Abdominal Function

All too often the thought of “training” the abdominals comes as an afterthought in the fitness program. Frequently done at the end of the exercise session or as an active recovery between sets of other body part training, we think three or four sets of endless abdominal crunches will provide the necessary impetus to adequately strengthen the abdominals. Recent literature discusses the multi-joint, multi-planar movements in functional training; should we re-think our approach to training of the abdominals to optimize their function?

The abdominals are the “command center” when performing any movement pattern. They are actively involved in walking, running, cycling, swimming, jumping, turning, pushing, pulling, bending, extending, reaching, throwing or lifting. In each of these activities, the abdominals go through a lengthening phase and then a shortening phase, all within three planes of motion. Like all other muscles in function, the abdominals are most efficient when they first pre-load or eccentrically lengthen, then unload or concentrically contract. The physiology of muscle function reflexively contracts more forcefully and efficiently when it lengthens before it shortens. For instance, when a soccer player throws a ball from out of bounds, he or she first brings the ball overhead and then propels a forceful throw into play. If the throw were attempted without the overhead “pre-load,” the throw would be considerably less forceful. The ability to generate force on the inbound throw is largely based on the ability to lengthen the abdominal musculature and store energy, followed by a more efficient and forceful shortening. Yet, most of the traditional training of the abdominals (i.e., abdominal crunches) has been to only shorten, and not lengthen, when performing. Additionally, the typical abdominal training occurs only in one plane of motion.

Let’s briefly examine the traits of human movement and the actions of muscles in motion.

Human Movement Traits

Characteristics of human motion encompass movement within a three dimensional environment. Nearly all the joints and muscles in the body move in the sagittal, frontal and transverse planes. Each movement has a degree of flexion/extension (sagittal plane motion), abduction/adduction (frontal plane motion) and rotation (transverse plane motion). Some actions have more influence on one plane versus another. Nonetheless, there is motion at each joint in all three planes during free motion. The movements in the sagittal and frontal planes must overcome the resistance of parallel (downward) forces of gravity upon the body. In many instances, the forces of the load and gravity (as well as the bony structural restrictions in the range of motion) limit the action. In the transverse plane, movements are perpendicular to gravity, and the exerciser must decelerate the action through pure muscle strength and without the effects of gravity. Often this happens before they transform into the propulsive phase of the work. Based upon this premise, exercise and training programs should incorporate movement patterns in the three planes of motion and not isolate a joint or muscle group in only one plane of motion. Any time we limit action of an exercise to one plane of motion, the exercise is not functional in respect to human movement.

Re-thinking Muscle Actions in Motion: Transition

Momentum and the equal and opposite ground reaction of the body’s force upon the ground cause movement. Muscles control the movement. When examining human function, all muscles have similar actions that must decelerate motion before it can accelerate motion, and in most activities, they need to overcome gravitational forces. Muscles decelerate or control actions while they are being lengthened or loaded. As the lengthening occurs, energy is stored as the muscles are being “primed” for a propulsion or acceleration of movement. In reality, the muscles act to control the motion during the entire cycle of events but do not necessarily initiate the action. For example, if a person is going to jump, he or she often takes a short step and allows gravity to cause them to dorsiflex at the ankle, flex at the knee and hip, and flex the spine slightly to prepare the body for flight. As this preparation is taking place, the muscles are decelerating the downward force of the body weight caused by gravity and storing energy as they are eccentrically lengthening or “pre-loading.” The body must be able to absorb the downward forces from gravity as well as the weight of the body itself and simultaneously create a reaction from the pressure placed against the ground as the individual transforms into a leap. During the transformation, the individual must react from a deceleration phase and convert the stored energy into an acceleration phase, allowing the muscles to react by concentrically shortening muscles that propel him or her upward. The plantar flexion of the ankle, knee and hip extension, along with spinal extension, is a concentric movement that propels, unloads and accelerates. Without the “pre-load” in all three planes of motion, the individual will not “unload” with an efficient and forceful leap. Imagine trying to jump without the pre-load phase. It would be weak, inefficient and non-functional.

As stated above, an important characteristic of human function is the muscle’s reaction to transform energy from the eccentric or pre-load phase to the concentric or unload phase. To accomplish this, the body integrates multiple joint movements, resulting in greater coordination and thereby enhancing the pure functional effectiveness of the movement. We must also take into account that the performer must pass through a stabilization or balance moment when he or she transforms from the lengthening or deceleration phase, causing a reduction in force before the propulsion or acceleration phase and therefore causing force production.

