Supine Hip ABD and ER

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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

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

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

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

Prone Planks

  • 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.
  • They work up to 10 repetitions, holding each one for 10 seconds.

Side Bridges/Planks with Knees Straight

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 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.

Single Leg Bridge

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

Single Leg Bridge

To strengthen the L gluteus maximus:

  • The patient is lying on their back with both knees bent up and feet resting flat on the floor.
  • Ask the patient to bring their right knee up to the chest and hold with their hands.
  • Instruct the patient to draw the toes of the L foot up and gently push the left heel away to inhibit the left hamstrings.
  • Now ask the patient to bridge up on their L foot as high as they can while they hold their R knee to chest.
  • Have the patient hold for 10 seconds then slowly lower their L hip back down to the table.
  • Have them repeat for 3 to 5 reps initially working up to 10 reps on each leg.

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.

Unilateral Hip Abduction and External Rotation

in 2 Movement Tests Lower Quarter, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, Retraining, Supine Hip ABD and ER

Unilateral Hip Abduction and External Rotation

  • The patient is lying on the back, with their thumbs placed above the ASISs to monitor pelvic stability.
  • The patient is instructed to find the midpoint between 12:00 and 6:00 o’clock then draw the belly in towards the spine without flattening the low back so that they maintain a neutral lumbar spine.
  • The patient continues to monitor the position of the ASISs as they slowly drop the right knee out to the side.
  • The patient is instructed that if the R ASIS drops inferiorly when compared to the L ASIS while abducting and externally rotating the R hip they are to return back to the midline and start over.
  • The patient is instructed not to drop the R knee out to the side further than they can maintain leveling at the ASISs.
  • Repeat on both sides for 3-5 repetitions to start, increasing to 10 reps.
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