Week 2: Extremity Strengthening

what 4 things would lead you to do strengthening

MMT, observe functional task, postural observation, quality of moveement

when surgery is involved, whatis the number one priority

protecting integrity of the surgery

when to use open chain exercise in stead of closed chain

struggle with it or cant bear weight. Allows us to isolate muscles better

progression of strengthening

isometrics, resistive, advanced/functional

when to use isometrics

cant perform joint motion, reduce inhibition, minimize atrophy from immobilitly, initiate co-contractions, develop static strength based on needs

intensity of isometrics

at least 60% of MC

duration of isometrics

6 seconds, no more than 10 due to fatigue.

isometric considerations

avoid holding breath, slow speed of contraction, does it reduce pain?, decreases BP

high intensity isometrics are contraindicated for those with

cardiac and vascular disorders

exercise resistance isometrics and bp

reduce resting systolic and diastolic BP

3 things that are analgesic isometrics

pain reduction greater in isometrics vs isotonic, greater MVIC, lasted at least 45 mins

submaximal isometrics can induce

opp effects on pain sensitivity

isometrics 2 pain functions

static strength and endurance

external sources of isometrics

body weight, immovable objects, manual force, weight, t band

setting exercises, what is it

low intensity isometric contraction against little to no resistance.

purpose of setting exercise

decrease pain and spasms and promote relaxation and circulation during acute phase of recovery

scapular isometrics

scapular sets. can be done in different angles/resisted/prone/supported

RC isometrics

shrugs, 5 way shoulder isometrics

where to place pressure for shoulder isometric abd vs ir/er

abd is at shoulder, ir/er is at wrist

other isometric examples for the shoulder, elbow, wrist

UE weight shift and hold, walk outs, elbow/hand/wrist

what are glute sets

but squeezes, can be done sitting/standing/walking/squatting/etc

dynamic hip isometric example

single leg stance

whats good about a towel or hand for quad sets

feedback and comfort

how to target medial vs lateral hamstring sets

medial toe in, lateral toe out

ankle isometrics can be done against

wall, table, chair, foot, floor

is single leg stance an isometric?

no, this is more balance so you are jumping between ecc/conc and working on ankle strategy

AAROM used as strengthening

only an initial use, best for proprioception and kinesthetic awareness before moving on

AAROM easiest to hardest T band colors

black, blue, gree, red, yellow

resistance training easiest to hardest t band colors

yellow, red, green, blue, black

PRES (progressive resistance exercises) are what?

dynamic resistance training, constant external load is applied to the contracting mm. this is important!

in scapular strengthening whats important

proximal stability before distal mobiltiy

PRE examples for scaps

Y, T, I, W, A

what mm are worked in Y

lower trap, supraspinatus

what mm are worked in T

post delt, middle traps(thumb up), rhomboids (thumbs down)

what mm are worked in I

CHEER POSE, lats, triceps, post delt

what mm are in W

infra, rhomboids*, middle trap

position of the A's

downward Ys

PRE are good for

stability, but not necessarily the best for mobility in reaching overhead

where is resistance for low rows? what mm is this working

low resistance, better for upper rhomboids and traps

where is resistance for high rows? what mm is this working

resistance is high, working lower rhomboids and lats

rows also work which mm

biceps

scapular stabilization help with what things

function, pain, ROM, satisfaction, mm length, strength

when doing rows/YWTI, if you do scap setting vs moving scap each time what is it working

setting first-endurance and working individual muscles

scap each time-neuromuscular re ed

exercises for serratus

supine punches (only doing some fibers), push up plus, dynamic tree huggers, serratus wall slide, wall swims, downward dog with protraction

how to better do serratus punches

do arm at 120-130 degrees of flexion because its an elevator too

how did Bean's pts get better faster with what 4 exercises

sidelying shoulder flex, slidelying er, prone horizontal abduction with ER (T), prone extension (I)