Abdominal Integration

As transformation is imperative for optimal movement patterns, most common abdominal exercises do not embrace the above characteristics of human motion. Much of the traditional methods of training have occurred in the sagittal and frontal planes. Most abdominal exercises are performed in non-functional positions that isolate the abdominals from the rest of the body and often do not integrate the hips, spinal stabilizers and lower extremity within the exercise itself. On the other hand, if the majority of activities are done from the standing position, the adaptation of abdominal training can and should mimic some actions in real human motion.

To demonstrate the action of the abdominals in walking, imagine the left foot swinging forward. When the heel strikes the ground, the pelvis anteriorly tilts (sagittal plane action), which lengthens the abdominals to the front and downward. Simultaneously, the left arm swings back, causing the left shoulder to move posteriorly as the thoracic spine rotates to the left (transverse plane action). This causes the abdominals to lengthen up and backward. As the weight of the body begins to pass over the left and now supporting leg, the left hip hikes up while the right hip drops down. This causes a “pulling” of the abdominals laterally (frontal plane action). As these reactions are occurring, inherent to this action is the rotation of the hips, shoulder and back through the transverse plane, adding additional lengthening and tension to the abdominals to allow a more forceful and efficient reaction. This lengthening allows a smooth transition for the same reaction to occur on the right side during the gait cycle. The chain reaction associated with walking causes the abdominals to lengthen prior to shortening as they function to stabilize the torso within all three planes of motion. In “normal” gait processes, we do not realize the efficiency the abdominals provide when walking. In contrast, notice the difference in effort required while walking with your hands in your pockets or on your waist. The pre-load or lengthening reaction has been reduced, causing more energy requirement for the gait cycle.

Abdominal Architecture

When viewing the abdominal group, one can see the arrangement of the fibers in all three planes. The rectus abdominis has a vertical arrangement to enhance movement within the sagittal plane. The origin of the rectus abdominis is the pubis symphysis. The insertions are the xiphoid process and ribs five through seven.

The external obliques have a diagonal arrangement to enhance the rotational movements that are inherent in the transverse plane. They originate at the borders of the eight ribs at the side of the chest, merging with serratus anterior and insertion is anterior half of iliac crest, inguinal ligament, fascia of rectus abdominis. The external oblique attaches to the rectus abdominis; both these muscles will be affected by movement of one or the other.

The internal obliques originate at the upper half inguinal ligament, anterior two thirds ileum crest, lumbar fascia and insert eight to 10 ribs and linea alba. These attachments form a network with the external obliques by their attachment at the iliac crest and ribs, as well as the rectus abdominis, by way of connecting with the linea alba of the rectus. Additionally, its attachments are part of the “connection” to form the relationship and strength of the lumbar spine. The lumbar spine is greatly influenced by the motion of the gluteals and hips; therefore, a case can be made that the abdominals are impacted by the hips and gluteals in all movement patterns.

The transverse abdominis has a horizontal configuration to allow frontal plane actions. Its origin is the outer one-third inguinal ligament, inner rim iliac crest, lower six ribs and lumbar fascia. The insertion is the pubic crest and iliopectineal line (close connect with the obliques) and aponeurosis of linea alba (connects to rectus abdominis). It becomes very obvious the abdominals all attach at one point or another and create a synergistic unit that cannot be isolated; rather, they work as an integrated unit. For this reason, the abdominal unit must be trained through an integrated approach.

Because these muscles all attach to the pelvis, the tri-plane motion of the hips and pelvis creates reactions in all the abdominals when actions are initiated. Likewise, all the abdominal muscles attach to the ribs; therefore, motion in the thoracic spine will also create a reaction of the abdominals when properly trained. All movements in any facet of life or sport require the motion of the pelvis and thoracic spine. In fact, two of the most mobile regions of the body are the hips and thoracic spine. To enhance performance and reduce risk of injury to other regions of the spine and body, it is critical to maintain adequate mobility AND good strength and stability in the hips and thoracic spine. In view of that, it appears logical to appropriately train the abdominal in a functional manner involving actions of the pelvis and thoracic spine.

