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Creasing your Hips in Squat

Creasing your Hips for Better Squats

I always want to make sure clients are initiating the correct joints and muscles throughout a movement, and with the squat I always look at where the hips are at the beginning of the lowering phase.  I verbalize ‘crease the hips’ and what I mean by that is to reach  back with the hips or flex the hips while pushing heels into the ground. 
Doing this before initiating the knee bend puts your hips in a place so that you are able to squat over your heels, your knees don’t scream forward over the ankles, and you are more likely to feel your heels drive into the ground and drive through your heels on the ascent.  
Take a look at the example in the link below in the video and how I reach with the hips first before the descent.
Additionally, as a coach, it is very helpful to have some verbal cues to instruct the patient/client on how to perform the hip crease effectively. Some verbal cues that help me relate what I’m looking for with my clients: 
Crease the hips
Lower your body into your heels
Hip Crease for Better Squats
Utilizing the hip crease before performing the squat sets your patient/client up for success and helps accelerate appropriate form which will improve movement skill and eventually healing/strength.

Ben Warstler, CSCS, NSCA-CPT, USAW-1, KBA, YFS-1

Ben, former owner of Fortitude Fitness Systems, INC (Bens Bootcamps) for 12 years is returning to his roots in rehabilitation. Ben graduated from the University of Maine at Presque Isle with a degree in Athletic Training in 2001. Expanding his Sports Medicine skill at Amherst College for 2 years working with 40 varsity athletic teams, Ben moved more into the strength and conditioning field but has always pulled on his athletic training background. He enjoys seeing his clients realize their potential and break through previously thought barriers in their movement and abilities.

Ben, originally from Maine, moved to Vermont in 2005 and lives in Lyndonville with his 4 children, and wife Nedah. In his free time Ben enjoys weightlifting, spending time with his family, and tending to his chickens.

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Knee Replacement Therapy: A Quick Reference Guide

Today Physical Therapy Assistant, Megan Lynch has a step by step process of the therapy process of recovering from Knee Joint Replacement. If you are thinking about a knee replacement or your doctor has mentioned this procedure, this can be some very helpful information.

When looking at a knee joint replacement or any significant surgical procedure, it’s important to prepare the body for surgery. One of the ways is to build up the strength of the surrounding muscles. The knee is no different. Some have physical therapy before surgery to focus on strengthening the surrounding muscles. This will ensure a much more smooth recovery post surgery.

 

Immediate post surgery, with a timeline of 1 to 2 weeks, will start with proper gait mechanics most often beginning with a front wheeled walker to a cane/walking poles, manual lymphatic drainage, soft tissue mobilization, and passive range of motion.

As weeks progress the therapist will wean out the manual lymphatic drainage once swelling is managed and focus more on balance exercises and Range of Motion and strengthening for Lower Extremity. The muscle groups included are Quadriceps, Hamstrings, Glutes, Inner thigh and outer thigh, calf and core stability.

Physical therapy will typically come to a conclusion when patients have achieved an end goal 130 degrees of flexion in the knee and 0 degrees of extension. This can typically take about 4 to 6 weeks.

 

Megan Lynch, PTA

Megan has been employed as a Physical Therapy Assistant at Dan Wyand, PT & Associates since October, 2005. She graduated from River Valley College in 2004 with an Associate’s degree in Allied Health Science. Her clinical interests include lymphedema and pulmonary rehabilitation.

Megan’s hobbies include hiking, reading and snowshoeing.

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Biking and Knee Pain: Sharon Lamb

Biking and Knee Pain

Cycling is GREAT for knees!!  Low joint loading, no twisting and you can go at your own pace. Here in the Northeast Kingdom exists some of our nation’s most spectacular cycling trails and roads.

