Lower Leg Corrective Exercise and Sample Routine

**Lower Leg Dysfunction: Corrective Exercise and Sample Routine

**

By Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS

Typical Findings During Movement Assessment:

Overhead Squat Assessment:

• Feet Flatten
• Feet Turn-out
• Knees Bow in
• Knees Bow out
• Anterior Pelvic Tilt
• Excessive Forward Lean

Goniometry:

• Limited Dorsiflexion (Less than 20°)
• Limited Knee Extension (90/90) (Greater than 20°)
• Limited Hip Internal Rotation (90/90) (Less than 45°)
• Limited Hip External Rotation (90/90) (Less than 45°)

Specific Flexibility:

• Ober's Test
• Ely's Test
• Thomas' Test

Strength Assessment:

• Tibialis Anterior  Compensation (toe extension)
• Tibialis Posterior Weakness (compensation may include toe flexion)
• Gluteus Medius Weakness and/or Compensation (hip flexion)
• Gluteus Maximus Weakness or Compensation (knee flexion, external rotation, or adduction)
• Core Compensation (abdominal distension)

Typical length change and motor behavior of involved musculature:

Overactive (Release and Stretch):

• Lateral Gastrocnemius
• Soleus
• Fibularis Longus
• Fibularis Brevis
• Extensor Digitorum Brevis
• Tensor Fascia Latae /Vastus Lateralis /Iliotibial Band Complex
• Biceps Femoris
• Gluteus Minimus
• Deep Longitudinal Subsystem

Underactive (Activate and Integrate):

• Tibialis Anterior
• Tibialis Posterior
• Medial Gastrocnemius
• Flexor Hallucis Longus
• Flexor Digitorum Longus
• Pens Anserinus Group
• Gluteus Medius
• Gluteus Maximus
• Deep Rotators of the Hip
• Posterior Oblique Subsystem

For a complete analysis of Upper Body Dysfunction check out this article - Lower Leg Dysfunction

Brookbush Institute – Integrated Warm-up/Corrective Exercise Template:

1. Release
2. Mobilize (When appropriate)
3. Stretch
4. Isolated Activation
5. Core Support (Optional)
6. Stability Integration (Optional)
7. Reactive Integration (Optional)
8. Subsystem Integration

It is the intent of the Brookbush Institute that the personal trainer will artfully select exercises from the appropriate progressions to create a workout that has an immediate impact on the quality of movement and “feels-like” a warm-up. To create this effect it is important to choose at least one exercise for each modality, that each exercise can be done in quick succession (without rest), and creates a series of exercises that increases in intensity from “Activated Isolation to Whole Body Exercise.” Be careful not to rely too heavily on unilateral exercises as this will decrease intensity. The result is a sophisticated approach to exercise selection that can improve the quality of movement while maintaining the intensity of a general warm-up.

It is not uncommon for a new client to feel like a significant amount of work has been accomplished at the end of the integrated warm-up, especially when the sequence is repeated 2-3 times. Further, it is not uncommon for Brookbush Institute faculty to solely utilize the “Integrated Warm-Up template” as the initial phase of training, or in periods between high-intensity training.

Exercise Repertoire:

Lower Body Self Administered Release Techniques Playlist:

Self Administered Mobilization:

Static Stretching Playlist:

Note: The "Kneeling Hip Flexor", "Standing Adductor", and "Calve (and Peroneal) Stretch" are the most commonly used for Lower Leg Dysfunction

Lower Body Isolated Activation Playlist:

Core Integration Playlist:

Lower Leg Integration Playlist:

Typical Integrated Warm-Up/Corrective Exercise Routine:

Note: All exercises are linked to video

Release (Hold each for 30 -120 seconds or until a release is felt):

• Calves
• Peroneals
• Biceps Femoris
• TFL

Mobilization (Perform 10 - 15 repetitions, holding for 2 seconds at end range):

• Ankle Mobilization

**Stretch *(Hold each for 30 -120 seconds or until a release is felt):***

• Calve Stretch
• Kneeling Hip Flexor Stretch
• Active Biceps Femoris Stretch

Isolated Activation (10-20 reps, 1-3 sets, form is more important than load):

• Tibialis Anterior
• Tibialis Posterior
• Gluteus Medius
• Q-Ped Alternate Arm/Leg Raise

Core Support (10-20 reps, 1-3 sets, form is more important than load):

• Ball Bridge

Integrated Stabilization (Try and maintain single leg balance for 60 seconds on each side)

• Single Leg Balance and Reach
• Resisted Side Stepping

Reactive Integration (10-20 reps, 1-3 sets, form is more important than load):

• Heel Walks

Subsystem Integration (10-20 reps, 1-3 sets, form is more important than load):

• Frontal Plane Step-up to Curl and Press

Note: You may perform the exercises from "Isolated Activation" to "Subsystem Integration" in circuit (no rest in-between sets), and perform that circuit 1 - 3 times.

© 2011 Brent Brookbush

Questions, comments, and criticisms are welcomed and encouraged –