4 standing scap balance (not the good ones)

bow and arrow, er with scap squeeze, lawn mower, robbery

is standing vs sidelying easier for scapular movements

standing is lower level (easy), sidelying is harder (against gravity)

higher poisitons of scap favor what mm

UT

optimal UT/MT and UT/LT is present in

scapular retraction

optimal UT/SE is present in

protraction

exercises for LT

press up, half push up, one handed plank

exercises for SA activity

half push up, push up plus, scapular protraction

upper cross syndrome is fixed by

engaging MT and LT while minimizing UT. this way they all balance.

what 5 muscles showed most activity in EMG analysis of RC and deltoid for ER

infraspinatus, supraspinatus, teres minor, middle delt, posterior delt

is it better or worse to use a towel roll? why?

better, less compensation with abduction

What 2 mm work most in Er activites at 90 abd

supraspinatus and subscapularis

best scapular balance position

prone ER with 90 deg abduction and sidelying ER with towel

what mm is higher activity during ir at 0 degrees

lats

for supination and pronation, where should the weight be

hold at the end of the weight or thred it through fingers

types of grips to work on

hook, cylinder, spherical, fist, towel grips, lumbrical (plate pinches)

2 peg exercises

minnesota manual dexterity test, purdue peg board

closed chain UE strengthening examples

push ups, push up plus, planks, ball on wall, tricep dips, pull ups

how to improve stability in the ball on wall exercises

do it in the scapular plane rather than flexion, could also move to table or flex elbow (shorter lever arm)

what to watch for in hip motions

keep knee straight in abduction (avoid flexion and er), watch hip hiking or trunk leaning with abd or ER

bent knee works more glutes or hams?

glutes

if HS is cramping whats wrong

relying too much for motion (active insufficiency)

what to watch for hip extension

if in prone, they are near end range already. any further mootion will strain SI and lumbar. DO STABILIZATION

3 exercises with 5% body mass weight

clams, hip abduction with ER, hip abduction

what to do if glute med is goal

abduction

what to do if AHF, glute max and some glute med is goal

clams

what to do if tfl is goal

abd with er

what 4 exercises activate glutes while minimizing TFL

clam, side steps, unilateral bride, quadruped hip extension

what mm is targeted by hip thrust

vastus lateralus

what mm is targeted with bridge

upper and lower glute max, glute med

muscle sequence for hip thrusts

glute max, erector spinae, biceps femoris, semi T, VL, glute med, VM, rectus

hip thrussts improve what acitivites

sprinting

good glute max exercise

step up

exercise vs meds in knee strengthening

same effect, so do exercise

how to isolate VMO

if you can get the adductors contracting, it can get vmo to activate more

exercises for VMO

SLR with ER, ball squeezes, knee extension with ER, electrodes on VMO

VMO NMES settings

1:5 ratio, ramp time 2 sec, to contraction, 35 hz, 200-300 pulse dispertion, large electrodes

does altering orientation of lower limb with co-contraction enhance VMO over VL

no

short arc quads degrees

45 to ext

long arc quads degrees

90 to ext

post tib motion

PF and inv

ant tib motion

DF and inv

fibularis longus and brevis motion

eversion and PF

fibularis tertius motion

Df and eversion

what activities for foot intrinsics

towel scrunches, marbles

what does the marbles exercise work

intrinsics

how do you put the marbles down

based on what mm you want to work

1st layer foot intrinsics

abductor hallucis, FDB, ADM

2nd layer foot intrinsics

Quadratus plantae, lumbricals

3rd layer foot intrinsics

FHB, adductor hallucis, FDMB

4th layer foot intrinsics

palmar and dorsal interossei

real foot intrinsics- foot PREs

arch pick ups (foot domes), toe yoga

closed chain le exercises

squats, step up and down, calf raises, bridges, deadlifts, hip hikes, glute slides, good mornings

what is the better way to do lateral band walking? bent or straight knee

higher glute activity and decreased tfl in squat

ways to combine strengthening, mobility, and stability

nordic HS curls, turkish get up, reverse nordic leg curls, etc