Here are some TIPS to help keep your cycling experience pain-free:

Setting up your Bicycle’s Seat Height is like “the 3 bears”…neither TOO LOW nor TOO HIGH, the seat height should be “JUST RIGHT”…

If you are developing front of knee or outside of knee pain, your seat height may be TOO LOW.  If discomfort is behind your knee, your seat height may be TOO HIGH.  To correctly figure out your “JUST RIGHT” seat height; place your heel on your pedal and when that pedal is extended toward ground, your knee should be straight. Therefore, when you place the ball of your foot on the pedal, there will be a slight bend at your knee…”Ahhh…JUST RIGHT”!!

Here are a couple references to help you to set up your cycle for correct alignment:

https://www.bikeradar.com/features/4-simple-steps-to-set-up-your-mountain-bike/(USE THIS for MTN)

https://www.bikeradar.com/advice/sizing-and-fit/road-bike-position/  (Use this one for road, gravel.)

https://www.cyclingweekly.com/fitness/bike-fit/set-up-new-road-bike-370764  (This one is for the SERIOUS CYCLIST, VERY DETAILED)

How your kneecap (Patella) moves in front of your knee is determined by:

The angle that your thigh and lower leg form, (“Knock Knee or Bowlegged”) and how the muscles that attach to and cross over that kneecap pull on it. A common cause of knee pain when cycling is altered Alignment of the leg and Muscle Imbalance.

Muscle IMBALANCES usually include a combination of BOTH: TIGHTNESS of one MUSCLE and “INACTIVITY” of another muscle. One muscle being TOO TIGHT can render another muscle not being able to contract strongly (“Inactive”).  “I’m not calling you weak here….just a muscle not being active when it should be”.

Here is one common example:

The muscles in front and outside of our thigh (Hip flexors/ Quad / ITB) can get tight from prolong sitting (at work, school, driving).  That tightness can lead to, insufficient activation of VMO. The VMO, (Inner Quad) controls Patella alignment as it moves. This IMBALANCE is a leading cause of patella femoral pain in cyclist and walkers/ runners.

A Physical Therapist can evaluate your Alignment (Both Bones and Muscle Imbalances). They will assist you with corrective bone alignment techniques (modifications to shoe or pedal).  A check-Up with your Physical Therapist can help you identify your muscle imbalances and show you corrective exercises to keep your body moving pain free.

Set up your cycle with proper alignment settings….Let us here at DW PT help you set up your “Physical Body” alignment and “GET OUT THERE AND RIDE!!!”

Sharon Lamb, PT, SCS, ATC

Sharon joined Dan Wyand PT and Associates in April 2022 bringing over 35 years of experience in clinical outpatient orthopedic, manual and sports physical therapy.  She is a Sports Clinical Specialist and Certified Licensed Athletic Trainer graduating from UMass Lowell.
 
Sharon moved to the Northeast Kingdom after 27 years as owner and full-time clinician of an outpatient physical therapy and sports medicine clinic in the greater Boston area.  She has provided care to all levels of athletes from professional and Olympic to adolescent and seniors.  Sharon takes most pride in working with each of her patients to create an individualized treatment plan to meet their needs and guide them toward achieving their best possible rehabilitation goals.
 
Sharon appreciates all the NEK has to offer as an avid mountain biker and lover of nature.  She enjoys all 4 seasons outdoors, skiing, gardening, hiking and playing with her dog Kona.
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Slow Down your Bear Crawls

Bear Crawls are one of my favorite exercises that stresses the entire body metabolically.  I also will utilize it in a warm up.  Much like the Turkish Get up, it hits a lot of the areas I’m looking to warm up and prepare for exercise and will do it in a condensed amount of time.  

Sadly, Bear Crawls can get out of hand quickly.  What I mean by that is they can be compromised if they are rushed.  The most common movement compromise I have seen with the Bear Crawl is the hips being much higher than they should be.  Below in the first video, I’m demonstrating the high hip Bear Crawl which essentially eliminates any core involvement which is unfortunate because one of the biggest beneficiaries of the Bear Crawl is the core activation required to perform it effectively.  With the hips elevated, more stress is placed on the wrist and shoulders.

