6 Upper Body Exercises To Do At Home

6 upper body exercises

Doing upper body exercises for improved mobility and strength can provide a break from prolonged seated desk work. Try this group of 6 upper body exercises using your arms as your resistance and eventually progress the exercises by using cans of soup as 1 pound weights.

Scapular Retraction with External Rotation 

Stand with back against a wall (progression: holding a theraband or a pair of small weights in your hands) palms facing up. Keep your elbows pulled in at your sides and squeeze your shoulder blades back and together, allowing your arms to rotate out to the side. Repeat 10 times.      

Shoulder Flexion

Raise one arm at a time. 

Begin in a standing position with arms by your side. Slowly bring one arm forward to shoulder height. Hold at the top and then slowly lower arm back to starting position. Repeat 10 times and then switch to the other arm for 10 repetitions.     

Shoulder Abduction  

Raise one arm at a time.

Begin in a standing position with your arms by your side. Slowly bring one arm out to the side with your thumb pointing upward. Bring your arm to shoulder height, pause, then slowly lower back down to starting position. Repeat 10 times and then switch to the other arm for 10 repetitions. 

Prone Ts (middle trap arm raise exercise)

Raise one arm at a time.

Lie on your stomach with a pillow under the chest and stomach and a towel roll under the forehead. Start with arms resting out to the side. Try to pull your shoulder blade towards your spine (without shrugging), and slowly lift your arm out to the side in a “T” position with your thumb up.  Repeat 10 times then switch to the other arm for 10 repetitions.   

Prone Ys (lower trap arm raise exercise)

Raise one arm at a time

Lie on your stomach with a pillow under the chest and stomach and a towel roll under the forehead. Start with arms resting out to the side. Try to pull your shoulder blade towards your spine (without shrugging), and slowly lift your arm out to the side in a “Y” position with your thumb up.  Repeat 10 times then switch to the other arm for 10 repetitions.

As with any exercise, you might experience fatigue or tiredness of the arm(s). This feeling should go away once you have completed your set of 10 repetitions. If you experience pain in the shoulder, stop the exercise and do not continue the exercise until you have consulted a physical therapist.

6 Lower Body Exercises To Do At Home

6 Lower Body Exercises to do at Home

Regular exercise is one of the hallmarks of a healthy lifestyle, but sometimes real life gets in the way and we are not able to make it to the gym. Don’t let a lack of access to gym equipment stop you from staying in shape! Here are a few easy exercises to do at home.

Squats

Many gym workouts incorporate squats in some form, so why not do them at home too? There are many variations of this exercise to help increase the level of difficulty, but getting the basic squat form down first is imperative. Stand with your feet shoulder-width apart, and squat down until your knees reach a 90 degree angle. Make sure to “sit back” into the squat so that your knees do not move forward past your toes — like you are sitting into a chair. In fact, performing this exercise in front of a chair can help you perfect your form. Slowly sit back toward the chair, then, just before your bottom reaches the chair surface, push back up to return to standing.

When you master the basic squat and need a greater challenge, you can get creative. Perform squats on just a single leg, add weight with dumbbells (but not too much!), or use a softer surface, like a foam pad or BOSU ball, to make the exercise more difficult.

Lunges

Similar to squats, lunges are a versatile exercise that hit a number of muscle groups in the legs. Standing with both feet together, step forward and bend the front knee to 90 degrees, then push back to standing. Once again, make sure to keep your knee from moving past your toes. This same exercise can also be performed by stepping out to the side or backward, then bending the knees into a lunge. Another way to progress: if you are on a hard floor, put a sock or towel underneath one foot, then use that foot to slide backward or sideways while bending the opposite knee into a lunge. Just make sure your stance foot is nice and solid!

