I've been reading the articles on more, in depth assessments ie. muscle imbalances, one leg shorter etc and and am now looking for insight on the appropriate progressions for bringing someone along that might have a small curvature of the spine or uneven hips etc. I'm thinking you must focus on the weakened area in order to strengthen it and maybe then work up to more advanced exercises. But sometimes the exact problem area is not always to identify. Any articles on the next step, more less program design.
You need to ask a few questions if your client has a leg length difference or lateral pelvic tilt from a "small curvature" of the spine. The first question is "How" did this condition occur? Is it congenital or a car accident...? Has this small curvature been diagnosed by a health care professional? If so, what was the outcome? Clearance by the appropriate personnel is an important precaution.
Having disequilibrium between muscle groups is somewhat common. The question is how much difference between groups is there? By checking flexibility, strength and balance you can observe the level this dis-equilibrium.
Flexibility assessment checks the person for equal range of motion. A few general stretching positions are suggested below. Our web site also has some articles on improving flexibility. You may want to look at them for further ideas. Here are a couple to start with:
- Standing toe touches; most people avoid this stretch, but you can observe hamstring, low back and spine flexibility in one shot. Stand behind your client and look at the mid-back (thoracic) area. If scoliosis is present one side of their back will be noticeably higher. Standing to the side will show you hamstring and back tightness.
- Standing quadriceps stretch; if quads are tight it will be hard for them to grab their ankle to achieve the stretch. And, when they do their pelvis-low back will be hyper extended. View them from the side and back when they stretch. If they are real tight, a twisting type motion will occur from their shoulder to help alleviate the tightness.
Independent muscle strength can be tested relatively easy. This means using one side at a time and can be accomplished by several exercises. To start, explain the appropriate way to do the exercise and give them a warm set. Increase the weight to what you guestimate to be a 10RM. Then let them go to max. reps. What usually happens is the person will start with their dominate side first. This gives a good RM test for the "strong side" and if their is weakness it will be shown when the less dominate side takes a turn.
Here are a few suggestions:
- Hip Extension Machine; working muscles arespinae erector group, glutes and hamstrings. There are other muscles involved, but these are the main target.
- Single Leg Press will show R.O.M. and strength differences.
- One Arm Pulldown(cable system)
- Dumbell One Arm Curl
- Dumbell One Arm Press
- Seated One Arm Chest Press(machine)
- Your favorite abdominal exercise
After the testing is complete you will have an idea of where your client is strong & weak. Then train accordingly.
The Wobble Board, Tilt Board or Dyna Disc are simple tools to help view balance. Simply have your client stand on the board or disc and hold their balance. Then move them to 1 foot. This should show the superior- inferior side difference and the training needed.
Other suggestions; train the weak side first. This will eliminate the tendency of increasing dis-equilibrium. Also, our web site has several articles using the Exercise Ball for a work out. The Ball creates a balance training effect along with variety and fun. Good Luck with the training and let us know how it goes, Aloha.
- Rasch,P.and R.Burke. Kinesiology and Applied Anatomy 6th edition. Lea&Febiger
- Dintiman,G.et al. Sports Speed 2nd edition. Human Kinetics