Sports Injury Bulletin

Sports

Body

Conditions & Symptoms

Treatments

User login

RSS feed

Syndicate content

 

proprioceptive training, proprioceptive exercises, proprioceptive routines, proprioceptive programme, strength balance agility coordination, injury prevention

Proprioceptive exercises training prgramme

The Sports Injury Doctor

Register today to receive valuable, injury prevention and treatment advice every week.

Email:    >> 

This eight-week exercise programme can help you guard against getting hurt and increasing your strength, balance, and agility.

In our last issue, we described in detail how proprioceptive training can improve your coordination and reduce your risk of injury during sporting activity. In this article, we provide you with a specific, simple-to-carry-out, eight-week exercise programme which will upgrade your strength, balance, and agility and reduce your chances of getting hurt at the same time. The programme incorporates both proprioceptive and sport-specific (functional) exercises, and it can be blended very easily with your current training.

Here's what to do:
Weeks 1 & 2
Three times a week, warm up adequately and then perform the following exercises:

(1) One-leg balances. Stand on your left foot with relaxed, upright posture and with your right leg flexed at the knee so that the right foot is off the floor or ground. Your left, weight-bearing leg should be lightly flexed at the knee, hip, and ankle, as they would be when your left foot is on the ground during the act of running. Simply hold this position for one minute, rest for 10 to 20 seconds, and then repeat twice more. After a brief rest, complete three similar reps with your right leg as the weight-bearing limb.

(2) Forward-backward leg swings with knee flexed. Rest for a moment after completing the one-leg balances, and then stand with your weight fully supported on your left leg. Begin by flexing your right hip and raising your right knee up to waist height (so that your right thigh is parallel to the ground), with your right knee flexed to approximately 90 degrees or a little more. Perform this action reasonably quickly so that your leg 'swings up' to this top position - rather than being slowly lifted (if necessary, you may place your right hand on a wall or other support to maintain balance as you do this).
Continue the exercise by swinging your right leg downwards and backwards until your right leg is extended behind your body (as if following through on a running stride). Your right knee should be completely extended at the end of this backswing, eg, your right leg should be nearly straight at the back of the swing - just as it would be after take-off during a sprint stride. Once you have reached full extension, drive your right leg forward, flexing your right knee as you do so, until your right thigh is once again in front of you and parallel with the floor or ground.
Repeat this forward and backward action 30 times while gradually increasing the speed and range of motion of the movement (for those with insecure balance, it sometimes is helpful to start with 'baby swings' in which the thigh does not reach the parallel-with-ground position, nor does full leg extension occur on the backswing). Rest briefly, and then repeat 30 more times with your right leg. Make sure you are sustaining a relaxed posture, with your upper body upright and your gaze directed ahead of you, not at your feet. You should try to achieve the same posture you would utilise during running. If you lose balance and must touch down with your right foot momentarily, relax, support body weight on your left leg again, and resume the exercise.
Finally, be sure to coordinate arm activity with your leg swings. That is, as your right leg swings forward and up, your left arm should also swing ahead, as it would do during running. As your right leg moves backward, your left arm also retreats. Try to keep the overall feeling of the exercise as close to the sensation of running as possible.
Once you have completed two sets of 30 reps with your right leg, carry out the same movements with your left leg.

(3) Forward-backward leg swings with knee extended. After you have completed your forward-backward leg swings with knee flexed on both legs, rest momentarily and then stand with your weight fully supported on your left leg (once again, you may initially place your right hand on a wall or other support to maintain balance). Begin the exercise by flexing your right hip and raising your right knee up to waist height (with right thigh parallel to the ground), but this time extend the lower part of your leg so that your right knee is near fully extended (you will be almost 'straight-legged'). As with the previous exercise, perform this action reasonably quickly so that your leg 'swings up' to this top position rather than being slowly lifted.
Continue the exertion by swinging your right leg downwards and backwards until right hip and leg are extended behind your body (as if following through on a running stride). Your right knee should remain nearly fully extended throughout the entire movement, eg, your leg remains straight at all times. Once again, coordinate leg and arm activity (as right leg moves forward, left arm does also, and so on).
Repeat this back-and-forth action 30 times with as much coordination as you can muster while gradually increasing the speed and range of motion of the movements. Rest, carry out one more set with your right leg, and then repeat the same movements with your left leg (two sets of 30 reps).

