Question

Mr Q is a 37 year old ironman triathlete who competes regularly at a national level. He states his success has been limited by poor performances during the run section of those races due to knee pain. He has been to see a physiotherapist and they suggested that he may benefit from improved hip muscle function. At the moment Mr Q has no injuries, symptoms or medical history that would limit his ability to participate in a training program.

a) You decide to assess Mr Q’s hip extensor muscle strength to establish a baseline for the design of his exercise programme. List one (1) test would you perform and justify why you have chosen it. (4 marks)

b) You decide to give Mr Q two (2) exercises to improve hip extensor strength that may improve his run performance.

c) briefly describe the exercises that you have chosen and list all exercise variables (sets, repetitions, frequency, and amount of resistance). (6 marks)

d) Briefly describe one (1) progression of each exercise that will also challenge his sensorimotor system.

Answer 1

1.SUPINE HIP EXTENSOR TEST

In this test the client is placed in supine position on a flat surface and the straight leg raise range was assessed to determine if hip extensor muscle length was enough to assume the testing position and to obtain a sense of relaxed limb weight.The examiner then place his both hands under the heel of the client and ask him to press the test limb into the mat at the same time the examiner lifted the limb at least 90cm.He also instruct the client to lock the hip with out flexing.

GRADING CRITERIA FOR SUPINE HIP EXTENSOR TEST

GRADE 5(Normal)	Hip locks in neutral (full extension) through out the test. Pelvis and back elevate as a locked unit as the leg is raised by the examiner.
GRADE 4(Good)	A limited arc of hip flexion occurs before the pelvis and back elevate as aunit while the leg is raised by the examiner
GRADE 3(Fair)	Full extension of hip to the end of straight leg raised range with little or no elevation of the pelvis
GRADE 2(Poor)	Hip flexed fully with only minimal resistance felt by the examiner as the limb is raised
GRADE 1(Absent)	Hip flexed fully with no active resistance felt by examiner as limb is raised

2.EXERCISES TO IMPROVE THE HIP EXTENSOR MUSCLE STRENGTH

• Quadriped hip extensions
• Glute bridge

3.QUADRIPED HIP EXTENSIONS

A leg extension work both the gluteus maximus and hamstring muscles.It is very effective because it is functionally similar to the leg extension action that happens during everyday activities.To perform a leg extension,kneel on all 4 with your hands directly under your shoulders and your knees directly under your hips.Maintaining a flat back ,extend your right leg until you have a straight line from your head to your left leg.Perform 8-12 repitations on each leg.Wear ankle weights for an added challenge.

GLUTE BRIDGE

It primarily works the glutes,with the hamstrings and core muscles assisting.Lie on your back with knee bent and feet flat on the floor,hip distance apart.keep your knees in line with your hips and feet ,lift your hips until you form a straight line from your knees to your shoulders.Hold for one second ,then slowly lower hips,one vertebrae at a time,until you return to the starting position .Repeat 8-12 times.Hold a dumbbell on top of each hip,or try slowly marching one foot at atime while maintaining the straight line from your hips to your shoulders for an added challenge.