The Bear Crawl should work to or be performed as I demonstrate in the second video.  A spine that is parallel to the floor.  Opposing arms and legs move together (right arm left leg and left arm right leg).  Shorter strides are important in the Bear Crawl to ensure good core activation and weight balance between all 4 limbs.  I will often coach my clients the Bear Crawl while balancing a stick on their backs.  The stick cannot fall and this indicates good core control and weight balance.  Try this small fix with your Bear Crawls for a higher quality of movement.

Ben Warstler, CSCS, NSCA-CPT, USAW-2

Ben, former owner of Fortitude Fitness Systems, INC (Bens Bootcamps) for 12 years is returning to his roots in rehabilitation. Ben graduated from the University of Maine at Presque Isle with a degree in Athletic Training in 2001. Ben also is the Head Strength and Conditioning Coach and Head Women’s Lacrosse Coach at Northern Vermont University-Lyndon.

Expanding his Sports Medicine skill at Amherst College for 2 years working with 40 varsity athletic teams, Ben moved more into the strength and conditioning field but has always pulled on his athletic training background. He enjoys seeing his clients realize their potential and break through previously thought barriers in their movement and abilities.

Ben, originally from Maine, moved to Vermont in 2005 and lives in Lyndonville with his 4 children, and wife Nedah. In his free time Ben enjoys refurbishing furniture, spending time with his family, and being outdoors.

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The Hip Bridge: A video tutorial

The Hip Bridge: A video guide

Movement expert, Jen Hemond is back  with some excellent tips on a foundational movement that EVERYONE should be doing for better movement and muscle activation.  The Hip Bridge.  Here’s an excellent video that Jen offers some great advice for fixing the bridge.  Check it out!

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Activity Modification: Step by Step

Attention Athletes and Active Individuals!!!

This one is for you! Pain is not weakness leaving the body!

For many of us lifelong athletes, that is not what we were led to believe. However, thankfully our therapist Kelly Wilkins has a great step by step plan for helping us weekend warriors squash old beliefs. Here is your roadmap to Activity Modification- modifying daily tasks to ensure that you are optimizing your recovery from injury.

 

1.       Prioritizing

Vary your activity to avoid repetitive stress. Complete the activity when you are most rested- for some this is in the morning, some in the afternoon. If you can plan your activities on a daily basis, you will feel mentally better about accomplishing more when you are in less pain.

2.       Pacing

Listen to your body. Change activity regularly as well as your position to avoid pain. This is an important one. You must be in tune to your body and the signals it is trying to tell you. It’s telling you those messages for a reason. And that reason is not because you are a weakling or a wimp.

3.       Planning

Plan your day- break up activity to avoid over doing. Break tasks into smaller activities throughout the day or week. If you are like me and enjoy knocking things off your ‘to-do list’, this can be a hard one especially when you are short on time. However, the more you listen to this specific task, the faster your recovery can be and the sooner you can be moving without pain.

4.       Positioning

Reorganize to avoid repetitious tasks especially overhead. Keep what you use the most accessible at waist height. Minimize lifting heavy loads. Keep items in close avoid lifting with arms out stretched. Watching your posture is a very important component to ensuring your body positioning is optimal.

 

 

Kelly Wilkins, MPT

Kelly has been employed at Dan Wyand, PT & Associates since December 2003. She graduated from the University of New England in 2002 with a Bachelor of Science and went on to complete her Master’s in Physical Therapy in 2003. 

She has continued her education through multiple courses geared towards women’s health, including Pregnancy & Postpartum, Beyond Kegels I and II and Female Pelvic Floor Dysfunction. She has also received training in various other manual therapy techniques.