(4) Toe walking. Once you have rested from your knee-extended, forward-backward leg swings, walk for 20 metres high up on your toes with your toes pointing straight ahead, walk for 20 metres high up on your toes but with your toes pointing outwards, and then walk for 20 metres with your toes pointing in. When you point your toes out or in, be sure to turn your legs outward or inward from the hips; don't try to achieve all the turning at your ankles.
Rest for a moment and then repeat the straight-ahead, toes-out, and toes-in pattern of toe walking once more (20 metres for each version of toe walking).

(5) Heel walking. Walk for 20 metres on your heels with toes pointing straight ahead, walk 20 metres on your heels with toes pointing out, and then walk 20 metres with toes pointing in. As before, make sure you rotate your legs, not just your ankles, when you complete the toes-out and toes-in versions of this exercise. After a very short rest, complete this routine once more.

(6) Cross-body leg swings. Leaning just slightly forward with your hands on a wall or other support and your weight on your left leg, swing your right leg to the left in front of your body, pointing your toes upwards as your foot reaches its farthest point of motion. Then swing the right leg back to the right as far as comfortably possible, again pointing your toes up as your foot reaches its final point of movement. Repeat this overall motion 15 times with erect body posture and good balance, rest for a few seconds, and then repeat. Complete the same routine - two sets of 15 reps - with your left leg as the 'swing' leg.

'You should be able to complete all the movements with great coordination and excellent speed before moving on to your next challenges'

It is important to note that the above routines - and the ones described in the rest of this article - should be performed after warm-up but before your main training for the day is undertaken. This is because of the high degree of coordination required for the exercises; fatigue will tend to restrict coordination and make the exercises more difficult to perform with good form. Truthfully, one of the best things you can do as an athlete is to warm up, carry out the exercises, and then move right into a high-quality training session. The exercises will in effect 'fire up' your nervous system and make the challenges of your workout easier to handle.
Many athletes will become very comfortable with the above exercises and skilled at carrying them out after six workouts (three per week). Such athletes are ready to move into the week-three-and-four drills described next. However, if you feel you need more work with the above routines, don't hesitate to continue using them until you have gained mastery. You should be able to complete all
the movements with great coordination and excellent speed before moving on to your next challenges.
Weeks 3 & 4
Three times per week, warm up adequately and then perform the following exercises:

(1) Advanced one-leg balances. These are just like the one-leg balances from week one, except that you should swing your arms back and forth vigorously, mimicking the arm action associated with running, as you stand one-footed. Complete the same number of sets and reps you used for regular one-leg balances.

(2) Maximum forward-backward leg swings with knee extended. There's nothing major to learn here; you're simply carrying out the forward-backward leg swings with knee extended which we described previously, but there is one new 'wrinkle'. As your leg swings forward, instead of merely shooting for a parallel-with-the-ground position for your swing leg, try to elevate the swing leg as high as possible as it moves forward (of course, maintain good balance and coordination as you do so; do not let yourself get out of control). Think of yourself as punting a rugby ball and trying to achieve the maximum-possible follow-through.
Complete two sets of 30 reps with each leg, unless your hams and/or glutes begin to complain vigorously.
Tip: as before, start with little swings and gradually expand the swinging action until you are achieving maximal height with the forward foot (of course, don't start the rep count until you have accomplished max status).
(3) Toe walking. As before, but now pick up the pace.

(4) Heel walking. Use the earlier moves, but walk very quickly.

(5) One-leg squats. Stand with your left foot forward and your right foot back, with your feet roughly one shin-length apart (they should be hip-width apart from side to side). Place the toes of your right foot on a block or step which is six to eight inches high. All of your weight should be directed through the mid-foot region of your left foot. Now, bend your left leg at the knee and lower your body until your left knee reaches an angle of about 90 degrees between the thigh and lower leg. As you carry out this squat, your right arm should swing forward. Then, return to the starting position, maintaining upright posture with your trunk and returning your right arm to your side.
Complete 15 reps, rest for a moment, and then hit 15 more reps with your left leg. After another brief rest, complete two sets of 15 reps with your right foot forward and your left foot back. If you can carry these out with no problems, begin holding dumbbells in your hands as you do the squatting (eliminate the arm motion if you do this). Begin with five-pound 'bells' and work your way up gradually and progressively.

