#TNTEnhanced #Isometric exercises for #HamstringsTendinopathy

If you have a deep ache right underneath your "sitting" bone when you sit down, particularly after exercising, if you feel tight in your hamstring right at the very top of the back of your thigh, or if you're tight and aching generally down the back of your leg when striding out, then you may have hamstrings tendinopathy.  You need a physio (preferably The Good Physio... heh) to diagnose this correctly, but assuming that is your diagnosis, then this exercise will definitely be of benefit to you.

We know that irritated tendons respond well to isometric (static) strength exercises that do not put the muscle on stretch while exercising.  This is both pain relieving and strength improving.  We also know that if you are engaging more parts of the cortex of your brain while doing exercise then you are switching off the reflex inhibition that usually kicks in when exercising a sore part of your body.  In other words, doing an isometric exercise with auditory cues will both increase your strength AND decrease your pain and reflex resistance to exercising.  I go through the exercise in this video... 

The best exercises we know of for tendinopathy are isometric exercises which decrease the pain of contraction in the tendon, and also enhance our capacity to tolerate load through these structures. Recent research has shown that this is further enhanced by using outside cues to increase our mindfulness while exercising.

To make life easier, and so you don't need to listen to my whole spiel on the video every time you do the exercise, I've added a video of JUST the exercise (with counting) below.  I recommend that you listen to the video while doing the exercise for each repetition that you complete of the exercise.

KEY CONSIDERATIONS:

• Make sure your leg is quite straight while doing this, so the hamstrings are working hard
• Take as much weight as you can through the exercising leg, even on the "rest" phases as shown in the video above
• Focus on the auditory cues to improve activation and lessen inhibition coming from your brain
• This is a good exercise to do as a warm-up (ONLY ONE REP!) and warm-down (Full set of 4 reps) prior to the activity that hurts
• Once you are coping well with this exercise, we need to progress your exercises to include load with movement.

#TNTEnhanced #Isometric #HeelRaises for #Achilles pain

If you suffer from pain and stiffness at or just above your heel first thing in the morning, and it slowly warms up as you get going through your day, then the chances are that you have Achilles tendinopathy if you're older than 15yrs of age, or Severs Disease if younger.  Either way, the first port of call for settling your pain and stiffness down is performing isometric (or static) heel raises.  

The addition of the metronome and audio cues are intended to increase your attention and focus on the movement, which has been shown to decrease the levels of inhibition that your brain experiences when exercising a sore joint.  Thus, you need to listen to the video EVERY time that you perform the exercise (sorry)!

KEY POINTS TO REMEMBER:

• Listen to the video as you do the exercise
• Don't lift your heel too high off the ground - just a couple of centimetres
• Stay perfectly still while performing the exercise
• It is ideal to take all of your weight through the sore leg, but to begin with this might be too hard.  Build up to this as your tolerance improves
• This is not the end point of your Achilles rehab, but gets things started again.  
• Aim for 4x90s twice per day (with the 90sec including half time with straight knee, half time with bent)
• This is an excellent exercise to perform ONCE as a warm-up prior to activity, and then the full set of four reps as a warm-down following activity.

TRIBARS GLUTE STRENGTH: More push per pedalstroke

A big hole in the technique of many cyclists is their over-reliance on their quadriceps muscles to propel them down the rode.  This exercise is targeted at increasing your ability to engage your gluteus maximus while in the time trial position on the bike.  An excellent strength to develop if you want to get more out of your pedal stroke.

Key points to consider:

• Start with your knee a little bent, but keep it still from there
• Try and pivot exclusively from your hip
• Feel the muscles behind your hip burn and fatigue
• If you're feeling your hamstrings work, try to roll the arch of your foot (and thus your knee) outwards a little without physically turning your foot outwards

WALL PLANKS: Building load tolerance in your plantar fascia

If you're experiencing early morning pain and/or stiffness underneath your heel which slowly warms up as you hobble yourself through your morning, then the chances are that you have plantar fasciitis.  Treatment is multi-faceted, including strategies to lessen the load you are putting through your foot, and increasing the load that your foot can tolerate.  This exercise helps build load tolerance.

Key points to consider - 

• If you find getting into the position where your big toe is on a stretch too painful, try it on a rolled up towel, but REMEMBER TO HAVE THE TOWEL ON A NON-SLIP SURFACE!!
• Try to build load tolerance by taking more and more weight through your sore leg
• Hold the plank for 45s and repeat x4 at least twice a day.  Particular times to do the exercise are prior to an activity that you know will flare things up (like impact exercise or long walks)

THE SPANIARD: Isometric exercise for patellar tendinopathy

If you have been diagnosed with patellar tendinopathy, or "jumper's knee" then this is the best exercise we know of for you.  

Key things to consider - 

• Make sure the pole is solid!!
• Make sure the band is strong, and doesn't have a clip that could undo itself mid-squat
• Make sure your feet are not going to slip on the ground - this could be by having a short band so your toes are abutting the pole, or by wearing seriously non-slip shoes
• Push for an upright torso as your 1st priority
• Progress the difficulty by dropping your hips lower, with the goal of getting your thighs parallel to the ground
• Aim for 4x45s holds of this exercise
• If you have the pole to work from, this exercise is brilliant to use as part of your warm-up pre-training or pre-game

Isometric Hip Tilts: How and Why

If you have pain on the outside of your hip, particularly at night when laying no either the sore side or with the sore side up, and this pain hurts with walking long distances, quickly, on uneven ground or up & down steep hills or stairs, then this exercise can be a great place to start you getting this pain under control.

Key points to remember -

• the "towel" leg is NOT the exercising side, the "floor" leg is
• keep the "towel side" hip higher than the "floor side" hip
• don't let the "floor side hip" sag outwards - try and keep it straight over your foot
• if you have night time pain, a good time to try this is just before you go to bed
• hold for 45s - you should feel tired at the end of this period, rest for 30-60s and repeat x4
• as pain settles, you will need to progress to harder exercises (so book in!)