Monday, December 5, 2011

Lumbo-Pelvic Stability In The Frontal Plane - Learn To Spot It And Correct It Part 2

 Check out Part 1 HERE.

Now that we have discussed how to spot frontal plane hip instability, let's discuss some ways to correct it. 

1)  Make sure to examine their ADDuctor tissue quality and range of motion.

It is common for the ADDuctors to dominate the ABDuctors in stabilizing the pelvis in the frontal plane.  Therefore, the ADDuctors can become stiff and overused if the ABDuctors are not helping out enough.  If this is the case, then as soon as this person goes into single leg stance the dominance of the ADDuctors cause a lateral pelvic tilt and frontal pelvic shift (as discussed in the last post).  For this person, I would have them foam roll and go through a dynamic warm-up to target their ADDuctors.  Below are some of the most common mobility drills I use for myself and my clients.

2)  Now that we have improved ADDuctor tissue quality and ROM, it is time to get their ABDuctors working.  I would first address this in their warm-up with some activation drills.

I like sidelying clams, lateral band walks (watch for hip hike on these - don't want you going all Gainesville***), duck walks, and side bridge from knee (only bottom knee is down).  I am sure I am forgetting others, but these are a good start.  Again, test and re-test to see which gives you the best result.  Below are videos of some of the activation drills I mentioned above.

3) Now it is time to move to the strength training exercises. 

You need to have progressions and regressions in mind, and there are many ways to do this.  For frontal plane lumbo-pelvic stability I would always start with isolated exercises - where the ABDuctors are resisting motion vs. producing it.  From here, I would look at their position.  For example, this is how I would progress someone in terms of positioning:

1) Tall Kneeling
2) Half Kneeling
3) Standing
4) Split Stance
5) Single Leg

So, for example, if a person is really struggling then you may start him or her in a tall kneeling position with some chops and lifts.  Make sure his or her pelvis stays neutral (waist is fairly straight when viewing from the front and the side) and the spine is neutral throughout the exercise.  This is an isolated exercise that will force the person to use their ABDuctors on the knee closest to the machine to resist going into ADDuction.

Below is a video of a half kneeling cable lift.  A tall kneeling cable lift looks the same except both knees are down.

You can also target the ABDuctors in each position by using RNT.  To do this, place a band around the person's waist and pull them toward the side of the ABDuctor you are trying to target.  For example, if you want to strengthen your right ABDuctor then have someone place a band around your waist, in any of the positions listed above, and pull you to your right.  This will force your right ABDuctors to kick on so that you will not tip over (there are more muscles involved here, obviously, but let's just focus on the ABDuctors).

 Not exactly what I have in mind...

I am not going to tell you which exercises are best because it will all depend on your client.  However, I do want to say that if you have started your client with a split squat and he or she is having trouble controlling his or her pelvis in the frontal plane, then do not necessarily regress him or her right away.  I have some tips that may help.

- Try RNT, as discussed above.  It is a very effective strategy to correct someone if they are laterally tilting their pelvis and ADDucting.

- Give the person an offset loading - hold a DB or KB in one hand only.  An offset load, if heavy enough, can reflexively turn on a person's contralateral abdominal wall.  And, as I discussed in part 1 of this series, the hip ADDuctors and the contralateral abdominal wall work together to bring the pelvis from an ADDucted position to neutral.   This is also a great tool if you are a busy coach and do not have the time to use RNT for each client.

Finally, once a person is able to use their ABDuctors to stabilize their pelvis in isolated exercises, I would move him or her to more dynamic exercises in the frontal and transverse planes.  Below is a video of the low cable lateral lunge, a simple exercise you can use to force the ABDuctors to resist ADDuction and then produce ABDuction concentrically.  There are many more of these exercises out there and if anyone is interested I can post more videos in a future blog - just let me know.

A final point I want to make is this:  Constantly assess how your clients move and stand.  If they are always standing on one leg with their hip ADDucted, then over time this will cause weakness.  As trainers or coaches we must reinforce the importance of good movement and posture outside of the gym if we really want to make significant changes.

Have a great week everyone!!  If you have other coaching tips and/or exercises to address this problem then I would love to hear about it.

***This is a reference from a Postural Restoration Course video, which I highly recommend checking out.  You can go here for more information: Postural Restoration

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