Acceleration Runs

Hamstrings

Acceleration Runs

The hamstrings are often injured in the first part of a sprint, when the athlete is accelerating. Before returning to sport, the athlete should practice these runs, gradually increasing the intensity, up to 100% effort.

• Over a distance of 40-100 meters (start with shorter distances and increase), every 10 meters should be marked
• The athlete accelerates from 0-10 meters and then decelerates almost to a stop by 20 meters, before accelerating again between 20 and 30.
• This is only for those who have had at least 6 weeks of rest and treatment following a hamstring injury

Eccentric strengthening

• It is important to strengthen the hamstring muscles eccentrically (as they lengthen) as this is when they are most commonly injured.
• This is a very advanced exercise and should only be performed when the injury has healed and earlier strength training has been progressed.
• Starting in a kneeling position with the feet and ankles firmly fixed, lean forwards and aim to resist the downwards movement.
• Ensure you keep the back straight and do not pivot at the hips.
• Slowly allow your body to move forwards towards the floor, under complete control.
• Once you reach the 'point of no return' where you feel you cannot control the movement much further, hold for a couple of seconds, rest and then repeat.
• As your hamstrings become stronger you will be able to lower yourself with more control.

Functional exercises >

Image 6 - Advanced eccentric hamstring exercise

Hamstring Curls on Swiss Ball

Begin this hamstring strengthening exercise lying on your back with a Swiss ball under your legs as demonstrated (figure 6). Keeping your back straight, slowly bend your knees tightening the back of your thighs (hamstrings). Then return to the starting position. Perform 3 sets of 10 repetitions provided the exercise is pain free. Once this is too easy, the exercise can be performed on each leg individually (figure 7).

Figure 6 – Hamstring Curls on Swiss Ball

Figure 7 – Hamstring Curls on Swiss Ball Single Leg (right)

Begin this hamstring strengthening exercise lying on your back in the position demonstrated (figure 8). Slowly lift your bottom pushing through your foot, until your knee, hip and shoulder are in a straight line. Tighten the back of your thigh (hamstrings) as you do this and hold for 2 seconds. Then slowly lower back down. Perform 3 sets of 10 repetitions provided it is pain free.

Concentrics (for hamstrings and Buttocks)

Bridging

Begin this hamstring strengthening exercise lying on your back in the position demonstrated (figure 3). Slowly lift your bottom pushing through your feet, until your knees, hips and shoulders are in a straight line. Tighten the back of your thigh (hamstrings) as you do this. Hold for 2 seconds then slowly lower your bottom back down. Repeat 10 times provided it is pain free.

Single Leg Bridging

Begin this hamstring strengthening exercise lying on your back in the position demonstrated (figure 8). Slowly lift your bottom pushing through your foot, until your knee, hip and shoulder are in a straight line. Tighten the back of your thigh (hamstrings) as you do this and hold for 2 seconds. Then slowly lower back down. Repeat 10 times

Calf exercises (for Achilles pain, shin splints)

The following intermediate calf strengthening exercises should generally be performed 1 - 3 times per week provided they do not cause or increase pain. Ideally they should not be performed on consecutive days, to allow muscle recovery. As your calf strength improves, the calf exercises can be progressed by gradually increasing the repetitions and resistance provided they do notcause or increase pain.

Generally you should perform only 1 or 2 of the following calf exercises, provided they are pain free, beginning with Calf Raises (figure 3). Once this calf strengthening exercise is too easy, progress to the next exercise Calf Raises over Step (figure 4)and so on.

Calf Raises

Begin this calf strengthening exercise standing at a bench or chair for balance. Keep your feet shoulder width apart and facing forwards (figure 3). Slowly move up onto your toes, raising your heels as far as possible and comfortable without pain, tightening your calf muscles. Then slowly lower back down. Perform 3 sets of 10 repetitions provided it is pain free.

Figure 3 – Calf Raises

Single Leg Calf Raise

Begin this calf strengthening exercise standing on one leg at a bench or chair for balance (figure 5) . Keeping your foot facing forwards, slowly move up onto your toes, raising your heel as far as possible and comfortable without pain, tightening your calf muscle. Then slowly lower back down. Perform 3 sets of 10 repetitions provided it is pain free.

Figure 5 – Single Leg Calf Raise (right leg)

Calf Raises Over StepEccentrics (good for Achilles)

Begin this calf strengthening exercise standing with your heels dropped below the level of a step as demonstrated (figure 4). Ensure you have something to hold onto for balance. Slowly move up onto your toes, raising your heels as far as possible and comfortable without pain, tightening your calf muscles. Then slowly lower back down. Perform 3 sets of 10 repetitions provided it is pain free.

