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Resisted Single Leg Balance and Reach with Progression

Improve ankle stability, core strength and coordination with this resisted single leg balance and reach exercise. Follow along with this video to learn how to safely and effectively progress the exercise for maximum benefit.

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Transcript

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.

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