Single leg RDL (Romanian deadlift)

Deadlifts are a great exercise for strengthening your hamstrings, hips, core, and lower back. They also don’t require any weights! My favorite way to do them is on one leg. Make sure you have plenty of room around you first, though (especially behind you!). Stand on one leg with your knee slightly bent, then hinge forward at your hip, keeping your lower back and opposite leg straight. Allow your arms to hang downward until you reach your knee or shin (or, if you prefer, a small step or coffee table in front of you), then squeeze your hamstrings and glutes and return to standing. This can be a hard exercise to master, so remember to activate your core and keep from rounding your lower back.

Calf raises

Calf raises are another easy exercise to do at home, and are great for individuals who like to incorporate running or other cardio into their normal exercise routine. Stand near a wall or table (so you can reach out to keep your balance) then push up onto your toes. Hold for a beat, then return to the ground. If you want an additional challenge, perform the exercise on one leg. Doing the exercise with your heels hanging off a small step can also make it more challenging.

Bridges

Bridges are another great way to strengthen your glutes and hips, and can also be performed in a number of different ways. Start by lying on your back with your knees bent. Squeeze your glutes, and lift (or “bridge”) your hips off the ground, then hold for a few seconds before returning to your starting position. You can progress the exercise any way you see fit, but some easy progressions include holding the bridge for longer or using one leg while the other is lifted into the air (make sure your hips stay level!).

Side Lying Hip Abduction

The lateral hips are a very common area of weakness for most people, and side lying hip abduction (or side leg lifts) is an exercise we physical therapists prescribe regularly. Lie on your side with your bottom knee bent for balance. Keep the top knee straight and make sure your leg is in line with your torso — you should not be able to see your foot unless you look down. Keep your hips stacked on top of one another and your toes pointed horizontally (i.e. don’t rotate your foot upward), and lift your top leg up a few inches. Hold for a beat, then return to your starting position and repeat. This exercise should fatigue your lateral hip; if you feel the burn closer to the front of your hip, you likely need to move your top leg further backward.

Get To Know Your PT: Marylyn Presutti, PT, DPT, OCS, MTC

Therapydia DC Physical TherapistMarylyn Presutti, PT, DPT, OCS, MTC

Therapydia DC physical therapist Marylyn Presutti, PT, DPT, OCS, MTC takes some time to share a bit about herself, what first got her interested in physical therapy as a profession, her favorite Saturday routine and her plans for future education.

Find an activity that you really enjoy doing and you will never dread doing it.

When did you know that you wanted to be a physical therapist?

I grew up knowing that I wanted to do something with sports (I thought I was going to be the orthopedic surgeon for the Chicago Cubs), but when I was a senior in high school I fractured my L5 vertebrae (a spondylolisthesis). I was sent to physical therapy in an attempt to avoid surgery. The entire experience made me realize how effective exercise as medicine is, and it shifted my focus to physical therapy as a career.

What’s your favorite song to get you motivated?

‘Don’t Stop Me Now’ by Queen. It can amp me up to do just about anything.

What is the biggest challenge involved in being a PT?

The non-patient care tasks. A lot of times the stress of paperwork and insurance concerns and visit limits can become exhausting to deal with. Often times this leads to a lot of additional work, and it can be a real bummer

How do you like to stay active?

I enjoy everything from going on walks with my dog to boxing to pilates and everything in between. I recently found out that you get an amazing workout from doing demolition and renovations to your house (hello new bathroom).

What surprised you the most about the physical therapist profession?

I am always surprised by how few people know that physical therapy is a treatment option and that we are highly trained healthcare care providers.

Are you currently pursuing any further education/certifications?

Not currently, but earlier in 2019 I passed the boards to become an Orthopedic Certified Specialist. I hope that my next challenge will either be a pilates certification or concussion management

What’s your go-to breakfast?

Coffee and a granola bar or overnight oats

What do you wish everyone knew about physical therapy?

I wish more people knew that physical therapists can see patients through Direct Access, meaning they do not need to see a physician before coming to physical therapy. We can serve as a first point of contact for your aches and pains, and we are trained in differential diagnosis, so if we see something that does not appear musculoskeletal in nature, we can refer to another provider as needed.

What is the most important personality trait that a therapist must have?

