Progressing exercises are a systematic and organized approach that should be individualized to each person depending on their health, fitness level, and specific goals. The great part about exercise is that everyone is able to start somewhere! No matter what that starting point is for you, the only direction from there is UP. In this article, we will discuss a linear progression of how to progress lower extremity injuries in the clinic. It is imperative to master the fundamentals before working on highly skilled movements. This progression is inspired by the ‘Powers Program’, which is an evidence-based lower body exercise progression developed by Dr. Chris Powers, DPT, Ph.D. from the University of Southern California (USC). This program will begin with non-weight bearing isometric holds, don’t let these exercises fool you – they are extremely challenging! We then progress to static double-leg weight-bearing exercises, followed by single-leg exercises, and finish the exercise progression with dynamic strengthening movements. Follow along in this article to learn how to progress lower body exercises!

Start With Isometrics

Why isometrics? Iso’s help with increasing both corticomotor excitability (mind-muscle connection) in addition to increasing the representational area in the primary motor cortex! This is just a fancy word for the area of the brain that is responsible for activating muscles. Inherently, the real estate in the motor cortex that is responsible for the glute is poorly represented- demonstrated via Transcranial Magnetic Stimulation (TMS). In addition, if someone is in a more irritable state when first starting to exercise, isometrics allow one to still work on muscle activation while benefitting from the analgesic effect (pain-reducing effect) isometrics can have!

Clams, Sidelying Hip Abduction, Fire Hydrant

Begin this lower body exercise progression with 3 non-weight-bearing exercises to improve glute excitability. Simply hold the desired position with all 3 of these exercises. I recommend starting this exercise with some type of resistance; however, feel free to begin this exercise without any resistance initially. Here I am using a Hip & Core system by Crossover Symmetry.

• Clams: Focus on bringing the knee out and back. Avoid rotating the trunk, I bias the chest towards the floor to avoid cheating here. I push into the bottom arm to activate my core and stabilize my pelvis, which helps with isolating this motion to my hip, which allows for more optimal recruitment of the gluteal muscles.

• Side-lying Hip Abduction: I keep my bottom leg slightly hip flexed so I can bias my hip extensors in addition to hip abductors. This will target the glutes over the tensor fascia latae (TFL). Focus on bringing the top leg both up and back.

• Fire Hydrant: Drive your knee out to the side and back. Avoid rotating at the trunk or bending your elbows. Focus on pulling with the glute muscles.

With all of the exercises, hold the positions for 2×30 seconds on each side, and eventually, work towards progressing yourself to 2×60 second holds. You will feel the burn! This is a great way to start someone on a Lower Extremity Strengthening program prior to having someone work in a more demanding, closed-chain position.

Looking To Learn How To Progress Lower Body Exercises On Your Own?

Full Plank With Alternating Leg Lifts

Sample [P]rehab Lower Extremity Performance Program Exercise

The goal of the plank is to work on your core stability. Adding in the alternating leg lifts further challenges your core stability.  The intent of this exercise is to move the limbs as the core is engaged. Although the legs are moving, this exercise is still under isometrics because the emphasis here is on the isometric contraction of the core musculature.

Sidelying Hip Adductor Isometrics

For this exercise begin on your side. Squeeze your thigh and straighten your knee first, in particular, the inner portion of your thigh. While maintaining the squeeze, slowly lift up your leg. You should feel the muscles on the inside part of your thigh working. Do not let your hips/core move. Keep them tight the entire time!

Concepts For Glute Exercise Progressions

Double Leg Static Lower Body Exercises

Once you master the non-weight bearing isometrics, you have the option of performing these exercises in an isotonic manner; however, I like to get people weight-bearing as quickly as possible. This phase of the lower body exercise progressions will load the entire system more and will begin to activate the quadriceps in addition to the hip muscles. We still want to focus on getting great gluteal activation with a ratio of glutes to quads activation of ~ 2:1. If you are still having difficulty finding this ratio, you may need to prime your glutes with isometrics prior to performing these exercises. Often times in these earlier stages, I will implement a blood flow restriction cuff, allowing me to augment my results. Below are a few exercises to help improve your muscle function in this double-leg static phase.

LISTEN: TALKING GLUTES WITH BRET CONTRERAS

Chair Squat Isometrics

This exercise will help to strengthen your leg muscles, and back muscles, and promote trunk stability.

Get set-up on the edge of a chair or surface that you feel comfortable standing up from without having to use your arms for assistance. Lean forward and lift your butt off the surface, you should now be in a low squat position. Hold this position for 3-5s followed by slowly shifting your weight back towards the starting position and have a seat on the surface. This should feel like a leg workout! Your butt and thigh muscles should be working hard to maintain the chair squat hold position. Your back and stomach muscles will also be working to maintain an optimal trunk position. Follow the video for other cues and tips.

Split Stance Lunge Isometrics

Sample [P]rehab Lower Extremity Performance Program Exercise

• HOW: Begin in a split stance by placing the non-affected leg backward with the heel off the ground. Be sure to place 70-80% of your weight in your front leg and 20-30% in your back leg. Slowly lower yourself down, and then hold this position

• FEEL: You should feel all of the thigh muscles and butt muscles working, primarily in the forward leg.

• COMPENSATION: Avoiding having an over-arched or rounded back – keep a neutral spine with core engaged. Don’t let the knee cave in or bow out. Keep equal weight distribution in the entire foot of the forward leg.

Looking To Learn How To Progress Lower Body Exercises On Your Own?

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.