Hello, welcome to the Balanced Body podcast.
I'm Lindy Royer, physical therapist, founder of Pacmetos Pilates and Physical Therapy in
Lowentree, Colorado, and Balanced Body faculty member.
I'm here today with my friend Krista, who's going to help us show you some options for
adductor strengthening and balancing, specifically for knee and lower extremity rehabilitation.
We're using the trap table today, and as you can see, we already have a long yellow spring
sprung from the horizontal bar, and over here we have a short yellow spring sprung from
the vertical bar.
We've set this up already for Krista's size and limb weight.
However, keep in mind that if you have somebody who has a heavier, longer limb, you may want
to go to a purple or heavier spring, and a red or a blue spring at the other end.
We also have Krista already preset, if you will, with the knee strap and the ankle strap,
and what we're going to be doing here is we're going to suspend her right leg so that she
can start to work her left leg into a deduction.
So first of all, we're going to hook up the knee strap, and this is something to be really
careful with when you're working with patients who have knee issues.
They do not want to be hung from their ankle without support around their knee, so make
sure that when you're setting this up that you put the knee strap on first and support
that by suspending it from the spring, and then the ankle goes on next.
So we have Krista lying here inside lying, similar to how she would be if she were on
the mat.
We're aligned from the head through the shoulders, ribs, and pelvis.
Her left leg for right now is bent as we get her set up, but pretty soon she's going to
be straightening that leg out.
Keep in mind as soon as this leg extends that she's actually going to be less balanced.
So keeping that left leg for now bent is going to give her a little bit more stability as
we go into her setup.
We want to make sure that at the waist between ribs and pelvis, she's in a neutral position.
So typically what happens is our patients and students will go into more of a collapse
or side bend position, which is clearly not a neutral position in terms of that frontal
plane.
So we want to make sure that this is lengthened out.
If need be, sometimes you might even want to put a small towel roll or something like
that underneath the lower part of the waist.
We also want to make sure that the shoulder girdle is open.
She has space here above the shoulder and below the ear, and her head is gently resting
down into the pillow.
We use the pillow in our studio because I want to be able to have my students and patients
focus on what the task is at hand.
In this case, we're working on adduction and not have to worry about their neck.
So now, Christoph, you can just lengthen that lower leg down onto the table.
And so we're going to work from the inside of her left leg.
She's maintaining her trunk position.
Take a breath in, if you will, to prepare.
And then as she exhales, she's going to bring that leg straight up to the upper leg and
then lower it back down.
So what we're looking for here is control of the right leg.
And even though her left leg is moving, there's a lot of work going on here through the right
leg and through the pelvis in order to maintain that stability that she's maintaining of the
right leg.
So typically what you might see is instead of the left leg coming up, the right leg will
come down.
So Christoph's just going to show you what typically happens with most of us.
So instead of keeping stability of the right leg and then being able to access movement
through the left, you'll see a little bit of both.
So one nice way to think about this is if we can connect the left sit bone to the right
sit bone so that the activation is starting in the pelvic floor and the deeper core muscles
and then creating that nice adduction activation into the rest of the left leg.
Beautiful.
So now we're going to go into a little bit of a variation.
You're going to bring that left leg back into extension and she's going to externally
rotate the left leg.
The right leg can also be a little bit externally rotated just to match that.
And then from here, she's going to float that leg up to meet the other leg.
So here we're accessing a little more external rotation.
We're also getting a sense of imbalances potentially in the adductor system.
So making sure that we're looking at external and internal rotation is really important.
And can you just bring that leg into a little more extension?
And we're just going to challenge her.
One more, she's going to take that leg further back into extension and see if she can bring
that left heel behind the right one, which is a really, really big challenge.
And then bring the leg forward if you will, Christoph.
So now she's going to take that lower leg into a little bit of flexion and internal
rotation.
And then this is going to pull in a little more of the medial quadriceps as you exhale
so she can medially rotate that upper leg as well and then float the lower leg up.
Good.
We also want to pay attention here to what kinds of activity is going on in the foot and
the ankle.
Typically we'll see all sorts of interesting patterns of inversion, eversion, toe gripping,
all sorts of interesting and wonderful things in the foot.
We want to make sure that we're really focused on activating the leg from the core and having
that motion flow down rather than having the foot be in control of the movement.
And lower the leg down, bring the leg back to center.
And as you can see, that is quite a challenging exercise.
Very important for balancing the hip, the knee, the lower extremity and making sure that
our patients are balanced from the hip rather than just looking at the structure that's
being damaged, perhaps the knee.
Thank you very much, Krista.
And thank you for watching.
