Hip ABD Firing Pattern

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Standing Pelvic Clocks

in 2 Movement Tests Lower Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, Hip ABD Firing Pattern, Pelvic Clocks, Self-mobilization

Standing Pelvic Clocks

Standing Pelvic Clocks

The patient is standing facing a wall with their hands on the wall at about shoulder height and their feet hip width apart. Instruct the patient to imagine that they are standing on a clock on the floor such that when dropping the hips towards the wall they are moving towards 12 o’clock. Moving the hips forward and to the right is movement towards 1-2 o’clock and moving the hips forward and to the left is movement towards 10-11 o’clock.

They are instructed to drop their hips toward the wall then circle around from 12 to 3 and from 12 to 9.

They move in both a clockwise and counterclockwise direction, maintaining extension of their spine. They can focus on movement towards 1-2 o’clock to self mobilize for an FRS R or towards 10-11 o’clock to self mobilize for an FRS L.

They repeat the prescribed movement 10 times.

Shoulder Abduction with Hip Hiking

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Upper Quarter, Functional Integration, Hip ABD Firing Pattern, Scapular Depression, Scapular Stabilization, Shoulder Abduction

Shoulder Abduction with Hip Hiking

Elongation exercise in sitting:

  • This exercise helps to normalize shoulder abduction by asking the patient to hike up/lift the opposite hip to actively recruit the contralateral quadratus lumborum muscle.
  • The patient is sitting on a firm surface with the feet on the floor and is instructed to lift one arm out to side and up toward the ceiling.
  • At the same time as they are lifting the arm ask them to lift the opposite hip off the table/chair so that they lengthen the spine on the same side as the arm that is being raised. All of their weight should shift to the side of the pelvis that is directly underneath the raised arm.
  • Then they slowly lower their arm and repeat to the opposite side, alternating sides for 6-8 repetitions.
  • Tell the patient to try to coordinate raising the arm with lifting the opposite hip so that they occur simultaneously.

Tripod Stance

in 2 Movement Tests Lower Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, Functional Integration, Hip ABD Firing Pattern, Hip EXT Firing Pattern, Supine Hip ABD and ER

Tripod Stance

  • The patient starts in kneeling with the right foot forward and the left foot back. The patient comes up on the toes of their left foot and positions the right knee over the right foot and ankle.
  • Ask the patient to hold the arms out in front of them as if pushing against a wall and draw the abdomen in to stabilize the lumbar spine and pelvis.
  • Instruct the patient to come straight up off the floor a couple of inches while trying to maintain the right knee positioned over the right foot.
  • Ideally the patient moves straight up and down without the right knee advancing forward over the toes and without losing a neutral lumbar spine.
  • Have the patient hold this position for 10 seconds and repeat 3 to 5 times initially, adding repetitions as their strength improves.
  • They then reverse the leg positions to repeat on the opposite side.

Half Kneeling Chops and Lifts

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Upper Quarter, Functional Integration, Hip ABD Firing Pattern, Hip EXT Firing Pattern, Scapular Stabilization, Shoulder Abduction, Supine Heel slide, Supine Hip ABD and ER, Supine Shoulder Flexion

Half Kneeling Chops and Lifts

  • The patient starts in half kneeling with the left knee down and right knee up, with their right knee bent to a right angle so that their right knee is position over the right ankle.
  • The patient grasps a dowel in both hands with the palm of the right hand facing upwards (supinated) and the palm of the left hand facing down (pronated).
  • The patient is instructed to raise the dowel upwards to the right (lift). Then bring the dowel downwards towards the left (chop) so that they always lift towards the upside knee and always chop toward the downside knee.
  • Ask the patient to keep their head and eyes facing forward as they raise (lift) and lower (chop) the dowel in front of their body, keeping their trunk tall.
  • The trunk should remain still and the patient should try to maintain a neutral lumbar spine during the movement
  • Instruct the patient to repeat the movements 6-8 times then reverse their leg and hand positions to repeat the chop and lift to the left side.
  • The patient can begin this exercise with their knees initially separated for a more stable base and then bring the knees close together to increase the level of difficulty.

Tall Kneeling Chops and Lifts

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Tall Kneeling Chops and Lifts

  • Chopping is the downward movement across the body from a high position to a low position and lifting is the upward movement from a low position to a high position.
  • The patient starts in kneeling with a dowel in both hands with the palm of the top hand facing upwards (supinated) and the palm of the lower hand facing down (pronated).
  • Ask the patient to keep their eyes and head facing forward as they raise and lower the dowel in front of their body with both arms.
  • Their trunk should remain still and their spine in neutral as they perform 6-8 repetitions.
  • Then have them switch their hand positions and repeat the chop and lifting motions in the opposite direction.
  • The patient can begin this exercise with their knees initially separated for a more stable base and then bring the knees close together to increase the level of difficulty.