Muscle Tightness and Abdominal Function

It is interesting to study the chain reactions of gait and movement and how the abdominals can affect or are affected by tightness in other regions of the body. A few examples can demonstrate the keen balance that is required for “normal” function. In the apparently healthy populations, it is important for the calf to have adequate range of motion to allow proper loading or lengthening of the hips, which in turn will allow proper loading of the abdominals. Referring back to the gait cycle, as the person is preparing to take a step forward, the trail leg has the heel on the ground while the ankle is in a dorsiflexed position. If the calf muscles are able to lengthen, this will allow adequate dorsiflexion, which slows the tibia so the hip can continue ahead of the foot. As this happens, the hip can then properly lengthen and load, which will cause the hip to rotate anteriorly. This anterior rotation will lengthen the abdominals in the sagittal plane. As proper motion occurs in the sagittal plane and the body approaches mid-stance in the gait cycle, there will be greater excursion through the frontal plane, which will allow the abdominals to lengthen optimally. It then becomes necessary to control motion in the frontal plane to prevent loss of balance and stumbling to the side. While the left leg is still trailing the left hip, this will reflexively cause the left shoulder to extended, pulling the pectorals and abdominals into a lengthened position and thus stimulating the abdominals in the transverse plane. However, if there is tightness in the left calf and the ankle in unable to dorsiflex in the sagittal plane, the motion in the frontal and transverse plane will be reduced and less stimulation of the abdominals will transpire (see Figure 1 below).

Figure 1

If this situation continues over the long term, muscles shorten and become inhibited, reducing proprioception and creating numerous compensations. In this example, it is possible for a tight ankle, calf or hip flexor to cause improper functioning of the abdominals. Likewise, if the shoulder motion is limited, this will affect the extension (sagittal plane action) and rotation (transverse plane action), causing less stimulation of the abdominals. If we extrapolate the effects to the lower extremity, we often see reduced movements in other joints of the hip and leg, resulting in compensations and overuse the more these structures are stressed. If this situation or similar circumstances develop, this could affect motions such as throwing, twisting, golf or racquet sports swings, pushing movements, skating patterns or a myriad of other movement patterns. When there is limited range of motion in one part of the body, it will affect the abdominal function and will impact other parts of the body.

When looking at the gait of many elderly people, they often exhibit a “shuffle-like” walk that is inhibited in the frontal and transverse planes. The inhibited and shortened abdominals and pectorals contribute to a slouched, kyphotic posture, thereby reducing abdominal function in three planes of motion and torso rotation. This waddle is the compensation that has developed while ambulating. Common tendencies of these gaits are weak and inhibited muscles of the gluteals, tightness of the lateral gluteal complex, and overuse of the tensor fascia lata and iliotibial band. Due to the muscle shortening, the muscle spindles become desensitized and the ability to move further into the frontal and transverse planes becomes lessened. Many of the discomforts these people face are caused by muscular tightness that can be alleviated by stretching in all three planes of motion. Additionally, as they stretch, this stimulates the muscle spindles allowing the muscle to stretch further, which reflexively will cause greater eccentric strength. In cases such as these, when controlled, dynamic movement patterns that gradually increasing in range of motion, are integrated into the fitness program, the person is gaining both flexibility and strength. In such cases, this population can help slow or reverse the atrophy associated with little-used muscles.

Abdominal Training

Effective training of the abdominals does not necessarily require a “separate” exercise alone. Effective abdominal training should incorporate many of the larger movement patterns, often positioning the performer in stances of gaits that mimic the desired action and should involve a degree of rotation. Additionally, the movement should include a pre-loading or lengthening phase followed by an unloading or shortening phase, should be tri-planar in nature, and ground reactive. This “pre-load/unload” cycle will create an efficient and forceful reaction that can enhance performance, no matter what the activity may be.

I have found the following exercises to be effective for the development of the abdominals and will enhance function in all three planes of motion. They also benefit the gluteal complex, legs, back, and scapular musculature. The bold type exercises are examples of basic, body weight movement patterns, progressing to slightly more complex exercises.

