Functional Range Conditioning

Exercises for High Hamstring, IT Band, and Hip Pain

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A lot of runners, hikers, cyclists, and walkers will experience high hamstring, IT Band, or other hip pain in their lives. With 60% of runners experiencing high hamstring pain, and 50% of cyclists and 20% of runners experiencing IT Band pain, hip pain is one of the most common injuries/complaints among this active group. The good news is that with a little bit of prevention/intervention work, a lot of those aches and pains can be avoided.

The hip is a ball and socket joint which gives it its ability to move in a large variety of ways. The six motions of the hip are: external rotation, internal rotation, abduction (leg moving away from center), adduction (leg moving towards center), flexion, and extension. Tension and limited range of motion in the hip (and the whole body) can only be caused by 2 things – mechanical tension (structure limitation) or neural tension. Most of our day-to-day mobility restrictions are cause by the latter.

When expanding space in the hip capsule, rotation should be addressed over any linear limitations. Without the establishment of good rotation, both internal and external, other ranges such as flexion and extension will never improve. Good range AND control of both of these rotations should be the primary goal of anyone experience hip tension.

Below are a few exercises to help. When doing these exercises, there should be no pain. You should feel stretch in the long tissue (the part your are lengthening), but you should never feel restriction or pinching in the closed angle (where the body is shortening or folding). There should also not be pain in other joints like the spine and/or knees.

While both rotations should be explored, if you are primarily experiencing hamstring pain, you would want to focus on your hip internal rotation and control. If you are experiencing more IT Band symptoms, you should focus more on the external rotation movements.

First, explore your hip range with this exercise:

Next, let’s work on hip external rotation and hip extension first.

Now let’s work on hip internal rotation.

And then put it all together with hip CARs. This exercise can be done daily on its own as a warm up for a run.

Have questions? Reach out at Brenna@KoaFitUSA.com.

Exercises for Plantar Fasciitis and Achilles Pain

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While not the same, Achilles Pain and Plantar Fasciitis can come from the same mechanism – insufficient dorsiflexion. Dorsiflexion is the ability of your ankle to flex in a way that gets the top of your foot closer to your shin. How much you need depends on the movements you want to do. For example, at least 10 degrees is needed for walking on a flat surface and at least 15 degrees is needed to run on a flat surface. If you want to add hills or uneven surfaces to the game, you are going to need more.

Getting more dorsiflexion isn’t as easy as stretching your calves. In fact, stretching past your range of dorsiflexion is what probably caused the pain in your heel or achilles in the first place. When you dorsiflex, a bone called the talus rolls anteriorly, but then needs to glide posteriorly. Sometimes, we feel this lack of glide when we flex our ankles and feel a resistance or “hard stop” at the front crease of the ankle. This lack of glide overstretches the tissue on the backside of the ankle, and over time, can create inflammation at the heel or the achilles depending on where we are weaker, what’s happening with the rest of our gait, and other factors.

To gain back dorsiflexion, we need to establish heel rock. This is our ability to invert and evert at the calcaneus (heel bone). Watch the video below to practice this move.

After we understand inversion and eversion (and probably discover we lack eversion), we combine this motion with the entire movement range of the ankle.

After we establish this range of motion, we move on to working directly on our dorsiflexion. This next exercise can be hard the knees if done on the floor (as shown). You can modify it by placing the foot that you are working on up on a chair or table.

Once we increase the range of our dorsiflexion, we will want to gain control of it with this next exercise.

Finally, we want to work the eccentric (loaded and lengthening) of dorsiflexion to ensure we have the strength we need when we are out on our runs, hikes, and walks.

It is important to remember that if you currently have pain, you may need to include an anti-inflammatory method in your recovery. You can talk to your doctor about what is best for you. These things need to work in combination to reduce the inflammation and prevent the injury from coming back. Anti-inflammatory options alone (such as ibuprofen and cortisol shots) will not fix the mechanics of the problem that got you in pain in the first place. Meaning, as the anti-inflammatories wear off, you could be back at square one if you have not done the work to fix the issue (not to mention you are leaving a lot of strength and power on the table by not expressing your full range of motion).

Your best option? Prevention. Start these exercises now so you don’t have to experience pain in the future.

Want more? Koa Fit’s Online Library has 35+ routines not just for ankles, but for hips, shoulders, low back, and more. Try it out today boy clicking here.

3 Exercises for Your Ankles

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Do you keep rolling your ankles? Maybe you feel like they are stiff and don’t move well? Is there a little tweak in them after a big hike? Do you always feel the need to stretch your calves? Try these 3 moves (daily if possible) to help bring some mobility and control to your ankles and tension relief to your calves and feet.

