00:00 - 00:04This is Brent coming at you with another one of our collaboration videos, to bring
00:04 - 00:10you a progression of the single leg excursion, or the single leg balance and
00:10 - 00:14excursion. I think I mentioned it previously as the single leg balance and
00:14 - 00:18excursion of death, which makes a progression of this seem even more
00:18 - 00:22sadistic. I'm going to have my friend Rob come out and help me demonstrate, he is
00:22 - 00:26responsible for this sadistic progression. I want you guys to know PT
00:26 - 00:30for many years, certified orthopedic manual therapist, and faculty himself
00:30 - 00:36for the Maitland workshops, he decided to add resistance to this exercise. So, how
00:36 - 00:39you are going to get this started is you need something to resist you
00:39 - 00:44laterally. Alright the idea is to stimulate activity of your gluteus
00:44 - 00:48medius, so when you're setting up this resistance you want to make sure so that
00:48 - 00:54somebody can in fact stand on a single leg and maintain a neutral pelvis.
00:54 - 00:59Alright so just a real quick test before we go through all the postural cues, he
00:59 - 01:03can in fact maintain a neutral pelvis, I can feel his gluteus medius firing
01:03 - 01:08against the resistance we have pulling him that way. All right so let's go ahead
01:08 - 01:11and start over and get the setup. I'm going to make sure his upper
01:11 - 01:16body posture is good, head back, chin tucked, shoulders down and back.
01:16 - 01:18I'm going to go ahead and have him bring his feet together, make sure they're
01:18 - 01:22pointing forward. Now I know usually our kinetic chain checkpoints are hip width,
01:22 - 01:28but he's about to stand on one leg. Now the big cues for this exercise
01:28 - 01:33are not something we always pay attention to I think, but are extremely
01:33 - 01:38important in this particular progression. I want to make sure that he can press
01:38 - 01:46the first MTP, that's the ball behind his big toe, into the floor while maintaining
01:46 - 01:52the arch in his foot, that's his medial longitudinal arch, that's the inside arch
01:52 - 01:57of your foot. So can you press that big toe in but still maintain the arch of
01:57 - 02:02your foot, good. This whole exercise is going to be predicated on the fact that
02:02 - 02:08he can maintain single leg balance while maintaining that arch, squeezing his
02:08 - 02:12glute medius, he can squeeze his cheeks like he's got a dollar bill
02:12 - 02:18between them, and then draw his TVA, there you go. Now go
02:18 - 02:23ahead and lift this foot off the ground, and we can see that already this is a
02:23 - 02:27hard exercise you really don't even have to go any further. This alone just the
02:27 - 02:33challenge of that resistance, maintaining that arch, keeping your glute medius
02:33 - 02:39firing drawing in your TVA, this is very very challenging, but we're going to go
02:39 - 02:41ahead and progress it anyway, because at some point you're going to want to
02:41 - 02:46progress, and it's kind of fun to abuse Rob. So what you are going to do is
02:46 - 02:49you can go ahead and start doing your excursions. Now your excursions are going
02:49 - 02:51to be through sagittal, frontal, transverse, just as we've done before.
02:51 - 02:57Make sure you limit excursion, make sure you limit distance to as far as they can
02:57 - 03:02reach while maintaining the arch in their foot, that's it that's all you get;
03:02 - 03:08this isn't about reach as far as you can until your whole body collapses. The
03:08 - 03:12first thing somebody's going to want to do is go flat foot on you, and then reach
03:12 - 03:15really far, but that's that's already cheating it's already compensating. So
03:15 - 03:20make sure you keep a very very watchful eye, on the medial arch of that
03:20 - 03:25foot. Let's go a little frontal plane good. Now when I go frontal plane
03:25 - 03:31I do like to do a little abduction with extension, so he's going out and just a
03:31 - 03:35couple inches back for me. What I'm trying to promote is gluteus medius
03:35 - 03:40activation on the side, not TFL, a lot of people like to go abduction and flexion
03:40 - 03:43which is gearing up the TFL which is a short overactive structure in a lot of
03:43 - 03:50our postural dysfunction. The transverse plane stuff, now I like to teach this as
03:50 - 03:55the intention to move in the transverse plane, that is this leg is going to move
03:55 - 03:59in the transverse plane where he tries to keep his pelvis facing forward, his
03:59 - 04:06ASIS should be facing that way. Very, very challenging progression. You can see Rob
04:06 - 04:10is wearing out, this isn't actually our first take either so poor Rob is getting
04:10 - 04:16beaten down today, but you see these progressions, you see how you can add
04:16 - 04:21this resistance. One thing that Rob also brought up which I thought was
04:21 - 04:26awesome is he uses this in his practice, as a way to start integrating the
04:26 - 04:33gluteus medius back into our gait pattern. So once you have this resistance, once
04:33 - 04:38you know this person can balance on a single leg, you can actually have them
04:38 - 04:42work on stance phase with their right leg, while working through their
04:42 - 04:49swing phase on the left side. So they can go from a toe-off position,
04:49 - 04:53you're not actually doing toe off, but toe off position, and then we actually
04:53 - 04:58talked about you could go to heel strike. He likes to go back sometimes to
04:58 - 05:03just almost like an excursion activity, and just do a toe touch. I think either
05:03 - 05:07way would be acceptable depending on what functional impairment you're
05:07 - 05:12working on within their gait pattern, but but you do a few reps of that after
05:12 - 05:16you've done all this wonderful balance work to kind of set up that gluteus
05:16 - 05:20medius firing, to try to set up better mechanics in the foot, and I think you
05:20 - 05:24guys are going to see some huge improvements in the way people not only
05:24 - 05:28walk, but this would be a great warm-up activity for running. All of your
05:28 - 05:31athletes out there who have that lower leg dysfunction. I hope you enjoy
05:31 - 05:36that exercise. Rob once again thank you for all of the tips. I really appreciate
05:36 - 05:39you coming out today. We'll talk with you soon.