

Balanced Body Movement Principles Whole Body Movement ( ) Trunk Integration ( ) Lower Body Strength and Power ( ) Upper Body Strength and Balance Dynamic Flexibility

Balanced Body Movement Principles Moving on to Upper Body Strength and Balance!