I think physical therapists need to be curious people. We have to ask a lot of questions and do a lot of critical thinking to assist patients, and there is a high level of curiosity that has to occur to obtain a solution.

What do you do to de-stress/unwind?

Getting outside, going to the gym, or, more recently, trying to learn how to cross stitch.

Finish this sentence: On Saturday mornings, you can usually find me…

Walking with my husband and dog to a coffee shop. We have this tradition of getting ‘fancy coffee’ once a week, and our Saturday morning routine is one of my favorite things.

What is your favorite piece of wellness advice to offer?

Exercise should not feel like a punishment, so if find an activity that you really enjoy doing, you will never dread doing it.

Learn more about Marylyn and the other Therapydia DC physical therapists.

6 Ways To Improve Your Posture At Work

6 ways to improve your posture at work

Neck and back pain are two of the most common diagnoses we treat here at Therapydia. While these symptoms are occasionally caused by an acute injury, more often than not they are simply the result of sitting for too long during the work day! Unfortunately, desk jobs are not going away anytime soon, so it is important to make sure that you are doing everything you can during the day to avoid the repeated stresses that bring so many into our clinic.

Here are a few handy tips to address your sitting posture during the work day:

  1. Sit with your feet flat on the floor

By ensuring that your feet are on the floor and not hanging or crossed, you are taking stress off of your legs and hips that can translate up to your pelvis and back. Moving your feet around during the day is fine, but make sure that your chair is low enough that your entire foot (heel and toe) can rest comfortably on the ground without having to strain or stretch. If you cannot fully reach the floor, or can only touch with your toes, your chair is too high!

2. Make sure your lumbar spine is supported

Most modern office chairs offer a good amount of lumbar support, but not all chairs are perfect for the individual sitting in them. Some people require a bit more support, while others may find that their chair doesn’t provide the required support in the correct spot in their back. Use a small lumbar support (either a lumbar roll, available online, or a rolled up sweater) to help provide a bit more support in the small of your back.

3. Adjust your monitor to eye level

One of the most common causes of neck and upper back pain is related to the flexed posture that individuals sit in during the work day. Whether this is from looking down at our phones, reading, or just staring at the computer screen, individuals with neck pain often have it because of sustained flexed posture. This puts more strain on most of the structures in the neck, along with the upper traps. By moving your desktop monitor up to head level so that you can look straight forward while working, you can significantly help to reduce the amount of strain put on your neck during the work day.

4. Keep your arms in a resting position

Some desks are too tall for the person working at them, which can lead to neck and shoulder pain! Ideally, your arms should be resting by your side while typing and working at a computer, not elevated or extended out in front of you. If you find that your arms are away from your body, try to adjust your keyboard and mouse (either in their position on the desk or by using a keyboard tray) to help reduce neck and shoulder strain.

5. Make sure everything is in front of you

When someone complains of neck or back pain only on one side of their body, it can sometimes be related to a repeated movement or position that is only done to that side. In the office setting, that can be something as simple as turning to pick up the phone, look at a second monitor, or turning to talk to a coworker. If you find that you are repeatedly turning to just one side, it may be worth reconfiguring your office space to make sure that you are working in both directions, or better centered to complete your daily work tasks.

6. Get up regularly!

Even those who start with perfect upright posture don’t always stay there for long. Slouching happens, and the best way to avoid sticking in that position for long periods is to stand up frequently throughout the work day. One helpful tip we provide many patients is to set a timer for every 30-45 minutes, then get up when that timer goes off. Even standing for 10 to 15 seconds and performing a stretch or two can make a huge difference in your overall posture, and how you feel throughout the day!

5 Exercises for Plantar Fasciitis Relief

physical therapy dc

Plantar fasciitis is one of the most common causes of foot pain we endure. As a very common diagnosis seen in our clinic, plantar fasciitis can have a major effect on a person’s lifestyle. Those with foot pain may be less likely to walk or exercise on a daily basis, leading to poor fitness and a lower quality of life.