• Basic Abdominal Functional Gait
• Excursion
• Anterior Lunge w/ OH Reach
• Frontal Plane Lunge w/Frontal Plane Reach
• Transverse Plane Lunge w/ Transverse Plane Reach
• Anterior Lunge w/ Drop Step
• Tri-Plane Lunge w/ Oblique Reach
• Medicine Ball
• Wide/tight rotation
• Figure 8s
• Wood Chops
• Medicine Ball Reverse Overhead Toss
• Stability Ball
• Stability Ball Rollout
• Stability Ball Wheelbarrel Walkout
• Pike
• Russian Twist
• Tri-Plane Shoulder Press
• Oblique Cable Pull
• Frontal Plane Walk w/ Overhead Reach

When fitness and health professionals develop an appreciation for the function and integration of the abdominals, they can begin to understand the great impact these structures have on the entire body. A strong, stable abdominal region will directly affect the lumbar spine and serve as a bridge from the lower extremity to the upper extremity. If these muscles are worked and developed through an integrated tri-plane approach, the fitness professional not only enhances their exercise toolbox, but also greatly impacts the activities of daily living for their clients’ health and well-being.

Basic Functional Oblique and Gait Exercises

This exercise is based upon the creative genius of Gary Gray, P.T.

Targeted Muscles: Rectus Abdominis, Internal Oblique, External Oblique, Transverse Abdominis

Objective: Functionally develop the abdominals in three planes of motion from the gait weight bearing position.

Level: Developmental

Rationale: During the gait cycle, as the foot comes in contact with the ground and the corresponding leg becomes weight bearing, the same side pelvis goes into an anterior rotation. This lengthens the rectus abdominis and the obliques on that side. As weight transfers over the leg, the pelvis shifts to the weight bearing side causing a frontal plane eccentric load to the abdominals. Concomitantly, the same side shoulder extends causing thoracic rotation and a lengthening of the abdominals in the transverse plane.

Technique: The rotational component of this exercise is important for proper training. If the client has limited range of motion in the pelvis or thoracic spine, the full effect of this exercise will not be obtained. Additionally, the rotation will be compensated by the lumbar spine instead of the pelvis and thoracic spine, thereby increasing risk of injury to the lumbar region. Have the client stretch the pelvis and thoracic spine in the three planes of motion prior to beginning any program.

1. Stand with the back to the wall. The distance from the wall will depend upon the strength and range of excursion of the thoracic spine and pelvis the individual possesses.
2. Feet are shoulder width apart.
3. Place one foot approximately a half of the foot’s length forward to the other foot.
4. Flex the opposite shoulder simulating the gait motion of the shoulder in relation to the opposite leg during gait. (as shown in the accompanying pictorial)
5. The same side shoulder of the weight bearing leg will extend similarly as in gait.
6. Rotate the pelvis and thoracic spine so the shoulder on the lead leg side will posteriorly rotate and touch the wall. This lengthens the abdominals in the transverse plane.
7. Immediately after touching the wall, return to the starting position.
8. Repeat at a pace of one per second for 30 seconds, building toward 60-second bouts.

Anterior Lunge with Overhead Reach

Targeted Muscles: Rectus Abdominis, Internal Oblique, External Oblique, Transverse Abdominis, legs, gluteals

Objective: Functionally develop the abdominals in the sagittal plane from the gait weight bearing position.

Level: Developmental to intermediate

Rationale: During the gait cycle, as the foot comes in contact with the ground and the corresponding leg becomes weight bearing, the same side pelvis goes into an anterior rotation. This lengthens the rectus abdominis and the obliques on that side causing a sagittal plane eccentric load to the abdominals. Concomitantly, the same side shoulder extends causing thoracic rotation and a lengthening of the abdominals in the transverse plane.

Technique: The rotational component of this exercise is important for proper training. If the client has limited range of motion in same side hip flexors or thoracic spine, the full effect of this exercise will not be obtained. Additionally, the extension will be compensated by the lumbar spine instead of the pelvis and thoracic spine, thereby increasing risk of injury to the lumbar region. Have the client stretch the pelvis and thoracic spine in the three planes of motion prior to beginning any program.

1. Start with feet shoulder width apart
2. Imagine standing in the middle of a clock. Lunge toward the 12 o’clock position.
3. Lunge forward to a point when the tension is felt in the quads and gluteals.
4. Simultaneously each overhead with the same side shoulder girdle of the trailing leg (think about reaching with the scapula so the shoulder will go into flexion rather than just the elbow).
5. One the terminal endpoint is reached, immediately return to the start position.

Frontal Plane Lunge with Side Overhead Reach

Targeted Muscles: Rectus Abdominis, Internal Oblique, External Oblique, Transverse Abdominis, legs, lateral gluteals, opposite adductors

Objective: Functionally develop the abdominals in the frontal plane from the gait weight bearing position.