Figure 4 –Calf Raises over Step

Single Leg Calf Raise over Step

Begin this calf strengthening exercise standing on one leg with your heels dropped below the level of a step (figure 6). Ensure you have something to hold onto for balance. Slowly move up onto your toes, raising your heel as far as possible and comfortable without pain, tightening your calf. Then slowly lower back down. Perform 3 sets of 10 repetitions provided it is pain free.

Figure 6 – Single Leg

Add in arm weight to progress loading

Calf Raise Over Step (left leg)

Gluteals – Groin rehab and knee pain

Clams

Begin this gluteal strengthening exercise lying on your side with your shoulders, hips and ankles in alignment. Your knees should be bent at right angles and resting together (figure 5). Slowly lift your upper knee away from your other leg, keeping your ankles together, your pelvis still, and tightening your buttock muscles (gluteals). Hold for 2 seconds then slowly lower the knee back down. Repeat 10 times as far as possible pain-free.

Squats with Swiss Ball

Begin this gluteal strengthening exercise in standing with your feet shoulder width apart and your feet facing forwards. A Swiss ball can be placed between a wall and your lower back to improve your technique. Slowly perform a squat, keeping your back straight. Your knees should be in line with your middle toes and should not move forward past your toes (figure 8). Perform 3 sets of 10 repetitions provided the exercise is pain free.

Figure 8 – Squats with Swiss Ball

Lunges

Begin this gluteal strengthening exercise standing with your back straight in the position demonstrated (figure 9). Slowly lower your body until your front knee is at a right angle. Keep your knee in line with your middle toe and your feet facing forwards. Perform 3 sets of 10 repetitions provided it is pain free.

Figure 9 – Lunges

Gluteal Strengthening – Advanced Exercises

The following advanced gluteal strengthening exercises should generally be performed 1 - 3 times per week provided they do not cause or increase pain. Ideally they should not be performed on consecutive days, to allow muscle recovery. As your gluteal strength improves, the exercises can be progressed by gradually increasing the repetitions, number of sets or resistance of the exercises provided they do not cause or increase pain.

Single Leg Squat with Swiss Ball

Begin this gluteal strengthening exercise in standing on one leg with your foot facing forwards. A Swiss ball can be placed between a wall and your lower back to improve your technique. Slowly perform a squat, keeping your back straight (figure 10). Your knee should not bend beyond right angles and should be in line with your middle toe. Your knee should also not move forward past your toes. Perform 3 sets of 10 repetitions provided the exercise is pain free.

Figure 10 – Single Leg Squat with Swiss Ball (left leg)

Lunges with Weights

Begin this gluteal strengthening exercise standing holding light weights, with your back straight in the position demonstrated (figure 11). Slowly lower your body until your front knee is at a right angle. Keep your knee in line with your middle toe and your feet facing forwards. Perform 3 sets of 10 repetitions provided the exercise is pain free.

Figure 11 – Lunges with Weights

Progress to walking lunges ensuring you keep the same form as shown above

Patella tendinosis (knee pain below the knee cap)

Stand on a step (or an incline if you can) on the affected leg and keep the other leg straight just in front of you. Perform a small knee dip so that the other leg drops below the level of the step and the hips stay level.

Perform 40-60 reps of these. PLEASE NOTE: There may be an increase in pain initially but persevere. It will take 6 weeks of daily exercise

Rotator Cuff Strengthening (shoulders)

External Rotation vs. Resistance Band

Begin this rotator cuff strengthening exercise standing with your back straight, shoulder blades back slightly and holding a resistance band as demonstrated (figure 4). Keeping your elbow at your side and bent to 90 degrees, slowly move your hand away from your body keeping your shoulder blade still. Perform 3 sets of 10 repetitions as far as possible provided it is pain free.

Figure 4 – External Rotation vs. Resistance Band (left side)

Internal Rotation vs. Resistance Band

Begin this rotator cuff strengthening exercise standing with your back straight, shoulder blades back slightly and holding a resistance band as demonstrated (figure 5). Keeping your elbow at your side and bent to 90 degrees, slowly move your hand towards your body keeping your shoulder blade still. Perform 3 sets of 10 repetitions as far as possible provided it is pain free on each side.

Rotator Cuff Strengthening – Advanced Rotator Cuff Exercises

External Rotation at 90 Degrees vs. Resistance Band

Begin this rotator cuff strengthening exercise standing with your back straight, shoulder blades back slightly, arm side elevated to 90 degrees and holding a resistance band as demonstrated (figure 6). Keeping your elbow bent to 90 degrees, slowly move your hand backwards against the resistance band keeping your shoulder blade and elbow still. Perform 3 sets of 10 repetitions as far as possible provided it is pain free.