(6) Runners' poses. To do these, stand relaxed with erect body posture, with your feet roughly under your shoulders. Then, swing your right thigh ahead and upward until it is parallel with the floor (your leg should be flexed at the knee as you do this, so that the lower part of the leg should be pointing almost directly at the ground, ie, it should be nearly perpendicular with the ground); as you swing your thigh ahead and up, simultaneously bring your left arm forward, as you would do during a normal running stride).
Hold this position for a couple of seconds, while maintaining relaxed stability and balance, and then bring your right foot back to the ground and your left arm back to a relaxed position at your side (that completes one 'pose'). Perform 14 more pose reps with your right thigh, and then switch over to the left leg for 15 poses. As you get better at doing this exercise, gradually speed up the thigh-lift movement and also elevate the thigh beyond the parallel-with-the-ground position (so that the exercise eventually becomes a high-knee-lift pose).

(7) Bicycle leg swings without resistance. Stand with your weight fully supported on your left leg (you may place your right hand on a wall or other support to maintain balance). Then, flex your right hip and raise your right knee up to waist height (your right thigh should be parallel with the ground); as you do this, your right knee should be flexed to 90 degrees or more. Once your thigh is parallel to the ground, begin to extend your right knee (swing the lower part of your right leg forward, unflexing the knee) until your knee is nearly fully extended (eg, your leg is nearly straight), with your right thigh still parallel to the ground.
As your right knee nears full extension, allow your right thigh to drop downwards and backwards until the entire thigh and leg are extended behind your body (as if following through on a running stride). Your right knee should be near full extension (your leg should be straight) until it reaches the peak of the backswing. As your right hip nears full extension (eg, as you approach the end of the backswing), raise your right heel by bending your right knee; your heel should move closely towards your buttocks as you do this. As this happens, move your right knee forward until it returns to the appropriate position in front of your body, with your right thigh parallel to the ground.
Repeat this entire sequence of actions in a smooth manner such that the hip and leg move though a continuous arc without stopping or pausing. Once you are able to coordinate the movement, strive to perform the swings at a cadence of at least 12 swings every ten seconds (slightly faster than one swing per second). Complete two sets of 50 reps per leg.
As before, do not move on to the next series of exercises (in this case the ones for weeks five and six) until you have gained great mastery of the above exertions. All exercises should be completed with speed and skill.
Weeks 5 & 6
Three times per week, warm up adequately and then perform the following exercises:

(1) 'Blind' advanced one-leg balances. These are just like the one-leg balances from weeks one and two, except that you must keep your eyes completely closed as you perform the routine. Closing your eyes removes the strong, balance-enhancing input from your visual system and forces your nervous system to rely more heavily on your vestibular and somatosensory systems to produce balance; it's a bit like forcing them to lift more weight! During week five, don't worry about pumping your arms back and forth in a running-like fashion, but - if possible - add the arm pumping during the three workouts of week six.

(2) Bicycle leg swings with resistance. Securely attach a flexible 'stretch cord' at about knee height to a post or other object approximately three feet in front of you, and fasten the other end to your right ankle. Stand on your left foot, and carry out the bicycle leg swings with your right leg, as described in weeks three and four (exercise number seven). You may have to tinker a bit with your distance from the post; you should be far enough away so that the cord accelerates your swing leg as it moves forward and resists reverse motion of the leg during the backward swing. Start slowly, working on developing good, smooth form in spite of the pull and resistance provided by the stretch cord. Stay relaxed at all times, and keep your eyes focused straight ahead - not on the ground or the 'cycling' of your leg beneath you. Perform two sets of 50 reps with your right leg and then two sets of 50 with your left.

