07/05/2021- Marjon clinic- 1 hr
The first hour of this session, I had a client I have previously seen who an avid runner c/o p in the R glute/hamstring is. An improvement has occurred since including warmups and exercises to their daily run to which they can now run 8 miles without pain compared to the usual 6 miles so seeing improvements like this are good. For this session, we looked at running gate so got the client running on the treadmill and recorded them using video so we could place it into slow motion and assess with the client so they can analyse their own running and see what things we would like them to improve. The first noticeable thing was that they over inverted the right foot putting the muscles on stretch and secondly from the side in the video it was easy to see that the client was not flexing the knee enough when planting the front foot meaning they were not using the movement of their push off of the right foot as much as they should and therefore their glutes may be fatiguing faster as a result of this. This would explain why they have had an increase in distance before the onset of pain since activating their glutes and strengthening the lower limb over the last 2 weeks. Based on this we will adapt their programme and try getting them to actively flex their knee to use their momentum so reassessing running gate and assessing strength using the dynamometer is important.
Adaptations to HBE as of last week the client will now be following this plan:
Warm up 10 minutes on bike 0-5 mins at 50-60 RPM 5-10 mins at 60-70RPM @50-60% MAX HR
| Exercise | Sets | Reps | Link to Video | Extra information |
| Standing Side Abductions | 3 | 12-15 | Standing Hip Abduction Extension – YouTube | Use wall as support if needed and adjust resistance band if required |
| Tandem Stance | 3 | 30 Second hold
(on each leg) |
Tandem Stance – Ask Doctor Jo – YouTube | If you need support for blanc and stabilisation please use it, if not hold for 30 seconds at a time on each leg. |
| Isometric hamstring curl with a resistance band | 3 | 8-12 (hold for 10-15 seconds at the end range) | Isometric Hamstrings Curl with Resistance Band – YouTube | This can be done single legged if you wish |
| Glute Bridges with Hip Abduction | 3 | 12-15 | Theraband Glute Bridge with Abduction: Top Ten Ski Exercises – YouTube | Add resistance band around legs just above knees where possible.
Hold for 2-3 seconds at the end while in abduction. |
| Banded Squats | 3 | 12-15 | Banded Squat – YouTube | This can be done with or without the bands and tightness f band can be adjusted to suit you if you have the ability to do so. |
| Banded RDL | 3 | 12-15 | Resistance Band Romanian Deadlift (RDL) | Exercises to do at home | Travel Workouts – YouTube | If you do not have a resistance band this movement can be done suing a can of beans in each hand or bottles of water. |
| Isometric single leg Glute bridge | 3 | 8-12 (hold for 10 seconds on the L leg and 12-15 seconds on the right leg | Single Leg Hip Bridge + Hip Thrust Isometric Hold – YouTube | The aim of this is to be working the glutes individually and feeling them working separately. The main goal is to build strength especially in the Right side. |
We also used the handheld dynamometer to test the strength in the hamstrings, adductors and glutes of the client and compared left to right these were the results:
16.2 L Hamstring
24.3 R hamstring
33.5 R- Glute
38.2 L Glute
35.1 R Add
47.9 L Add
These results are measured in lbs of force and as you can see glutes and adductors are similar in strength however, hamstrings are considerably weaker than the other too so an adaptation to the HBE to include more isometric work for the hamstrings will be important to provide a balance in the muscles.