Figure 6 – External Rotation at 90 degrees vs. Resistance Band (left arm)

Internal Rotation at 90 Degrees vs. Resistance Band

Begin this rotator cuff strengthening exercise standing with your back straight, shoulder blades back slightly, arm side elevated to 90 degrees and holding a resistance band as demonstrated (figure 7) . Keeping your elbow bent to 90 degrees, slowly move your hand down and forwards against the resistance band keeping your shoulder blade and elbow still. Perform 3 sets of 10 repetitions as far as possible provided it is pain free.

Seated Row

Begin this rhomboid strengthening exercise sitting on a seated row machine with your back and neck straight as demonstrated (figure 7). Slowly pull the handle towards your chest, bringing your elbows backwards and tightening your rhomboids by squeezing your shoulder blades together. Perform 3 sets of 10 repetitions provided it is pain free.

Figure 7 – Seated Row

Rhomboid Pull Backs on Swiss Ball

Begin this rhomboid strengthening exercise standing with your knees bent, back straight, hand on a Swiss ball or bench and holding a light weight as demonstrated (figure 8). Slowly pull the weight towards your chest, bringing your elbow back and tightening your rhomboids by squeezing your shoulder blades together. Perform 3 sets of 10 repetitions provided it is pain free.

Ankle injuries

Proprioceptive ability is often lost or diminished following an injury. Proprioception needs to be worked on in order for a joint to return to or near its pre-injury level. Joints that do not have normal Proprioception are more likely to be re-injured because they will more easily be placed in an extreme position before the brain reacts

Any patient that has suffered a significant ankle or hindfoot injury (ex. Ankle sprain, ankle fracture, etc.) or has undergone ankle, or foot surgery should perform some proprioceptive exercises in order to optimize their recovery.

How is proprioceptive training done? Perform a graduated program that works to improve proprioception until both the right and left sides have equal proprioceptive ability (assuming one side is uninjured). Compare to your uninjured side (do exercises on both sides until each side is equal). Consider the following guidelines:

1. Do exercises daily
2. Do exercises for 30 seconds and repeat for 5-10 repetitions
3. Gradually progress the complexity of the exercises:

Basic Exercise

• Stand on one foot on a flat surface with your eyes open (30seconds)

Harder

• Stand on one foot on a flat surface with your eyes closed (30seconds). Have something available to grab if you lose your balance.

Even Harder

Stand on one foot on a flat surface with your eyes closed and move your head from side to side (30seconds). Have something available to grab if you lose your balance

Hardest Stand on one foot on a soft surface (ex. a pillow or bed) with your eyes closed and move your head from side to side (30 seconds). Have something available to grab if you lose your balance

Basic Balance Exercises

Single Leg BalanceStanding on one leg, maintain your balance. Try to hold for 1 minute. Once this exercise is too easy progress to eyes closed.A further progression can involve performing the exercisestanding on one or more pillows with eyes open and then eyes closed.

Figure 1 – Single leg balance (right side)

Intermediate Balance Exercise

Ball Around Back

Standing on one leg, take a ball around your back whilst maintaining your balance (figure 2). Once this exercise is too easy, progress to eyes closed.

Figure 2 – Ball around back balance exercise

Ball Under Leg

Standing on one leg, take a ball under your leg whilst maintaining your balance (figure 3). Once this exercise is too easy, progress to eyes closed.

Figure 3 – Ball under leg balance exercise

Ball Circles Around Leg

Standing on one leg, move a ball around your leg whilst maintaining your balance (figure 4). Perform clockwise and then anti-clockwise. Once this exercise is too easy, progress to eyes closed.

Figure 4 – Ball circles around leg balance exercise

Ball Throws Against Wall

Standing on one leg, throw a ball against a wall or to a partner whilst maintaining your balance (figure 5).

Figure 5 – Ball throws against wall balance exercise

Side Throw Against Wall

Standing on one leg, throw a ball across your body against a wall or to a partner whilst maintaining your balance (figure 6). Repeat the exercise, throwing the ball to the opposite side of your body.

Figure 6 – Side throw against wall balance exercise

Advanced Balance Exercises

Wobbleboard Balance Exercises

Standing on a wobbleboard with both feet, maintain your balance and try not to let the rim touch the ground (figure 7). Progress the exercise by doing circles with the rim touching the ground clockwise and then anticlockwise. Once this is too easy you can try these balance exercises with your eyes closed and, eventually, with only one leg eyes open and eyes closed.

Duradisc Balance Exercises

Begin standing on a Duradisc with both feet and maintain your balance. Progress the exercise by closing your eyes. Once this is too easy you can progress the exercise by balancing on one leg with eyes open and eventually with eyes closed.

Figure 8 – Duradisc balance exercise

Single Leg Jump and Hold (Multidirectional)

Using the general shape of a square, hop in different directions from one point of the square to the next (figure 9). Pause for 3 seconds once you have landed and maintain your balance. Progress this exercise by increasing the distance of the hop, or by closing your eyes.

Figure 9 – Single leg jump and hold (multidirectional)

Core Stability

Plank