 

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Coaching the Split Squat

Coaching the Split Squat

Working with clients over the years I have found that most struggle initially with the split squat movement.  As a coach I want my clients to be able to perform a split squat before a lunge movement and it was surprising to me how many struggled with this.
Over the past few months I have been working in the clinic with a lot of knee replacement patients and these patients have to re-learn a lot of movements but also retrain their bodies to utilize muscles they may not have previous to their surgery.  
For these patients, and honestly for a lot of clients I had in the gym, being able to perform daily activities with relative ease is very freeing to them, especially after a major surgery.  
In regards to the split squat, for a patient to get down and back up off the ground is a huge accomplishment and how I teach that is initially for the patient to perform a split squat with or without a modified depth goal (depending on the patient).
The important thing to remember with the split squat is that it is a 2 leg exercise.  You MUST use both legs in order for it to work effectively.  And this is a common mistake that a lot of my clients initially performed before correction.  I want to primarily discuss the back leg in the split squat (this also carries over to the lunge movement). 
The first thing I tell my clients is that the back leg initiates the movement of the split squat.  I tell them that because it keeps the front knee in a good place and keeps your body weight over your hips where it should be.  Bending the front knee first pushes weight forward onto the front knee more than you want.  The second cue I tell my clients is to lift the back heel but keep the toes planted.  This foot position keeps the back leg engaged and prepared for the lift phase of the split squat (getting off the floor).  The video below shows the two foot positions; the first one is a non engaged back leg for lift off and the second foot position is an engaged back foot position for lift off. 
 
So to review: 
Once in split position, keep back foot engaged by planting toes and heel elevated of back leg.
 
To initiate the movement, bend the back leg knee first to keep weight centered over the hips and utilize both legs in the movement.
 
To lift from the ground push through the front leg heel and the back leg toes to engage both legs.

Ben Warstler, CSCS, NSCA-CPT, USAW-1, KBA, YFS-1

Ben, former owner of Fortitude Fitness Systems, INC (Bens Bootcamps) for 12 years is returning to his roots in rehabilitation. Ben graduated from the University of Maine at Presque Isle with a degree in Athletic Training in 2001. 

Expanding his Sports Medicine skill at Amherst College for 2 years working with 40 varsity athletic teams, Ben moved more into the strength and conditioning field but has always pulled on his athletic training background. He enjoys seeing his clients realize their potential and break through previously thought barriers in their movement and abilities.

Ben, originally from Maine, moved to Vermont in 2005 and lives in Lyndonville with his 4 children, and wife Nedah. In his free time Ben enjoys weightlifting, spending time with his family, and upcycling furniture.

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Cleaning up your Row Technique



Rowing is one of my foundational movements for almost all of my clients.  In order for it to be a staple it needs to be performed correctly.  There are a lot of things that can go wrong with the row motion. 

A common example includes: shrugging the shoulders and using the trapezius to perform the movement rather than the lats and rhomboids (among others).  Then there is the example I’m highlighting here; excessive extension of the arms through the end range of motion needed for good row technique (essentially pulling the arms too far back while performing the row). 

 

Excessive extension in the row motion causes a couple of things to happen: it causes unnecessary stress to the anterior capsule and biceps tendon of the shoulder and also redirects the work to other muscles in the back other than the lats and rhomboids.

Below is a video of a good row technique. Notice the upper arm stops just beyond the midline of the body. Any more than that and you risk what I mentioned above. To clean up your technique you may need to use video or a mirror to check your endpoint before you can get a real good feel for your form

 

Ben is the former owner of Fortitude Fitness Systems, INC (Bens Bootcamps) for 12 years. Ben graduated from the University of Maine at Presque Isle with a degree in Athletic Training in 2001. Expanding his Sports Medicine skill at Amherst College for 2 years working with 40 varsity athletic teams, Ben moved more into the strength and conditioning field but has always pulled on his athletic training background. He enjoys seeing his clients realize their potential and break through previously thought barriers in their movement and abilities.

Ben, originally from Maine, moved to Vermont in 2005 and lives in Lyndonville with his 4 children, and wife Nedah. In his free time Ben enjoys furniture refurbishing, spending time with his family, and tending to his chickens.