Level: Developmental to intermediate

Rationale: To lengthen the rectus abdominis and the obliques on that side causing a frontal plane eccentric load to the abdominals.

Technique: The rotational component of this exercise is important for proper training. If the client has limited range of motion in same side lateral gluteals or thoracic spine, the full effect of this exercise will not be obtained. Have the client stretch the pelvis and thoracic spine in the three planes of motion prior to beginning any program.

1. Start with feet shoulder width apart.
2. Imagine standing in the middle of a clock. Lunge toward the 3 or 9 o’clock position.
3. Lunge laterally (in this photo, the left leg is doing the lunging) to a point when the tension is felt in the quads and lateral gluteals. Notice the hips are over the knees and the knee is not outside the hip. The reason for this position is this creates greater relative internal hip rotation and more recruitment of the gluteus medius, minimus, and maximus to decelerate this action.
4. Simultaneously each overhead with the same side shoulder girdle of the lunging leg (think about reaching with the scapula so the shoulder will go into abduction rather than just the elbow).
5. One the terminal endpoint is reached, immediately return to the start position.

Transverse Lunge

Targeted Muscles: Rectus Abdominis, Internal Oblique, External Oblique, Transverse Abdominis, legs, lateral gluteals, latissimus dorsi, rhomboids, trapezius, spinal rotators

Objective: Functionally develop the abdominals in the transverse plane from the gait weight bearing position.

Level: Developmental to intermediate

Rationale: To lengthen the abdominal unit in the transverse plane and eccentrically load the abdominals.

Technique: The rotational component of this exercise is important for proper training. If the client has limited range of motion in the hip flexors, gluteals or thoracic spine, the full effect of this exercise will not be obtained. Have the client stretch the pelvis and thoracic spine in the three planes of motion prior to beginning any program.

1. Start with feet shoulder width apart.
2. Imagine standing in the middle of a clock. Rotate the hips to the 4 or 8 o’clock position and lunge toward the 4 or 8 o’clock position.
3. Lunge (in this photo, the left leg is doing the lunging) to a point when the tension is felt in the quads and lateral gluteals.
4. Simultaneously reach over the same side shoulder girdle of the lunging or forward leg (think about reaching with the scapula so the shoulder will go into abduction rather than just the elbow). 
5. When the terminal endpoint is reached, immediately return to the start position.

Oblique Cable Pulls

Step 3

Targeted Muscles: Rectus Abdominis, Internal/External Obliques

Objective: Develop the abdominal group through the transverse plane.

Level: Intermediate

Rationale: The obliques and hips are recruited when stabilizing a load through rotational and pulling movement patterns. The ability to lengthen the abdominals, particularly the obliques becomes critical during the rotational, pulling phase of motion.

Technique: The rotational component of this exercise is important for proper training. If the client has limited range of motion in the pelvis or thoracic spine, the full effect of this exercise will not be obtained. Additionally, the rotation will be compensated by the lumbar spine instead of the pelvis and thoracic spine, thereby increasing risk of injury to the lumbar region. Have the client stretch the pelvis and thoracic spine in the three planes of motion prior to beginning any program.

1. Utilizing a cable column, cable abdominal machines, or resistance tubing, align the client with their shoulder perpendicular to the machine or to the attachment of the tubing. In photo 1, the right shoulder is closest to the unit, the left hand is at the bottom of the handle and the right hand is midway up the attachment.
2. Be sure the navel is drawn in toward the spine and the client is in the “stand tall” position. The client’s hips are perpendicular to the machine. The movement is “driven” by pelvic rotation.
3. The left foot and lower extremity is slightly externally rotated about 45 degrees.
4. The motion is created by pushing off the right foot and rotating the hips to the left (relative right external hip rotation). This causes the right hip to anteriorly tilt while the thoracic rotation is to the right. The abdominals lengthen in the transverse plane. It is critical to keep the “stand tall” position and the navel drawn in. (refer to Step 2)
5. Be sure to hold the attachment above shoulder level to attain adequate transverse stretch. Perform spinal flexion to finish the movement pattern and further recruit the abdominals through the sagittal plane. It is important to have the client lower the hip to load the legs and hips and synergistically allow the glutes to assist through the deceleration phase.
6. When returning to the start position, extend the spine. The natural tendency is to allow the weight resistance to extend the spine. The abdominals must eccentrically control the movement so the spine does not go into hyperextension. It is critical to rotate the pelvis back to the start position. This will reduce the tendency to rotate in the lumbar region.
7. When reaching the start position, allow the weight stack to return to the rest position. By doing this, thoracic rotation will occur to the left. If this motion is resisted, the left latissimus dorsi and parascapular musculature will be recruited to decelerate the movement.
8. Perform 2 sets of 8 repetitions and build to 2-3 sets of 15 repetitions.