(3) Partial squats. Stand with your left foot directly under your left shoulder, keeping your left knee just slightly flexed and maintaining relaxed, fairly erect posture. Hold a barbell (initially with no weight attached) so that it rests on the top-back of your shoulders just behind your neck; you may incline your upper body just slightly forward for balance. Most of your body weight should be directed through the heel to mid-portion of your left foot. Your right leg should be flexed at the knee so that the foot is not touching the ground at all - your right foot is literally suspended in air (however, you may occasionally need to 'spot-touch' the floor for balance with your trailing leg).
From this position, if you were carrying out a traditional one-leg squat you would ordinarily bend your left leg at the knee and lower your body until your left knee reached an angle of about 90 degrees between the backs of your thigh and lower leg (usually at this point your thigh would be almost parallel with the ground). However, for the partial squat you should just go down about half-way - so that the angle between the back of your thigh and lower leg is just 135 degrees or so. Then, return to the starting position, maintaining upright posture with your trunk. That's one rep!
Continue in the manner described above until you have completed 10 reps (10 partial squats). Then - without resting - descend into the 11th partial squat, but instead of rising back up hold the partial-squat position (the 135-degree position) for 10 full seconds. We'll call your body alignment during this 10-second period the 'static-hold' position.
After completing 10 seconds in the static-hold position, immediately - without resting - rattle off 10 more reps, maintain the static hold for 10 seconds again, hit 10 more reps, and then hold statically for 10 more seconds.

Here is a summary of the overall sequence:
(1) 10 partial squats
(2) 10 seconds of holding your leg and body in the down position
(3) 10 partial squats
(4) 10 seconds of holding
(5) 10 partial squats
(6) 10 seconds of holding

After completing this series with your left leg, do the same with your right. If you can complete the entire sequence with each leg, add 10 pounds to the barbell for your subsequent workout. Keep adding 10 pounds, as long as you can complete the entire series on each leg. If you fail at any time during the sequence, continue using the weight which caused failure until you can complete the whole run-through with each leg, and then advance the weight for the next workout.

(4) Toe skipping. This is just like toe walking, but you must skip on your toes (again with toes pointing ahead, out, and in), instead of walking.

(5) Heel skipping. In this challenging exertion, which happens to be a great shin-splint preventer, you simply skip on your heels, instead of walking on them, going 20 metres or so with toes ahead, 20 metres with toes out, and the same distance with toes in. Initially, use a very forgiving surface such as sand, soft grass, soft dirt, or a 'tuned' basketball court.

(6) High-bench step-ups. Begin from a standing position on top of a knee-high bench or step, with your body weight on your left foot and your weight shifted slightly toward your left heel. Your right foot should be free and held slightly behind the body, dangling just below the back edge of the bench or step. Lower your body in a controlled manner until the toes of your right foot lightly touch the ground, but continue to maintain all of your weight on your left foot. Then, simultaneously exert force on the platform with your left foot, flex your right leg at the knee, and drive your right leg up and forward, so that your right thigh is parallel with the surface of the bench (the position is similar to the one you achieved while doing the 'runners' poses').
As your right leg swings up and forward, synchronously swing your left arm forward, as you would do during running. Hold the 'up' position for a moment, and then drop your right leg in a smooth fashion until the right toe once again touches the ground (your left arm will return to your side). Complete 12 repeats total with your left leg, and then switch over to the right. Maintain absolutely upright posture with your trunk throughout this entire movement - try to avoid the temptation to lean forward as your trailing leg moves toward the floor.
Weeks 7 & 8
Three times per week, warm up adequately and then perform the following exercises:

(1) One-leg balances on a rocker board. Carry out the one-leg balances, as described previously, on a rocker board (a balance board, aka ankle disk, which provides instability in only one plane of motion). At first, do not swing your arms or close your eyes while performing the exercise. Complete one minute of balancing on your left foot with the rocker board set for front-to-back instability, and then perform one minute of balancing with the board providing side-to-side instability. Repeat on the right foot, maintaining good posture at all times. If you momentarily lose your balance, simply touch the ground with the non-weight-bearing foot to regain balance and resume the exercise. Once you have mastered the rocker board, you should progress to a wobble board (a balance board with instability in all planes of motion).

(2) Partial squats. This is the same exercise described above; continue adding weight, as indicated in the exercise description.

