Bruins Hip Protocol

Research supports symmetry in hip rotation as a determinate of lower body performance.

Transcript

1. Bruins Hip Protocol
2. Bruins Hip P R O T O C O L The Bruins Hip protocol looks at the linkage between the core and all parts of WKHORZHUH[WUHPLW\7KHSURWRFROWDNHVLQDOOLQÁXHQWLDOIDFWRUVWKDWDIIHFWMRLQW movement, integrity & function. Why is the hip not transferring the load well? Where’s the breakdown? CORE FUNCTION #1 Provide isometric support for upright posture. #2 Control the movement of the hips. HIP FUNCTION 7LJKWKLSÁH[RUVSXOOWKHSHOLYVLQWRDQDQWHULRUSHOYLFWLOWWKLVSRVWXUH almost always leads to tight internal hip rotators. +LSÁH[RUVWLJKW$QWHULRUSHOYLFWLOW7LJKWLQWHUQDOURWDWRUV Obliques shut down Glutes inhibited The problem is rooted in hip rotation The Bruins Hip Protocol includes: ‡$VVHVVPHQWVIRUKLS NQHH ‡,VRPHWULFVIRUWKHKLS VKRXOGHUURWDWRUV ‡1HXURPXVFXODUUHHGRIORZHUOHJPXVFOHV ‡0RYPHQWUHHGWRUHLQIRUFHFRUUHFWPRYHPHQW in a closed kinetic chain
3. Symbols The Standing Firm ® system uses a series of symbols to help you to see the procedure and objective of the exercise more quickly. e 360-degree movement of the rotation wheel challenges balance and proprioception. In addition, every move that takes the extremity away from the midline activates the stabilizers in the hip and core. Preloading is a counter movement that allows a various amount of torque in internal or external rotation in order to activate speci c muscle. Preloading activates muscles on the onset of the exercise. e preload may be loaded and rotated to a neutral position or rotated further into internal or external rotation. Controlling the preload past neutral can improve muscle-tendon shortening and release of energy, which is important in developing power and quickness. 1. Preload IR | ER rotate to neutral 2. Preload IR | ER | Rotate past neutral into further IR or ER Rotation exercises may also be performed with equal resistance in both directions. is option utilizes the V-tube without a preload. Rotation Resistance Free Moving Wheel Resistance V-­Tube Lower Body  Cuff Upper   Body  Handle Loop None Locked Preload Preload & Rotate Resisted Rotation Control Rotate Assess
4. Preloading The goal of neuromuscular reeducation is not hypertrophy as with traditional training but rather to improve the ability of the muscle to contract. The closed chain rotational force VSHFL¿FDOO\WDUJHWVZHDNVWDELOL]HUVLQVWHDGRIGRPLQDQWSULPHPRYHUV Preloading creates a greater stimulus for muscle contraction. The isometric work performed in the preload is necessary to reach inhibited muscles. Preloads can be done facing any direction. When facing the side as in the knee and frontal plane exercise, line the foot with a 45 degree angle and rotate to neutral. Hip Preload Rotation Preload Resistance ‡3UHORDG,5IRUUHVLVWDQFH against internal rotators ‡3UHORDG(5IRUUHVLVWDQFH against external rotators 5RWDWHSDVWQHXWUDOIRUJUHDWHU muscle activation Shoulder Preload Rotation Preload Plank or Kneeling Resistance ‡2QHRUWZRKDQGSUHORDG Preload Internal Rotation Preload External Rotation Starting Position External Rotation
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   EFHSFFT Hip Assessment Rotation )HPXU5RWDWLRQ Assessment | (YDOXDWHPXVFOHEDODQFH 5RWDWLRQDODVVHVVPHQWVJLYH\RXDQLGHDRIPXVFOHWLJKWQHVVWKXVVLJQLI\LQJPXVFOH weakness. When evaluating the rotation of the femur watch for movement of the low back. The femur should move freely without disturbing the pelvis. Resistance None SET-UP: Face #1; feet in parallel one foot on diamond, one foot on base; rotate ACTION: Rotate femur IR and ER Shoulders Square to Front Foot Centered Hips Level Don’t Move Only Femur movement Knee and Hip in Line Rotate From Femur Starting Position Internal Rotation External Rotation Internal Rotation Starting Position External Rotation Close-up
6. Sports Medicine Protocol | Bruins Hip SET-UP: Face #1; feet parallel one foot on diamond. one foot on base ACTION: Preload IR; rotate into neutral; rotate past neutral into further IR Objective: "DUJWBUF
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   SFQT Bene t: Muscle balance and hip alignment NEURO | Isometric Hip Activation Rotation Preload line right foot with #2 rotate to #1, hold Resistance V-Tube ,IWKHLQWHUQDORUH[WHUQDOURWDWRUVRIWKHKLSDUHIRXQGWRODFNV\PPHWU\LQ the range of motion assessment, isometric neuromuscular reeducation is necessary. The Bruins hip protocol focuses on limited internal rotation. Shoulders Square Hip Level Foot Centered Preload Internal Rotation Perform a posterior pelvic tilt for deeper activation of internal rotators 45º Starting Position Internal Rotation