Transverse Plane Shoulder Press

Step 1	Step 2	Optional Opposite Shoulder External Rotation

Targeted Muscles: Deltoids, obliques, gluteus medius & minimus, peroneals, spinal rotators, shoulder girdle musculature

Objective: Enhance the relationship of hip range of motion and shoulder function through the transverse plane, while at the same time improve strength of structures through rotation from a weight bearing position.

Level: Advanced

Rationale: A strong relationship exists between adequate range of motion in the hips and proper function of the shoulders. This exercise is designed to enhance strength of the shoulders through the transverse plane, strengthen the conduit between the shoulders and hip through the abdominals and obliques. Additionally, the stabilizing action of the peroneals and hip abductors during rotation occurs when performing rotational movements.

Technique: When performing this movement pattern, it is critical the exerciser select weights that can use and proper form be maintained. A breakdown in form often occurs when weights are too heavy.

1. Stand with feet approximately shoulder width apart and dumbbells held just proximal to shoulder level.
2. Starting with the right hand, rotate the hips to the left while pressing the dumbbell to the 11 o’clock position (reference 12 o’clock is directly overhead) (refer to Step 2). Keep the left hand near the left shoulder joint, do not drop it out of the position. It is very important the hips rotate nearly 90 degrees when moving through the rotational phase of the movement, otherwise, the risk of back or hip pain increases. For this movement to be successful, there must be adequate range of motion in the hip flexors, obliques, thoracic spine, and left external hip rotators.
3. Return to the start position.
4. Repeat to the opposite side.
5. Perform 5-8 repetitions, building to 2 sets of 15 repetitions before increasing weight.

To add a scapular reaction moment of the opposite shoulder girdle, as the movement pattern is being performed, add adduction with external rotation of the opposite shoulder not doing the pressing movement. This will assist in the development of movements requiring the reaction of one side scapular abduction while the opposite shoulder girdle adducts.

Figure 8s

Step 1	Step 3

Step 2	Step 4

Targeted Muscles: Abdominals, Hips, Spinal Rotators

Objective: Functionally develop the abdominals, hips, and spinal rotators in a weight bearing, integrated mode in three planes of motion.

Level: Advanced

Rationale: During the gait cycle, as the foot is comes in contact with the ground and the corresponding leg becomes weight bearing, the same side pelvis goes into anterior rotation. This lengthens the rectus abdominis and the obliques on that side. As weight transfers over the leg, the pelvis shifts to the weight bearing side causing a frontal plane eccentric load to the abdominals. Concomitantly, the same side shoulder extends causing thoracic rotation and a lengthening of the abdominals in the transverse plane.

This exercise causes the body to decelerate and reactively accelerate motion against a resistance in all three planes. This movement pattern will train all muscles groups from the plantar surface of the foot to the cervical spine.

Technique: The rotational component of this exercise is important for proper training. If the client has limited range of motion in the pelvis or thoracic spine, the full effect of this exercise will not be obtained. Additionally, the rotation will be compensated by the lumbar spine instead of the pelvis and thoracic spine, thereby increasing risk of injury to the lumbar region. Have the client stretch the foot, subtalar joint, hamstrings, pelvis and thoracic spine in the three planes of motion prior to beginning any program.

1. Select a medicine ball or weight no greater than 5% of the individual’s body weight.
2. Hold the ball in front of the body at waist level.
3. Stand tall with the navel drawn toward the spine. Maintain the “stand tall” position throughout the movement pattern.
4. The motion of the arms will create a figure 8 pattern. It is important to reach at each point of the cycle.
5. Starting with the left leg, proceed forward and simultaneously raise the med ball on the oblique angle through the transverse plane to slightly above shoulder height of the left shoulder. Be sure the shoulder and pelvis rotates to the same side of the med ball (refer to Step 1).
6. As the client walks through the motion, the med ball swings down through the oblique angle through the transverse plane to the lateral aspect of the opposite hip level (refer to Step 2).
7. As the weight of the body transfers over the lead foot, the med ball is brought slightly above shoulder height of the same side shoulder (refer to Step 3). During this transition, it is important to rotate the hips and thoracic spine through this phase of the movement. If not, the lumbar spine will be required to perform considerable rotation, which is not conducive to lumbar spine function.
8. As the client walks through the motion, the med ball swings down through the oblique angle through the transverse plane to the lateral aspect of the opposite hip level (refer to Step 4).
9. Start with 5 repetitions per side and build to 12 per side, 3 sets.

