Throughout this post, I will use myself as a case study. I will walk you through how I would prepare for a training session that consisted of barbell front squat as my primary lift. During my evaluation, I was able to identify that I lacked hip flexion, which inhibited my ability to perform a good bodyweight squat. My lack of hip flexion was attributed to a tissue compliance problem of the glutes.
In order to restore the squat pattern and ultimately improve strength qualities within that pattern, we will traverse the performance pyramid. We will begin by upgrading the specific parts that are limiting the squat pattern, in this case hip flexion. Next, we will coordinate this new hip range-of-motion with the rest of the body before looking to improve strength qualities within the squat pattern by performing a barbell front squat.
When addressing a movement dysfunction, we first start at a segmental level, or a specific position we are aiming to improve. In my case, this position is hip flexion. We begin with manual therapy. The objective of manual therapy is to remove barriers, whether that be pain, stiffness, or joint dynamics. Manual therapy can include a wide range of treatments, such as massage, cupping, joint mobilizations, or self-myofascial release (foam rolling or trigger point release).
As a reminder, I have identified that my lack of hip flexion was due to decreased tissue compliance of the glutes. Another way of saying this is that my glutes are “stiff,” or not willing to lengthen. I have elected to use a medicine ball as a self-myofascial release technique to address this stiffness. The deep pressure being applied by the medicine ball acts as a muscle inhibition technique to decrease muscle tone. By decreasing muscle tone, the muscle becomes more willing to lengthen.
Now that we have reduced tissue tone, we capitalize by improving the mobility of the hip joint. I have elected to use a pigeon pose slide to improve my hip flexion mobility. The pigeon pose slide is a great way to improve the extensibility of the glutes.
Now that we have successfully improved hip flexion mobility, we look towards patterning, first at a segmental level and next at a global level. We start by teaching motor control at the hip itself. By teaching the body how to use this newly aquired range-of-motion, we decrease injury risk by insuring the individual is able to control the range-of-motion they possess, we optimize performance by giving the individual more range-of-motion to produce and absorb force with, and we increase the likelihood that the new range-of-motion will have more lasting effects. I have found that T-Hip is a great way to teach the hip to actively control hip extension/external rotation as well as hip flexion/internal rotation.
We know that the body does not work at a segmental level to create meaningful movement, such as a squat pattern. Hip flexion is just one segment in the kinetic chain. The segments must work in concert with one another to create sound global movement. This is known as kinetic linking. One of my favorite ways to teach kinetic linking is with the single leg hip hinge with a slider. The single leg hip hinge with a slider incorporates all the motions present during fundamental movement. As the slider moves posteriorly, the stationary leg’s ankle dorsiflexes, hip flexes and internally rotates, and thoracic spine rotates towards the flexed hip. This mimics absorption mechanics. As we return to the starting position, the opposite happens, which resembles propulsion mechanics.
Now that we have successfully restored fundamental movement, we look to build capacity within our newly found range-of-motion. Capacity is synonymous with performance qualities. Examples of performance qualities include strength, power, speed, agility, and metabolic qualities. There are countless ways to improve these qualities, such as resistance training, sprinting, performing plyometrics, medicine ball training, or High Intensity Interval Training. Since my goal was to improve strength, I selected the barbell front squat. I could have just as easily selected other exercises, such as walking lunges, rear foot elevated split squats, or barbell back squats, to achieve the same outcome.
Ultimately, our job as clinicians is to improve the performance qualities of our clients to create better resiliency, whether that be in sport or in life. In order to do this, we must identify the dysfunction, at the segmental level, that contributes to the bigger global movement problem. Once the segmental problem has been identified, we work to upgrade that specific segment, first with manual therapy to remove barriers, and next with mobility exercises to improve range-of-motion when necessary.
Once mobility is improved at a segmental level, we work to improve the motor control at that segment by teaching the body how to use this newly acquired range-of-motion. After teaching motor control at a segmental level, we move on to teaching motor control at a more global level via kinetic linking. By teaching the body how to control its allotted range-of-motion at both a segmental and global level we decrease injury risk, optimize performance, and increase the likelihood the range-of-motion will have more lasting effects.
Finally, after fundamental movement has been restored, we build capacity by improving performance qualities such as strength, power, speed, agility, or metabolic qualities.