(3) One-footed heel raises. Stand with relaxed, erect posture, with all your body weight supported on your right foot (your left leg should be flexed at the knee so that your left shin is roughly parallel with the ground and your left foot is off the ground). The hip, knee, and ankle of the right leg should be slightly flexed. Then, contract your right calf muscles as strongly as possible, so that your right heel rises vertically and you rock forward onto your right toes. Hold this tip-toe position for a second or two (all of your body weight should be supported by the toes and forefoot of your right foot). Then, let your right heel return to the ground smoothly and with moderate speed. Once your right foot hits the ground, instantly 'explode' upward, rocketing back up to the tip-toe stance. Again, hold the weight-on-toes position for a second or two, and then continue the described movements. As you do the exercise, move rhythmically and without hesitation (except at the tip-toe position), and try to maintain good balance, posture, and stability at all times (initially, you may touch a wall, fence, or other structure for support if you are having trouble with your balance). After completing 15 repetitions on your right foot, perform 15 reps with your left, move back to your right for 15 more reps, and finish with 15 exertions on your left foot. At first, you should perform this exercise on a level surface, but as your skill improves you will want to carry out your one-footed heel raises on an inclined surface (start modestly and progressively make the inclination more challenging).

(4) Rocker-board lunges. Stand with relaxed, erect posture on a platform, step, or curb which is about four to six inches in height. While supporting full body weight on your left foot, step forward about 12 to 15 inches with your right foot onto a rocker board which is positioned on the ground or floor in front of you and the platform. When your right foot 'hits' the rocker board, shift full body weight to the right foot, and go into a squatting position, flexing your right knee to about a 90-degree angle while keeping your upper body relaxed and upright. Hold this position very briefly while keeping the rocker board stable, and then rock back to the beginning, standing position, driving your body backward by applying force to the rocker board with your right foot.
Carry out a total of 15 reps with your right foot, and then complete 15 lunges in similar manner with your left, using front-to-back instability with the rocker board. After a brief break, complete 15 reps with each leg using side-to-side instability with the rocker board. Once you are an accomplished rocker-board lunger, you will want to replace the rocker board with a wobble board.

(5) One-leg balances with perturbations. Stand with full body weight supported on your left leg only, as you would do with a normal one-leg balance. However, for this exercise you should run a short stretch cord between the shin of your left leg (attached just below the knee) over to the shin of your right leg. As you stand perched on your left foot only, 'perturb' your balance by swinging your right leg backwards and forwards, so that the cord pulls strongly on your left, support leg. After 20 front-to-back swings with your right leg, complete 20 side-to-side swings with the same leg, so that your left, support leg must deal with lateral instability.
Finally, complete the exercise with 40 diagonal swings with your right leg; 20 of these will be completed in a 'northwest' direction, and 20 will be accomplished to the 'northeast' (not literally, of course; to picture these, simply think of your straight-ahead position as being true north; thus 'northeast' would be at about 45 degrees, halfway between straight-ahead and directly to your right). Once these swings are completed, carry out the same movements with your right leg as the support limb. Over time, increase the difficulty of the exercise by performing the swings while standing on a gymnastics mat or plush carpet.

(6) One-leg squats with lateral hops using the balance board. These are a bit like one-leg squats, except that the support foot is perched on a rocker board (the rear foot is lightly placed on a bench, step, or chair, as before). Once the knee of the leg in contact with the balance board reaches an angle of 90 degrees between the thigh and lower leg, you should hop laterally off the balance board (with your front foot; the back foot stays in place). When your foot hits the ground in a position lateral to the board, you should squat to 90 degrees and then hop back to the 'centre' position on the board. Squat again on the board, and then hop medially off the board (to the right if your left foot is on the board, to the left if your right foot is in board contact). When your foot hits the ground in the medial position, squat and then come back to the centre position and re-establish your starting, standing posture. That's one rep! Perform 10 reps with your left leg forward (remember that a rep has an initial central squat, a lateral hop and squat, a second central squat, a medial hop and squat, and then a return to centre), and then 10 reps with your right leg forward. Rest for a moment and repeat. You can make the exercise more difficult over time by replacing the rocker board with a wobble board.
Once you have completed the whole programme, you may start over, cycling back through the exercises and spending extra time on any which give you difficulty. It is best to start the overall programme toward the end of your 'off-season' or break period, just before your regular training season or year begins. However, if you have not carried out this kind of work before, it is OK to start the programme at any point in your training cycle. You will get positive results even if you are only able to complete the first few weeks of the scheme before your major competition occurs! The positives include better balance, greater strength - and an enhanced resistance to injury.

Owen Anderson

proprioceptive training, proprioceptive exercises, proprioceptive routines, proprioceptive programme, strength balance agility coordination, injury prevention

Recent comments