Reverse Wood Chops

Note: The motion of the arms is a result of the rotation of the pelvis and torso. You can think of it as the arms are attached to the torso and are going for the ride. The arms do not pull the med ball through the movement pattern.

Targeted Muscles: Quadriceps, Hamstrings, Gluteal complex, Spinal Rotators, Spinal Erectors, Entire Abdominal Complex

Objective: Functionally develop the abdominals, hips, and spinal rotators in a weight bearing, integrated mode. Additionally, this exercise will train the musculature through the transverse plane, thereby requiring a strong decelerating action to control the motion.

Level: Advanced

Rationale: Movement patterns through the sagittal and frontal plane not only must overcome the external resistance that is being moved, but gravity as well. Additionally, both the resistance and gravity decelerate the action. In the transverse plane, the action occurs perpendicular to gravity and must be controlled and decelerated by muscular action without the direct influence of gravity. This exercise develops eccentric loading and control of muscles during rotation.

Technique: The rotational component of this exercise is important for proper training. If the client has limited range of motion in the pelvis or thoracic spine, the full effect of this exercise will not be obtained. Additionally, the rotation will be compensated by the lumbar spine instead of the pelvis and thoracic spine, thereby increasing risk of injury to the lumbar region. Have the client stretch the foot, subtalar joint, hamstrings, pelvis and thoracic spine in the three planes of motion prior to beginning any program.

1. Select a medicine ball or weight no greater than 5% of the individual’s bodyweight.
2. Hold the ball in front of the body at waist level.
3. Stand tall with the navel drawn toward the spine. Maintain the drawn in navel position throughout the movement pattern.
4. Starting with motion to the right, turn the pelvis toward the right knee by lowering the hip and rotating the med ball to the lateral side of the right leg. Be sure to maintain the neutral spine position. It is important to rotate the pelvis toward the right knee and not keep it facing forward (refer to photo Step 1).
5. Forcefully push off the right foot and rotate the pelvis to the opposite side while extending upward from the squat position. Do not pull the med ball, rather allow the arms to be “carried” by the torso rotation and bringing the med ball to the lateral aspect of the opposite shoulder. It is very important for the pelvis to face toward the left (Think of the navel facing to the left when completing the rotational movement pattern) (refer to photo Step 2).
6. Repeat the movement pattern starting with 8 repetitions and build to 2-3 sets of 15 repetitions before increasing resistance.

Fitness professionals must assess the tri-plane range of motion and muscle balance of their clients before developing a fitness program that involves integrated training. We all move the same; it is the speed, amplitude, and any osseous changes that are different among clients. It is our job to assess the client and determine a path by which they can attain their goals. With this in mind, all these movement patterns can be modified to meet the needs and limitations of each individual. As the client improves on strength and flexibility, the exercise can then be modified to increase range of motion, speed, repetitions, body angles, and use of external weights when appropriate.

Examples of Commonly-Used Exercises for the Elderly

Wallbanger

Targeted Muscles: Spinal rotators, spinal erectors, lateral gluteals, lower extremities

Objective: Promote lengthening and strengthening of the thoracic spine, hips, and lower extremities

Level: Developmental to intermediate: often used as a rehabilitation movement pattern.

Rationale: Often dysfunction and balance issues are a result of limited range of motion in the thoracic spine, pelvis, lateral gluteals and lower extremities. The wallbangers movement pattern is designed to lengthen and strengthen these muscle structures while enhancing movement through all three planes of motion, especially through the frontal plane. This exercise emphasizes the lateral gluteals, which are critical for stability in the frontal plane and balance. By lengthening muscles, the proprioceptors will be stimulated and improve balance and movement for the client.

