McEntee Physio & Performance Centre

🎯Knee Extension - Re**us Femoris Bias

📍The re**us femoris is one of the quad muscles, it crosses both the hip and knee joints and is commonly injured during sprinting and kicking.

📊When rehabbing a re**us femoris strain it's important to ensure that our exercise selection is specific to the re**us femoris to cause adaptation and increase strength. We have delved into this area in a great degree of detail in recent weeks around the publication of the Aspetar Re**us Femoris Pathway which has had a heavy influence from there Irish physio contingent there.

👉Reclining the seat or sitting in a reclined position on the knee extension as shown lengthens the re**us femoris muscle and therefore biases it compared to the other quad muscles.

🎯Hamstring Rehab:

📊Developing strength into trunk flexion with rotation to the same side can help to build strength in a movement/position which can typically be vulnerable (a common mechanism of injury for some big hamstring injuries).

📍Within our rehab journey we want to create robust athletes and expose the body to a variety of positions and demands that reflect what needs to be done on the pitch (eg a forced tackle from behind when in an outstretched sprinting position).

⚡One can progress this exercise by adding more of a reactive element with an increase in speed.

🎯Cable / banded long lever hip flexion

📍This long lever hip flexion exercise with the knee in extension is an important exercise outlined in the Aspetar Re**us Femoris Injury Rehabilitation Pathway management framework.

📊The re**us femoris muscle crosses both the hip and knee joint. Compound lifts such as the squat pattern don’t preferentially bias the re**us femorus muscle. This exercise specifically targets the re**us femoris muscle and prepares tissue for a return to kicking and sprinting, where it is most commonly injured and re-injured.

👉This is a progression from the short lever variation outlined in the pathway. The longer lever and maintaining the knee in full extension as the hip flexes increase re**us femoris demand and increases hip flexion torque.

🔴It’s important to:
-Keep the knee locked in extension
-Maintain an upright trunk position avoiding lumbar extension / anterior pelvic tilt
-Ensure movement comes from the hip
-Slow and controlled lowering

⚡Hopping isn't just about being explosive, it's equally as important that we learn to absorb force effectively (as is necessary with every running stride).

👉Our main focus:
- get low & land quietly

🎯Eccentric Hamstring Bridge

📍With hamstring injuries being very common in sports requiring high speed running, it is important to train them to become more resilient.

📊Eccentric exercises are movements where the muscle is lengthening under load. This form of exercise increases muscle strength & enhances tendon resilience. Building strength in this way helps muscle tendon units to cope with these movements more effectively, which we believe will assist with reducing injury risk

🎯Inner Range Quads Strength

📍After knee surgery/injury restoring inner range quads strength should be one of the first objectives.

👉This banded inner range quads exercise can be used as progression from standard inner range quads exercises in the early stages of rehab.

📊Using heavier or multiple power bands allows us to progress this exercise and develop adequate strength in inner range before progressing to deeper ranges of knee flexion.

🎯Arm supported step up

📊The arm supported step up is an exercise commonly used in the load introduction phase of long-term knee injuries such as ACL rehab. It is an entry level compound movement that utilises the quadriceps, glutes and hip/trunk stabilisers.

📍The upper limb support allows the athlete to load the operated limb with improved confidence and less compensatory movement strategies. It is a good closed kinetic chain exercise that can improve quadriceps recruitment before progressing into unsupported single leg movement tasks.

👉It is important to:
-Use full foot contact
-Minimise pushing off the trail leg
-Control the descent using upper limb support

👀We use our coaches eye to look for:
-Pelvic drop
-Knee valgus pattern
-Trunk lean
-Reduced eccentric control

⚡To progress this you can:
-Reduce upper limb support
-Increase step height
-Add load

🎯Try this gem of an exercise

📊As you move the knee towards your chest, the hip flexor muscles are moving towards a shortened length, where strength and control are especially important. Reduced strength and control can lead to compensation from surrounding musculature, increasing stress on the hip, groin, and lower abdomen—particularly during sprinting, kicking, and change-of-direction movements.

📍It's a nice way of challenging lumbopelvic control in a weightbearing position also.

🎯Half-kneeling kettle bell shoulder press

📍This exercise helps to improve shoulder stability, overall shoulder strength while working on hip stability and trunk control.

📊Having the kettle bell positioned upside down increases engagement of the cuff alongside other surrounding stabilising muscles improving joint control in conjunction with wrist / grip control.

👉Together, this makes for a nice exercise to challenge and progress shoulder function.

🎯Lumbopelvic Control

📊Lumbopelvic control refers to our ability to control the position of the pelvis and lumbar spine. A lack of lumbopelvic control can place excess load on surrounding tissues such as the adductors and hamstrings.

📍We often see compensatory strategies when performing movements like this which means the muscles we are looking to strengthen aren't loaded sufficiently.
Sometimes its necessary to regress the exercise to affect the area we are targeting

⚡This exercise is a nice entry point to working on controlling the pelvis for those who struggle to maintain a neutral pelvic position with more common "deadbug" type exercises.