Prone Planks with Alternating Hip Extension

in 2 Movement Tests Lower Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, Hip ABD Firing Pattern, Hip EXT Firing Pattern, Retraining

Prone Planks with Alternating Hip Extension

  • The patient starts in prone lying resting on their elbows that are positioned under the shoulders.
  • Instruct the patient to rise up on their toes and forearms until they feel that their spine is straight. Observe their spinal position and provide feedback as indicated to make sure they are able to achieve and hold a neutral lumbar spine for 10 seconds.
  • Once the patient can perform 10 repetitions holding each one for 10 seconds they can increase the level of difficulty by lifting and holding one foot off the table for 10 seconds, then they reverse and lift the other foot off the table for 10 seconds before lowering back down to the floor.
  • An EMG analysis of 18 exercises designed to strengthen the gluteal muscles found that the prone plank with hip extension with the knee flexed had the highest % of MVIC of any of the exercises tested (Boren et al., 2011.) Caution is therefore advised when prescribing this exercise especially early on in the rehabilitation of a patient.

Side Bridges/Planks with Knees Straight

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Side Bridges/Planks with Knees Straight

  • The patient starts in sidelying with the R forearm under their R shoulder and the L hand on the L hip with the hips and knees straight.
  • Ask the patient to lift the R hip off the table until their spine is straight and have them hold the position for 10 seconds and repeat 3 to 4 times.
  • They are instructed to repeat this exercise on the left side.
  • The goal is for the patient to work up to 10 reps with 10 second holds on both sides with the hips and knees straight.
  • Boren et al., 2011 reported the highest levels of % of MCIV for the gluteus medius occurred with side planks so caution is advised before advancing a patient to this exercise, especially in the presence of severe atrophy or post hip surgery.

Side Bridges/Planks with Knees Bent

in 2 Movement Tests Lower Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, Functional Integration, Hip ABD Firing Pattern, Supine Hip ABD and ER

Side Bridges/Planks with Knees Bent

  • The patient starts in sidelying with the R forearm under their R shoulder and the L hand on the L hip with the hips straight and the knees flexed.
  • Ask the patient to lift the R hip off the table until their spine is straight and have them hold the position for 10 seconds, working up to 10 repetitions.
  • Once the patient can easily perform 10 repetitions with 10 second holds with their knees flexed they can increase the level of difficulty of this exercise by starting with the hips and knees straight.

Heel Sitting to Kneeling

in 2 Movement Tests Lower Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, Functional Integration, Hip ABD Firing Pattern, Hip EXT Firing Pattern, Retraining, Supine Curl Up, Supine Heel slide, Supine Hip ABD and ER

Heel Sitting to Kneeling

  • The patient starts by sitting on their heels with the trunk erect.
  • Ask the patient to find a neutral lumbar spine by rotating the pelvis toward 12:00 then 6:00 and find the midpoint.
  • Instruct the patient to draw the belly in and hold a neutral lumbar spine.
  • From this position and while maintaining a neutral lumbar spine, instruct the patient to rise up to a kneeling position by extending through their hips and not through the lumbar spine.
  • Once in the kneeling position the patient slowly reverses back to heel sitting, again by moving through the hips and not through the back.
  • Instruct the patient to repeat 3-5 times and increase the reps as their strength improves.
  • This exercise helps to improve a patient’s standing tolerance and strengthen the quadriceps.
  • Make sure that the patient’s lumbar spine stays neutral throughout the exercise.

Star Diagram

in 2 Movement Tests Lower Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, Functional Integration, Hip ABD Firing Pattern, Hip EXT Firing Pattern, Sensorimotor, Supine Hip ABD and ER

Star Diagram

Closed kinetic chain facilitation of the gluteal muscles:

  • With the patient’s arms at their sides instruct the patient to advance the right leg as far forward as possible keeping their right foot approximately an inch off the floor as they bend the left knee.
    The patient then reaches back as far as they can with the right foot staying an inch off the floor.
  • Then ask the patient to reach with their right foot out to the side and finally to draw a star taking the right foot behind and to the left and forward to the right and finally back to the right keeping the right foot an inch off the floor each time and bending their left knee as far as possible.
  • Repeat in each direction 4 to 5 times, then repeat standing on the right leg.
  • Make sure to watch for any valgus deviation of the stance knee during this retraining, which should be avoided.
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