Case Study – Dislocated Shoulder

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Session 1

A client of mine came in recently who had dislocated his shoulder. The dislocation happened 9 days prior and he had already been to the ER to have it “popped” back into place. The shoulder was still very sore, did not take load well, and was extremely guarded (shoulder elevated towards the ear, elbow flexed, and arm hugged into the body).

Letting pain be our guide, we used shoulder CARs (controlled articular rotations) to explore the full range of the shoulder in all movements (external rotation, internal rotation, abduction, adduction, flexion and extension). This gave us a baseline of his current movement capacity, allowed him to explore his pain-free range, and displayed where the “weakest links” resided.

After the CARs, we moved onto some capsular work for the shoulder. Again, letting pain be are guide, we explored the range of motion in shoulder external rotation. We used PAILs (progressive angular isometric loading) to establish if the reason for the lack of motion was neurological tension (guarding) or mechanical (something injured). This allowed my client to gain range in a safe way without further injuring his shoulder.

Once we created more range in the shoulder (most of his loss was due to guarding), we gently moved the shoulder through the full, pain-free range of shoulder external rotation and internal rotation to “upload” to the nervous system the availability of this new range.

This may not seem like much, but it is a safe and easy way for this client to learn where he can move his shoulder safely. It connects our mind and body (via the nervous system) so we are less likely to guard and compensate. This expedites the healing process and gives us a roadmap of what we can train during this time so there is no “waiting” between rehab and fitness. We have identified where there is a lack of range, where there is a lack of control or strength, and we can use those perimeters to adjust the workouts so he can keep getting strong while protecting his shoulder from further injury.

Session 2

When we met again, and we went over his shoulder CARs, his range had much improved. We could see there was still limited motion in his internal rotation and his flexion, so we addressed that lack of range of motion first by adding a PAILs (progressive angular isometric loading) for shoulder internal rotation.

After creating that space, we repeated our shoulder CARs movement and then moved on to some strengthening for the shoulder capsule.

We started with shoulder external rotation since he had been working on that at home for the last week. We also started with eccentric loads (loading as the muscles elongates rather than shortens) in both shoulder external rotation and internal rotation because it has the ability to train the tissue as if it wasn’t injured. Eccentric exercises can override the reflex to guard the joint and lets the nervous system know that it is okay to move and load that area. This is the path back to full range strength.

This is the beginning of the strength phase. Again, loading in the eccentrics allows us to strengthen the shoulder, in full-range, while avoiding any unnecessary re-injury or pain. He will be sore from this exercise, but in a normal, muscle-sore capacity.

Stay tuned for more updates as we continue to progress.

Want to know more of have questions? Reach out Brenna@koafitusa.com

Morning CARs Routine

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Your daily routine to maintain joint strength and mobility to keep your body moving well. CARs stands for Controlled Articular Rotations. When doing this routine, you want to be pain-free – especially no pinching on the closed-angle side fo the rotation (short side). To get the most out of your CARs, make any part of your body that is not doing the motion rigid and stiff.

Neck CARs

Spinal CARs

Scapular CARs

Shoulder CARs

Elbow CARs

Wrist CARs

Hip CARs

Knee CARs

Ankle CARs

Toe Work

Elbows Can Be a Pain

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Who has a tweaky elbow? One of those twinges or aches that seem to almost go away, and then with one wrong pick-up or swing, the pain is back. For a lot of people, the position of their shoulders is the root cause of their elbow discomfort. Below is a set of 5 exercises, to be done in order and together, to help relieve minor aches or tweaks in the shoulders, elbows, and wrists. Done daily, noticeable changes will happen within 1-2 weeks. Try these out and share with your friends!

Also, check out my Online Platform for the Shoulder Strength Series that can help you incrementally build stronger shoulders fo injury mitigation.

How are your hips?

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For the last few months, we have been playing with our hip mobility. A lot of our focus has been on rotation. Why? Because no other movement can be accessed or gained without it.

The hips move in 6 ways – extension (leg moves behind you), flexion (leg drives in from of you), adduction (legs squeeze together), abduction (legs move away from each other), internal rotation (thigh spirals inward), and external rotation (thigh spirals outward).

Below are a few videos that work with hip internal and external rotation. This is a great starting point for anyone looking for more freedom in their hips. Want more? Check out my full hip mobility program featured this week on the Koa Fit Online platform.

Hip Mobility Month – Week Three

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We are working on our hip external rotation this week. If you are stiff in the hip when trying to cross an ankle over the knee (say to tie a shoelace), these are for you. Work on the end-range of motion and strength these muscles for better stability when walking and to help relieve low-back tension.