Unfortunately, there are no quick fixes for plantar fasciitis. It is a chronic, nagging injury that can take a frustratingly long amount of time to go away. As physical therapists, we can use manual techniques and other tools to help reduce tightness throughout the foot and lower leg during PT sessions, but the course of treatment also requires buy-in from the patient. A good home exercise program performed frequently by the patient is essential for treating plantar fasciitis-like pain.

Those same exercises can also be used to help prevent foot pain! If you have had plantar fasciitis in the past, or are worried about foot pain, it’s possible to tackle the problem before the pain even starts. Here are five exercises we use frequently that can help reduce or even prevent foot pain associated with plantar fasciitis.

Soleus Stretch

Many patients who come in to our clinic reporting plantar fasciitis pain often complain of tight calf muscles. This is common — tightness throughout the calf muscle can put more stress on other structures in the ankle and foot — but your normal calf stretch isn’t enough! Stretching the soleus and other deeper calf muscles is also important for reducing ankle and foot pain.

To perform the stretch, stand near a wall with your feet staggered, but still fairly close together. Lean against the wall and bend both knees. You should feel a stretch near the Achilles tendon on your back leg. Hold for up to 30 seconds, and do the exercise a couple more times.

Foot Arch Squeezes

The plantar fascia is a band of fibrous tissue in the foot, but there are muscles in there as well! Strengthening the muscles within the foot is a key element of treating plantar fasciitis.

To perform the exercise, sit in a chair with your feet flat on the floor. Try to make the arch of your foot as large as possible WITHOUT curling your toes. Hold the squeeze for a few seconds, and repeat. We usually recommend using a timer for 30-60 seconds so that you can focus on the muscle contraction itself, not the number of repetitions you are performing.

Self-Massage With Ball

This is another staple of treating plantar fasciitis. Take a firm ball, like a tennis or lacrosse ball, and roll your foot over it while applying a bit of pressure. This exercise should be a little uncomfortable, as you are working on stretching the tissues within your foot. Like the last exercise, set a 30-60 second timer for this one.

Clamshells

It’s important to treat the foot when dealing with foot pain, naturally, but the hips also play a big role! Improving lateral and posterior hip strength helps stabilize the entire pelvis and lower body with activity, which can reduce stress on the knees, ankles, and feet.

Clamshells are a staple exercise for hip strengthening. To perform them, lie on your side with your knees bent. Keep your feet together and bring your top knee upward without rotating through your spine (place your top hand on your hip to help keep yourself aligned properly). This may feel easy at first, so add an elastic band or a 5-10 second hold to the exercise to increase the difficulty. You should feel a nice muscle burn in the side of your hip after this one!

Sidelying Hip Abduction

This is another good one for improving hip strength! Lie on your side again, but keep your top knee straight this time. Lift that top leg straight up toward the ceiling, and hold for a couple of seconds. Perform these in sets of 8-10 at a time, and do them on both sides! Even if only one foot is bothering you, it’s always good to give the other side some love too.

If you have any questions or any pain with these exercises, please consult a Therapydia DC physical therapist.

4 Strategies to Improve Posture and Reduce Strain

DC Neck Pain Physical Therapy Improve Posture

One of the most common reasons we see patients in our clinic is for neck and upper back pain. More often than not, these patients note that their symptoms are not the result of a specific injury, but rather have just gotten worse over time.

The main culprit? Sitting at work. Between slouched posture and the amount of time spent in a seated position (and often the combination of the two), many of our patients are set up to fail. Does that mean that if you sit at a desk all day that you’re destined to have pain? Not quite! Here are a few tips to reduce strain and prevent pain associated with sitting at work throughout the day.

#1: Stretch and Stretch Often

One of the first exercises we give most patients with neck pain is a simple Upper Trapezius Stretch. It helps reduce strain in several muscles in your neck and upper back (not just the upper traps), and is one of the most effective exercises patients can do on their own to help reduce neck pain and tightness.

