Standing Cobra

Note: This is the same exercise used for "Trapezius Exercises (Activation)", but in a standing position with a stability challenge. If using this exercise for "Stability Integration", it is no longer necessary to perform Trapezius Exercises during the "activation techniques" portion of a corrective exercise routine.

1. Explain to your patient/client the reason for performing a Single-leg Standing Cobra
2. Ask your client/patient to start in a standing position, addressing any discrepancies in posture and form (Cue examples: 2nd toe pointing straight ahead, drawing-in maneuver, squeeze the glutes, stand upright, shoulder blades back and down, chin tucked, etc.)
3. Ask your client/patient to grasp the handles of the cables or bands. Note, the bands/cables should be hanging about arm's length in front of them.
4. Have the client/patient lift one leg. Ideally, the client would reinforce triple extension on the stance leg by "squeezing/contracting" the glute and quadriceps (driving the foot into the floor), and reinforce triple flexion on the lifted leg with 90° of hip flexion, knee flexion, and ankle dorsiflexion.
5. Have your client/patient retract and depress the scapula, extend and externally rotate the arms, reaching for the heels. Note, do not cue "arms back" as this often results in anterior tipping of the scapula as terminal extension of the shoulder is reached.
   • Note: the range of motion (ROM) for the scapula is fairly small. A helpful cue is "chest up", which promotes scapula retraction, scapula depression, and thoracic extension.
6. Cue the client to allow the bands/cables to slowly return to the starting position.
7. Perform 12 – 20 repetitions through full available ROM, with a 2:4:2 or 4:2:2 tempo, and move on to the next activation exercise. A second set may be performed if you desire and the patient is capable.
   • Note: During this exercise, the Brookbush Institute prefers to hold the end position for 4 seconds (2:4:2 count) to emphasize cervical retraction, scapular depression and retraction, and optimal lower extremity mechanics (triple extension and triple flexion).

Common Mistake:

• Scapular Motion is the Goal: The goal of this exercise is scapular retraction and depression (and upward rotation depending on the progression), not how much shoulder/arm motion can be achieved. Excessive arm/shoulder ROM often results in excessive scapular elevation or anterior tipping, during the end of the concentric contraction.
• Palms Facing Backward: Rather than allowing your client/patient to pull with palms facing back, ask them to end each repetition with palms facing forward to increase the activity of the commonly under-active external rotators (infraspinatus and teres minor), and decrease the activity of the commonly over-active shoulder internal rotators (latissimus dorsi, pectoralis major, subscapularis, teres major, and anterior deltoid).

Arm Motion Progressions:

• Abduction with External Rotation: (See video below) With your client/patient's elbows extended (arms straight), cue the patient into abduction, just below shoulder height, while externally rotating the arms so the thumbs are pointing up or back.
• Scaption: With your client/patient's elbows extended (arms straight), and thumbs "pointing up," cue your client to reach back in a "Y shape" at about 130 degrees of shoulder abduction.
• ITY's: With your client/patient's elbows extended (arms straight), cue them into a cobra, followed by abduction with external rotation, followed by scaption, commonly referred to as an ITY.

Progressions:

• Unstable Environment: A yoga mat, Airex pad, half foam roll, balance board, or bosu ball may be added, under the foot of the stance-leg, to increase the stability/balance challenge.
• Alternating Cobra: While holding both bands/cables, instruct the client/patient to perform a repetition on one side, followed immediately by the other side. This progression challenges the ability to stabilize unequal loads, including significant rotational forces and challenge to the core muscles and lower extremity.
• Unilateral Cobra: This progression removes the "counter-balance" allowed when both band/cable handles are held simultaneously, which significantly increases rotational forces. Only one cable/band is held, the other hand can rest on the ilium, and all repetitions are performed on one side before switching sides.
• Additional Load: Additional load may be added to challenge strength.