Technique:

1. Stand in the “stand tall” position, abdominals drawn in, with the feet about shoulder width apart. Feet are pointed forward.
2. Stand about 6-12 inches away from the wall. The distance will vary among clients depending upon their range of motion through rotation, and strength of their lateral gluteals.
3. With the right shoulder closest to the wall, reach out to the left. Be sure the client rotates the hips toward the left foot, flexes the knees, drops the hips, and maintains a neutral lumbar spine.
4. As the client reaches to the left, the natural reaction is for the right hip to move toward the wall. Let the client’s right hip “bang” into the wall, and immediately return to the starting position. It is critical the client does NOT hold the reaching position, as this removes the elastic recoil tendency of the muscle and thereby removes the eccentric loading required in this movement pattern (The range of motion and rotation will vary depending upon the client’s ability to eccentrically load through the transverse and frontal planes. This action will become greater as the person improves range of motion, which will inherently and functionally improve strength).
5. Return to the start position by rotating the hips back to the left and the to the upright position.
6. Perform 8 repetitions and progress to 3 sets of 15 reps.
7. Repeat with the left shoulder closest to the wall and the action requires reaching to the right.

Basic Modified Matrix

Targeted Muscles: Spinal rotators, spinal erectors, lower extremities

Objective: Promote lengthening and strengthening of the thoracic spine, hips, and lower extremities

Level: Developmental: often used as a rehabilitation movement pattern.

Rationale: Often dysfunction and balance issues are a result of limited range of motion in the thoracic spine, pelvis, lateral gluteals and lower extremities. Additionally, proprioceptors are desensitized by shortened, inhibited muscles. The basic modified matrix is designed to lengthen and strengthen these muscle structures while enhancing movement through all three planes of motion, especially through the transverse plane. By lengthening muscles, the proprioceptors will be stimulated and improve balance and movement for the client.

Technique:

1. Stand in the “stand tall” position, abdominals drawn in, with the feet about shoulder width apart. Point the left foot to 12 o’clock and right foot at 3 o’clock.
2. Position the right arm in the abducted and externally rotated posture.
3. Rotate the hips toward the left leg and transfer weight to the left leg.
4. Reach with the right hand to a point between the left hip and knee. As the client reaches, it is imperative they lower the hip as they flex the spine so that the loading will be felt in the hips, legs, and low back (The range of motion and rotation will vary depending upon the client’s ability to eccentrically load through the transverse plane. This action will become greater as the person improves range of motion, which will inherently and functionally improve strength).
5. Return to the start position by rotating the hips back to the left. Be sure a weight transfer to the right leg occurs.
6. Perform 8 repetitions and progress to 3 sets of 15 reps.
7. Repeat with the left foot in the 9 o’clock position and the right foot in the 12 o’clock position. The left hand will then become the reach hand.

Related Reading

Chain Reaction Explosion Seminar. (2001). Wynn Marketing, Adrian, MI.

Chaitow, L. (1996). Muscle Energy Techniques. New York: Churchill Livingstone.

Carlsoo, S. (1972). How Man Moves. London: William Heinemann Ltd.

Clark, M.A. (2001). Integrated Flexibility Training. Thousand Oaks, CA: National Academy of Sports Medicine.

Dykyj, D. (1988, July). Anatomy of Motion. Clinics in Podiatric Medicine and Surgery, 5(3).

DeMont, R. & Lephart, S. (1998, April). Repetition Drives Neuromuscular Recovery after ACL Injury. Biomechanics.

Gambetta, V. Too Loose Too Much. Retrieved from www.gambetta.com.

Gray, G. (2001). Total Body Functional Profile. Adrian, MI: Wynn Marketing.

Inman, V. (1981). Human Walking. Williams & Wilkins.

Katch, F, Katch, V.L. & McArdle, W.D. (1986). Exercise Physiology: Energy, Nutrition, and Human Performance. Philadelphia, PA: Lea & Febiger.

Kurz, T. (1994). Stretching Scientifically - A Guide to Flexibility Training. Island Pond, VT: Stadion Publishing Company, Inc.

Myers, T.W. (2001). Anatomy Trains, Myofascial Meridians for Manual and Movement Therapists. Churchill Livingstone.

Powers, S.K. & Howley, E.T. (1990). Exercise Physiology: Theory and Application to Fitness and Performance. Dubuque, IA: Wm. C. Brown Publishers.

Simon, S., Mann, R., Hagy, J. & Larsen, L. (1978, June). Role of the Posterior Calf Muscles in Normal Gait. Journal of Bone and Joint Surgery, 60-A(4).