To perform the stretch, sit up straight and tilt your head to one side (if you are having pain, tilt your head away from the painful/tight side). You can use the hand on that side of your body to help pull your head further to the side, increasing the amount of stretch on the opposite side of your neck. Hold for 30 seconds, and repeat on the other side.

Another common exercise is a Chin Tuck.

Sit up straight, and focus your eyes forward while drawing your chin straight backward. You should be able to maintain your gaze on a specific point ahead of you while performing the exercise.

#2: Strengthen Your Shoulders

No, we’re not talking about bench press or biceps curls here. Sitting in a slouched position with your shoulders rounded forward puts many of the muscles attached to your shoulder blade on stretch. By sitting in that position for long periods of time, that stretched position causes these muscles to weaken. Strengthening your shoulder and scapular muscles will help to keep you in an upright position, as well as ward off any imbalances between your upper traps and the muscles in between your shoulder blades.

A quick note: while the exercises shown below utilize elastic bands (therabands), these are not required. Even doing the exercise without the band can help strengthen your shoulder and scapular muscles.

Exercise 1: Rows

Begin by keeping your shoulders relaxed. Pull your elbows backward and try to squeeze your shoulder blades together without letting them elevate. Hold for a second, and return to your resting position. After every few repetitions, take a deep breath to keep your shoulders relaxed. It may help to perform this exercise in front of a mirror at first to ensure your shoulders are not hiking up as you go.

Exercise 2: No Moneys

Stand with your elbows bent and your palms facing upward. Keeping your elbows tucked in by your side, rotate your hands outward. Finish the exercise by gently squeezing your shoulder blades together, and hold for a second, then return to your resting position.

#3: Address Your Work Station

There are a number of adjustments, both big and small, that one can do to help improve their posture and reduce strain throughout the work today. On the easier side of the spectrum, see if it is possible to raise your computer monitor to eye level. By raising the height of your monitor, it helps eliminate the amount of time you are looking down, easing stress on your neck and upper traps. It is also a good idea to lower your mouse and keyboard so that your shoulders can remain relaxed while working. Make sure to also keep your feet flat on the floor to help reduce strain on your lower back.

Work on a laptop? That makes for a tougher adjustment. Make sure to keep your arms and shoulders relaxed while working, and try to keep your head level while only focusing your eyes downward to look at your computer screen.

If you want to make bigger changes, ask your employer about an adjustable desk. Many companies are investing in adjustable, or “standing” desks so that their employees can change position throughout the day while remaining productive at work. These workstations aren’t for everyone, but can help you change your position and reset your posture more frequently during the day.

#4: Get Up and Move!

We find that many of our patients are able to achieve proper upright posture when asked. Many of them even note that they are diligent about finding this position when they first sit down. However, that only lasts for so long. We all tend to slouch forward when seated for long periods of time, whether we are focused on a specific project or taking a break from the grind of the work day.

No one maintains proper sitting posture 100% of the time, and it’s not good for anyone to sit for hours on end. One easy way to help combat slouched posture and stiffness from sitting for long periods is to get up and move around. It doesn’t need to be a long break — even standing up and stretching for 30 seconds or so can make a big difference in a person’s average posture throughout the day.

One strategy we often instruct our patients on is to set a timer. Everyone’s smartphone has one these days, so it’s easy to set a timer for 30 minutes or so and get up every time that goes off. Whether it’s to go to the restroom, get a drink, or do some of the exercises above, standing up and resetting your posture frequently is an easy way to reduce the strain and stiffness associated with sitting for long periods throughout the work day.


 

Dr. Rob Rogacki attended George Washington University where he earned his Doctor Of Physical Therapy. He believes in fostering patient independence throughout the rehab process, empowering patients to take control of their symptoms and maintain a healthy and active lifestyle. Learn more about Rob and the other Therapydia DC physical therapists.

7 Stretches to Help You Stick to Your New Year’s Workout Plan

washington dc physical therapy stretch workout performance exercise

By Robert Rogacki, PT, DPT, CERT. MDT

Is “Exercise More” your 2019 resolution?