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   EFHSFFT Knee Assessment Rotation 7LELDO5RWDWLRQ 5RWDWLRQDODVVHVVPHQWVJLYH\RXDQLGHDRIPXVFOHWLJKWQHVVWKXVVLJQLI\LQJ muscle weakness. When evaluating the knee, keep the knee facing forward; guide the knee position with your hand only allowing the tibia to move. This is a very subtle movement. Resistance None SET-UP: Face #1; one foot on diamond, lunge position with weight centered ACTION: ,FFQ
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   forward rotate tibia IR and ER Assessment | (YDOXDWHPXVFOHEDODQFH Keep  Knee   Facing  Forward Starting  Position Internal  Rotation External  Rotation Starting Position Internal Rotation External Rotation Variation: Seated Position
8. Sports Medicine Protocol | Bruins Hip SET-UP: Face #7 knee bent to 90 degree angle; ankle, knee, and hip in line (lunge position) ACTION: Preload, rotate into neutral; hold, rotate tibia into GVSUIFS
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   SFQT Bene t: Balance of lower leg, alignment of the pelvis NEURO | Post Tib, Popliteus Rotation 3UHORDG,5+ROGRU5RWDWH  tibia toward #6 Resistance V-Tube The lower leg muscles are often the root of hip dysfunction. Studies have shown that even if quad strength is adequate after a knee injury, the return of function requires lateral and medial training. A little known muscle called the popliteus functions as a ODWHUDOVWDELOL]HUDQGPD\SUHYHQWDWKOHWLFLQMXULHVDQGIDFLOLWDWHUHFRYHU\E\DVVLVWLQJ quads, hamstrings and gastroc. Keep Knee Straight Preload IR Line foot up with #8 Rotate to #7 Starting  Position Internal  Rotation
9. Sports Medicine Protocol | Bruins Hip SET-UP: ,OFFM
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   NVTDMFT NEURO | Shoulder Rotation Rotation 3UHORDG(5OLQHULJKWKDQG with #8; rotate & hold at #1 Resistance V-Tube Shoulder function is linked to the opposing hip. As with all the exercises, alignment rules over repetition. The spine should be in neutral for shoulder rotation. Slow movement with control over eccentric rotation will strengthen the URWDWRUV7KH%UXLQ+LSSURWRFROIRFXVHVRQH[WHUQDOURWDWLRQRIWKHVKRXOGHU Starting Position External Rotation
10. Sports Medicine Protocol | Bruins Hip SET-UP: Face #7, one foot on diamond, reach leg diagonally in any direction ACTION: Single leg stance + resisted rotation Objective: Rotate slowly, controlling eccentric motion Treatment: Rotate for 30 seconds, repeat | 2 sets Bene t: Improve hip to shoulder stability NEURO | Frontal Plane Movement Rotation 3UHORDG,53UHORDGIURP the side. Line foot with #8 rotate to #7 Resistance V-Tube Preloading and controlling eccentric force is key to injury prevention. Neuromuscular sagittal or frontal plane rotation challenges eccentric movement in a dynamic IXQFWLRQDOZD\5HWXUQHFFHQWULFURWDWLRQVORZO\IRUJUHDWHUPXVFXODUFKDOOHQJH Shoulders Square Hip Still Open leg may be positioned diagonal, back, front, side Rotate From Femur
11. Sports Medicine Protocol | Bruins Hip SET-UP: Face #1, one leg on diamond, extend leg diagonally back, side or front ACTION: ,FFQ
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    shoulders square, rotate leg IR & ER Objective: )JQT
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    rotate while maintaining neutral spine with minimal hand grip Treatment: Rotate for 30 seconds with leg forward, side back; repeat | 2 sets Bene t: Improved positional sense & strengthened stabilizers MOVEMENT RE-ED | Sagittal Plane Rotation 5RWDWH Resistance None Movement re-ed involves reproducing movement in a closed kinetic chain without resistance. The ankle, knee and femur should rotate as one unit, watch for overdeveloped muscles taking over the movement. ‡$EHQWNQHHLQYROYHVWKHNQHHDQG ankle to a greater extent ‡DVWUDLJKWOHJLQYROYHVWKHKLSPRUH Open Leg May be Positioned Diagonal Back Front Side Maintain alignment in ankle & knee Hips Level Keep plams open
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    "MJHONFOU NOTE: Notice how the rotating hip has limited rotation (the position of the foot doesn’t get far past neutral) the knee instead collapses in. e body will compensate in any way it can to perform the motion. Movement Re-Education 360° Rotation 0RYHPHQWUHHGWDNHVSODFHDIWHUZHDNPXVFOHVKDYHEHHQDFWLYDWHG,Q order to break compensatory patterns you must stay aware of how the movement is performed. Movement originates from the core; stay neutral and avoid “sitting into the hips”. External Rotation Internal Rotation MOVEMENT RE-ED | Frontal Plane