BAD EXERCISES in Physical Therapy Clinics
In our physical therapy clinic in Voorhees NJ ( Body Solutions ) the clinicians meet on a monthly basis and review the current research. Hundreds and hundreds of papers later, we've realized that many of the typical physical therapy exercises are actually BAD!
How many of you have seen or done squats with your back against a wall or a theraball? I see it in gyms and other clinics all the time! If you look at the research on shearing forces, that exercise is horrible. It shuts the hamstrings down and creates an anterior shear in the Tibiofemoral joint. Yet, it is still prescribed as an exercise. My theory is that the prescriber is LAZY! Yes, they figure that the wall or ball will give the patient an easy way to do squats "correctly without their knees going over their toes".
I have plenty of BAD exercises to list and explain. I would REALLY like the readers to contribute to this. IT WILL HELP ALL THERAPISTS WHO READ IT!!!
So do you know of a bad exercise???
wall squats
sit ups or trunk flexion on a machine
back extension on a machine
empty cans
quadraped hip extension (typically done wrong)
standing on busu and lift weights of any kind
I would like people to vote which ones they want to discuss. If I went into detail on all of them, it would be a BOOK. For our short attention span purposes, lets pick a few to discuss. I will try to shoot videos of the exercises we choose to discuss and upload on my website. The new site will be done in ONE WEEK!. <a href="http://www.bodysolutionsinc.com">Body Solutions</a>
When you consider what is clinically significant, you have to look at it from a purely biomechanical and a physiological perspective. The shearing force is not likely to tear a meniscus. However, the forces are causing excessive wear and tear of the cartilage. Aside from the biomechanics, you are also training the muscle firing patterns to be quad dominant. From a neuromuscular perspective, that is a bad idea. Many issues arise from lack of hip extensor firing (ACL injury, back pain, patellofemoral issues)
Janet,
the Ortho you know in NYC is one smart ortho! It is sad that therapists are not reading research. I see therapists and strength coaches performing horrible exercises everywhere. One common mistake is the resisted run. i.e. a band is applied around the waist while the therapist pulls against the running patient / client. Apparently these people have never read any research on gound contact force/time and don't realize that this exercise does nothing to help running. It totally changes the mechanics of running and reinforces improper muscle firing.
The resisted walking is OK. I was referring to resisted running. I've seen therapists and strength coaches / personal trainers apply the resisted running to their treatment / training. It dramatically increases the ground contact time (due to the high resistance) and turns the running from a pulling to a pushing activity.
If you are going through spinal surgery recovery, I highly recommend reading Stuart McGill papers or books. It is great info on working abdominal stability and knowing how much spinal compression you are exposed to.
Interesting Blog-
I bet your readers will find the Awareness Test on my blog fun and instructive-
It's amazing to discover what a person can see or not see, hear or not hear or feel or not feel depending on where that person focuses their attention.
Michael Ellner