Monday, April 10, 2017

Assessing and Improving the Hollow Body Position w/ Dr. CJ DePalma PT, DPT

Intro & Simplified Kendall Leg Lowering Test:


#MondayMusings:
From @the_movement_dr:


This week I teamed up with Doctor of Physical Therapy candidate, CrossFit coach, #CWCC & @clinicalathlete student forum member, @physio.praxis to use the reliable and valid #KendallLegLoweringTest as an objective measure to determine where your athlete or patient is on the #HollowBody spectrum.


Scoring is as follows:
3 - From 90 to 45 degrees: These athletes will compensate through the hip flexors, extending the lumbar spine when asked to hold a hollow just off of the ground. They will build upon dysfunction in an effort to get into appropriate position.
2 - From 45 to 15 degrees: These athletes maintain control throughout most of the movement, but begin to lose that control at the end range of movement - say on a heavy-ish shoulder to overhead or after a few toes to bar.
1 - From 15 to 0 degrees (or to the ground): These athletes exhibit good strength, endurance, and control of the anterior core and are well prepared for loading and dynamic movements.

Here @dani.f.baby would be on the border of 2 & 1. 


Over the next few weeks we will be providing exercise progressions and suggestions to build upon where the athlete currently stands. Keep in mind, core strength and endurance can be subjective—but this system aims to provide a starting point for you, your athlete, and/or your patient. Tune in next Monday for the first progression, or for the full series, follow the link in @praxis.physio's bio! 

Cite:
Staniszewski B, Mozes J, Tippet S. The relationship between modified sphygmomanometer values and biomechanical assessment of pelvic tilt and hip angle during Kendall’s Leg Lowering Test of abdominal muscle strength. Proceedings of the Illinois Chapter of APTA, Fall, 2001.



Level 3 First Progression: Single-Leg Active Leg-Lower:



#MondayMusings:
This test is a good starting point for those athletes who have difficulty getting into the hollow position. By taking a limb out of the equation, we reduce the force demand of the core and the difficulty of the task.

Many athletes make a common fault when “contracting” the deep core, or transverse abdominus (#TrA), where a hyperactive or excessive contraction is produced. This in turn engages the lumbar parapsinals -- creating over extension of the lumbar spine.

Points of Performance:
-Exhale the entire downward motion of the exercise while keeping the lumbar in contact with the ground.
-Once 15 degrees is reached, the athlete will isometrically hold—inhale and exhale—then bring the leg back up to 90 degrees.
-Avoid External Rotation of the leg, focus on keeping the leg linear throughout the full movement.
-Repeat 8-10x


Progressing from Level 3 to 2: Dead Bug Upper Extremity Isometric Variant


#MondayMusings:
The #DeadBug against the wall is a good starting point for those with a score of 2, or as a warm up/ramp up for athletes who score a 1 prior to lifting or gymnastic movements. This variation employs the use of upper extremity isometric firing to light up the central nervous system (#itsLIT), which in turn increases neural firing to the deep core musculature.

Points of Performance:
-Forceful exhale prior to initiating the movement followed by a quick inhale to breathe into the created tension while pressing into the wall or weight.
-Raise the tailbone slightly off of the ground and lower one leg slowly. Make sure that the pelvic positioning is maintained during this eccentric motion
-Repeat for 5-6 breaths per side.


Tune in Monday for the next progression with @the_movement_dr, or head over to #MusingsOfMills -- link in bio. 


Level 2-ish: Plank to Pike on Rower:



#MondayMusings:
Our 3rd installment for the #KendallLegLoweringTest is the Plank to Pike on Rower. This exercise is for those who scored a high-level 2, moving closer to a 1 during the test.

The starting position of this movement is opposite to the starting test position and the previous two exercises. We begin in a bottom up fashion: starting in a plank then working towards a Pike. By doing so, we are able to increase our initial lower core engagement in a concentric fashion.

We need variance to create change, and this movement fulfills just that.

Points of Performance:
- ROM may become an issue, just pike as high as you can and the exercise will still maintain the benefits.
- Exhale as you pike up
- Hold for 1 to 2 seconds at the tope
-Slowly lower the body back down
-Repeat 4-5x 


Levels 2 to 1: Bar-Supported Leg Raise:


#MondayMusings:
In our second to last exercise, again for those on the border of 2 & 1, we use a barbell (or heavy resistance band) to externally cue the athlete (@dani.f.baby) to maintain a #hollowbody position while perform an active leg raise.

Points of Performance:
-Begin by exhaling and elongating your spine, while gently hollowing the low back into the bar or band
-Brace the core, squeezing the feet and quads together synchronously.
-Initiate the movement with your lower abdomen (focusing on engaging the internal obliques and TrA) similar to how you did with the #pike.
-Only lift so high as you can maintain the position without compensation, i.e. beginning position.
-Repeat for 5-6 reps/breaths or until fatigue


This can be paired with a #hollowarch to begin working on the movement specificity needed to perform all #kipping movements, especially if you turn into a #FloppyBaby as soon as you attempt full speed. Tune in next for the final exercise - or visit #MusingsOfMills -- link in bio .  

Level 1: Strict Hollow Body to Arch


#MondayMusings:
For the athletes who have made their way through the progressions or for those who scored a 1.

The Hollow Body to Arch Strict Transitions are the ideal precursor to any kipping Bar or Ring movements.

Focused and controlled transitions will help engage the #Lats and #Trunk in the free-hanging #HollowBody position, as well as improve our bodies kinesthetic awareness as we engage in movement towards an arched position.

Points of Performance:
-Do not swing. Stay as still as possible. Synchronous, co-contraction.
-Keep your body elongated and your feet touching.
-Each transition from Hollow to Arch should take roughly 3-5 seconds
-Repeat 8-10x
     

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