Every January, millions of newcomers flock to gyms across the country in hopes of losing weight, improving their physique, and starting a healthier lifestyle. As physical therapists, we love this! We want all of our patients to be happy and healthy, and regular exercise is a key component to both of those goals.

But with a new exercise regimen also comes an increased risk of injury. Regular stretching, with ample warm-up and cooldown periods, is essential for staying healthy while exercising. It can help you improve flexibility, reduce tightness and act as a great way to increase your chances of long-term success. Here are a few simple stretches you can do to stay limber as you get rolling with your new exercise program.

Standing Quadriceps Stretch

Stand on one leg, grab your ankle and pull your foot up towards your buttock. Make sure your knee stays parallel with your stand leg and does not move out in front of your body. Hold each stretch for 30 seconds and perform 2-3 times on both sides.

Standing Hamstring Stretch

Prop your foot up onto a chair or step. Slowly lean forward, bending at the waist until you feel a stretch behind your thigh. Maintain a neutral spine throughout the stretch and do not lean forward for extra distance. Hold each stretch for 30 seconds and perform 2-3 times on both sides.

Standing Calf Stretch

Stand facing a wall with one leg behind the other. Keep your back heel on the ground and lean forward toward the wall until a stretch is felt in the back leg. Your front knee should bend comfortably as you’re leaning forward. Hold each stretch for 30 seconds and perform 2-3 times on both sides.

Kneeling Hip Flexor Stretch

Place one knee on the ground (or on a pillow) and bring your other leg in front of you to achieve a half-kneeling position. While maintaining a neutral spine and upright posture, shift your hips forward until a stretch is felt in the thigh on your back leg (the one kneeling on the ground). Hold each stretch for 30 seconds and perform 2-3 times on both sides.

Posterior Shoulder Stretch

Reach one arm across your body. Use your other arm to pull at the elbow, taking the arm into more of a stretch. The stretch should be felt in the lateral or posterior shoulder, near the shoulder blade. Hold for each stretch for 30 seconds and perform 2-3 times on both sides.

Triceps Stretch

Reach one arm overhead, then bend your elbow as if to reach your hand down your back. Use your other arm to pull at the elbow, taking the arm into more of a stretch. Hold each stretch for 30 seconds and perform 2-3 times on both sides.

Upper Trap Stretch

Tilt your head to one side. Using the arm on that same side, reach over the top of your head and pull further to the side until a stretch is felt along the other side of the neck. Hold each stretch for 30 seconds and perform 2-3 times on both sides.

If you have any questions or any pain with these exercises, please consult a Therapydia physical therapist.

4 Easy Exercises to Reduce Running Injuries

Running Injury Exercises Stretches Physical Therapy Washington DC Running Stretches

Are you a runner? Chances are you have had some sort of leg pain or injury in the past. Some of you may have even sustained a longer-term injury. While there is no surefire way to prevent running injuries — trust us, we’d love to find that magic elixir as much as you would — there are ways to keep the body strong and limber enough to withstand all of the miles you are putting on it, whether you’re just going out a few times a week or training for your next marathon!

Exercise 1: Soleus Stretch

Let’s face it; most runners aren’t great about stretching, and the ones that are don’t always hit everything they should. The soleus is one of those oft-neglected muscles that could use some TLC, especially if you have had any Achilles issues in the past.

Running Injuries Physical Therapy Stretch

For this running stretch, position yourself like a normal calf stretch; move into a staggered stance, with one leg in front of your torso and one leg behind you. Keep the back heel down as you lean forward, but make sure to bend your back knee as you lean into the stretch. This one may feel a bit awkward at first, and you may need to have your feet a little closer together than usual. You can also put your big toe up on a small book or something similar to get more of a stretch in the soleus, Achilles, and even plantar fascia.

Exercise 2: Toe Yoga

Nothing is more important for a runner than taking care of your feet. Not only does this mean providing appropriate skin care and avoiding blisters, it also means keeping them nice and strong! Many runners who suffer foot or ankle injuries suffer from a lack of strength and stability within the foot’s intrinsic muscles. These muscles provide your base of support, and can affect everything else up the kinematic chain.

