Balance. Coordination. Strength.
Indications and Clinical Use
- Individuals that would benefit from the health benefits of Neuromotor and Strength activities.
- Conditions related to instability and poor coordination:
- Neck and lower back pain
- Anterior knee pain.
- Recurrent shoulder dislocations and rotator cuff injuries.
- Chronic hamstring strains/ other muscle strains
- Pelvic and groin pain.
- Chronic ankle sprains
- Most chronic, overuse injuries of the shoulder, spine and knee.
- Prevention of osteoporosis and fall injuries.
- Any medical condition that can be aggravated or made worse by physical activity, including but not limited to:
- Heart, Lung, or Metabolic Disease
- Acute injury
- Active arthritis
- Less experienced individuals should consider participating in mobilize sessions first.
- Patients in the sub acute and chronic stages of healing will likely need to modify certain activities.
- These workouts have a high skill requirement - patients may get annoyed because they feel uncoordinated or have trouble performing the exercises correctly at first. Instruct beginners to ask for the simplest progressions of the various exercises.
- Patients with histories of chronic or recurrent pain may experience aggravation or worsening of symptoms at first. A trial and error period is often necessary for patient’s and staff to learn what individualized modifications are necessary for each patient.
- Rotator cuff and shoulder stability exercises can cause a stiff or irritated feeling for beginners – assure patient and encourage light resistance with gradual progressions in volume.
- As with any exercise program, some positions may prove uncomfortable for patients (for instance the wrists may be uncomfortable in front support) – patients should be encouraged to ask instructors for modifications rather than take a ‘no pain no gain’ approach.
Sample Heart Rate Summary (Polar)
- 1-3 appointments per week, or 60-180 minutes per week.
- Maintenance of Stability
- 1-2 per week (60-120 min/ week)
- Improvement of Stability
- 2-3 per week (120-180 min/ week)
- To get up to higher doses, never add more than 60 minutes of additional mobilize sessions per 2-week period. Thus, a beginner would take 5 weeks to work up to 180 minutes per week.
- Re-evaluate at 2-4 months
- Exercises that bias the small, stabilizing muscles around the:
- Lower back and pelvis
- Scapula and Shoulder Joint
- Foot and ankle
- Typical activities:
- Muscle isolation
- Hip rotators, abductors and adductors
- VMO and Hamstrings (knee)
- Lower Trapezius, Serratus Anterior and Rotator Cuff (Shoulder)
- Spinal stabilizers such as multifidus and deep neck flexors
- Peroneals, Tib Anterior and Posterior (Ankle)
- Oblique abdominals and Transverse Ab
- Low resistance, full body activities that emphasize endurance and proper technique.
- Reverse lunge with medicine balls or functional trainers, thoracic rotations with functional trainers, pushing, pulling, squatting, lifting movements
- Moderate intensity cardiorespiratory activities (ex: bike, treadmill, resistance activities)
- This is the recommended “step 2” for most patients, as these appointments require more skill and coordination than the Mobilize sessions.
- Typical Timeline
- 20 minutes – Dynamic Warm up with equal parts flexibility, Neuromotor, and Cardiorespiratory activity.
- 20-30 minutes – Moderate intensity strength endurance and cardiorespiratory activity.
- 10-20 minutes – Cool down with targeted muscle isolations for local stabilizers.