Running Injury Toe Feet Health Physical Therapy

For this exercise, you can either sit or stand with your foot flat on the floor. It is best to do this exercise barefoot at first, so you can see what exactly your foot is doing. Start by lifting your big toe up while keeping the rest of the foot relaxed and flat on the floor. Return your big toe to a resting position, and then lift your other toes up off the floor. You should be able to lift the other toes without the big toe curling; if so, your flexor hallucis longus (one of the muscles coming from your calf) is compensating for a lack of foot intrinsic strength. Keep working on this one until you can keep that big toe straight while lifting the others.

Exercise 3: Prone Hip Extension

Most PTs tend to focus on the hip abductors when evaluating runners for hip and knee pain, and for good reason! Runners only tend to move in one direction, resulting in weakness in the outside of their hips. However, their pain may not always be related to weakness in the gluteus medius, the main muscle responsible for hip stability on the outside of your hip. Instead, research is showing that weakness or a lack of firing in the gluteus maximus can result in hip and knee pain in runners.

Running Injury Prone Hip Extension Exercise Physical Therapy

For this exercise, lie face down and bend your knee up to 90 degrees or more. It may be a good idea to perform this exercise in front of a mirror at first to get a sense of where your knee is in space. Once in position, lift your foot straight up towards the ceiling, and focus on activating your gluteal muscles. If this gets difficult after 5 to 10 repetitions, keep working on it! Those glutes need to be nice and strong to keep you stable when running.

Single Leg Balance

If you break it down, running is merely the body jumping back and forth from one foot to another. You will never have both feet on the ground at the same time when running, so it is extremely important to have good balance on one leg!

Running Injury Single Leg Stance Exercise Physical Therapy

This one is as easy as it sounds. Stand on one foot! It may be better to do this barefoot at first, as you want to avoid your toes from “splaying,” or spreading out and trying to grip the surface you are standing on. If this seems easy, progress to standing on carpet, a pillow, or a piece of cushy foam to create a more unstable surface, forcing your foot and leg to stabilize even more.

How to Prevent ACL Injuries for Athletes

Washington DC Physical therapy soccer ACL injury recovery injury prevention

By Robert Rogacki, PT, DPT, CERT. MDT

If you play soccer — or have played on a team in the past — chances are you know someone who has torn their anterior cruciate ligament, or ACL. It’s just a matter of probability, really; female soccer players are 4-8 times more likely to suffer an ACL injury compared to the normal person, and the injury rate is higher than average for males as well. While surgical interventions have come a long way in helping athletes recover from these injuries, wouldn’t we be better off preventing them in the first place?

What is the anterior cruciate ligament?

The ACL is a ligament within the knee that is essential for stabilization during running, jumping, cutting, and twisting; basically, everything that soccer players are doing on the field. Most ACL tears are non-contact injuries, and occur while cutting or changing direction.

Why do ACL injuries occur and how can we prevent them?

Most ACL injuries occur as a result of valgus forces at the knee, or an inward movement of the knee when jumping, landing, or cutting. Avoiding these movements is not easy. It takes concentration and practice to learn correct movement patterns that avoid putting excessive stress on the knee and the ACL.

Here are a few easy exercises that will help soccer players (and other athletes!) decrease their risk of ACL injuries.

Side-lying Hip Abduction

Lie on your side with your bottom knee bent for support. The top knee should remain straight, and in a straight line with your torso. It may be helpful to lie with your back against a wall at first to get a sense of the proper hip position. Once in position, keep your top knee straight and toe pointed forward, and lift your leg straight up into the air (think about lifting with your heel). Stop when you start to feel your pelvis rotate. It may be helpful to keep your top hand on your hip during the exercise.

Why it’s important: Knee and leg strength are important for injury prevention, but so is hip strength. Strengthening the hip abductors (or the outside of the hip) can keep the hip in a more neutral position, which will in turn help knee the knee more neutral as well.

Standing Squats (With Proper Form!)

Squatting is a normal functional movement, but people have a lot of trouble with correct form when squatting for exercise. There are two key points to note here: (1) keep your knees from bending inward when squatting. The kneecap should stay even with or slightly outside of the toes.

Also (2), it is important to keep the knees from moving too far forward relative to the foot and toes when squatting. Many people have trouble activating their gluteal muscles when squatting, leading to a forward position that puts excessive force on the front of the knee, including the patellar tendon.

Why it’s important: Proper squat form is a precursor to proper knee bending form when running, jumping, and other high-impact movements. By learning how to activate your glutes and “sit back” into a squat, you will avoid putting excessive stress on the knee joint.

Standing Reach and Row

Stand on one leg with your knee slightly bent and either a weight or a band in front of you. While maintaining a slight knee bend and level trunk, lean forward to grab the weight or band. Allow the opposite leg to come up, ensuring you are hinging at the hip. Prior to rising back up, focus on elevating your glutes (on your stance leg) to help you return to a vertical position.

Why it’s important: Maintaining proper form when running, jumping, and cutting isn’t just about strength; balance and stability are important too! This exercise is a nice catch-all for many of the things PTs focus on when rehabbing patients with ACL injuries, and is beneficial for those looking to avoid injury as well. It helps improve standing balance, forces the athlete to focus on maintaining proper knee position, and strengthens the hip and glute muscles all at once!

Strengthen Your Abs Without Getting Back Pain

ab-exercise-no-back-pain

In most cases, strengthening is pretty easy. Find a weight, lift it up and down several times, and move onto the next exercise. But abdominal strengthening has continued to vex people, leading them to persist with the same standby exercises: sit-ups and crunches.

However, studies show that these exercises can lead to back pain and most people don’t even use their abs for sit-ups! Full sit-ups involve heavy use of the hip flexors; while it’s important to strengthen this muscle group too, this exercise isn’t accomplishing the desired goal.

So, skip the sit-ups! Here are a few exercises that are both easier on your back and harder on your abs, giving you more bang for your buck while helping you avoid low back pain.

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Exercise 1: Planks

These may look easy, but planks are a challenging full body exercise that force you to activate your entire core. Prop up either onto your elbows (low plank) or hands (high plank), maintain a rigid core and hold! The amount of time is up to you but you should stop when your abdomen starts to drop toward the floor; this is a sign of fatigue. If possible, perform this exercise alongside a mirror at first so you can gauge proper hip and pelvis position.

 

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Exercise 2: Side planks

When working on abdominal strengthening, most people neglect their obliques, or the muscles along either side of your abdomen. One good way to strengthen them is with side planks! Start by lying on your side, then prop onto your elbow or hand and lift your hips off the ground. Again, the hold time is up to you but you should stop when your abdomen starts to droop. Make sure you stay nice and level too! Most people tend to lean too far forward. Performing this exercise in front of a mirror at first is a good way to learn proper side plank position.

 

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Exercise 3: Bird dog

Patients who have seen a physical therapist for low back pain before might be familiar with this one. Bird dogs are a great exercise for many muscle groups, including your lower back and core. Start in a kneeling position with your hands on the ground (or a mat). Extend one arm and the opposite leg while contracting your abdomen to maintain a level core. Slowly lower both extremities to the floor and repeat with the other side. Ideally, the extended arm and leg will be completely horizontal but the most important part of this exercise is keeping your trunk nice and stable.

 

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Exercise 4: Bridges

Bridges are another old standby exercise for hip and core strengthening. Start on your back with your knees bent. Squeeze your glutes and your abdomen and lift your hips off the ground. Push all the way up until your abdomen is completely level, hold for a second or two and lower back to the ground. Longer holds are OK too but could put unwanted stress on your lower back if you don’t maintain a tight core. For an additional challenge, try flexing one hip and performing the exercise on just one leg!