1. Stable Hip to StickBrandi Smith-Young, PTPerfect 10.0 Physical TherapyPerfect10PT@gmail.comwww.perfect10physicaltherapy.com

2. Brandi Smith-Young Competitive gymnast 2 time USAG Collegiate National Champions at TWU Bachelors in Kinesiology at TWU Masters in Physical Therapy at Tx St Fellowship trained in Orthopedic manual physicaltherapy Board certified orthopedic specialist in PT Specialize in treating gymnast last 7 years USA Gymnastics National Congress Speaker 4 years Gymnastics Association of Texas Speaker 7 years USA Gymnastics National Health Care ReferralNetwork 3. What muscles make up the core Diaphragm Pelvic Floor Transverse Abdominus Internal Obliques External Obliques Paraspinals and MultifidusGraphic from Lee 2001 www.discoverphysio.ca 4. Graphic from gophoto.us 5. Anatomy contd All these muscleprovide stabilizationfor the low back,pelvis and hips If these muscles arenot functioningproperly increasedstress will eventuallylead to injury. 6. Demonstration Time 7. Loading mechanics 8. Foot Mechanics Single leg standing Single leg squat When taking off orlanding it isimperative to havegood mechanics. 9. SLS squat Test 10. Improper mechanics lead to repetitiveabnormal stress Leads to inefficient performance Leads to injury 11. Proper jump/landing mechanics Straight back Hips square Hip inline with theknee Knee inline with the2nd toe Hips slightly flexed Knees bent with theknee falling over themidfoot 12. Proper jump/squat mechanics 13. Chair Sit Squats 14. Ski Jumper Umbrella breath in relaxingthe abs & feel PF lower. Breath out & lift PT. Keep the PF lift as leanforward like a ski jumper. Keep PF lift as return to startposition. Repeat x10 Do 1-5 in between skills/routine/tumbling passes 15. Hand Heel Rocks Place a stickhorizontally across thehips/low back Tighten abs Do not let the stickmove as rock back Rock back and forwardas far as you can withcontrol 16. Hand Heel Rock with Theraband Get on all fours with the hands and theknees shoulder width apart. Hands directly under the shoulders. Knees directly under the hips. Place a water bottle or towel roll on thelower back. Place a theraband around the buttock. Breath into the umbrella and breath outlifting the lower abdominals withoutmovement in the spine. Engage abs and balance the bottle ortowel roll as you slowly rock backwards. Return to the starting position. Repeat 15 times. 17. Clams Strengthen the hipmuscles Clam progression Phase I (fig 6) Sidelying, roll hipforward. Tighten abs, tightenbuttock Keep heels together andlift one knee up Monitor hips, no motion Hold 10 sec x10Figure 6 18. Side step squat(add T Band) Umbrella breath in relaxingthe abs & feel PF lower assquat down. Breath out & lift PF. Keep the PF lift as squat up. Then Relax. Step together Repeat x10 *When easy can breath in onthe down and breath out-liftPF as squat up. Thenincreased speed/add jump(squat jumps/sumos) 19. Hip External & InternalRotation Quadreped & Prone Start on all 4s, kneesunder hips and handsunder shoulders. Theraband attachedto ankle pulling awayfrom the band Engage abdominals Gently squeezebottom with no hipflexor activation Rotate the hip so thefoot moves inward(ER) In the same position;move the band to theopposite foot. Rotate the hip so thefoot moves outward (IR) Repeat laying flat onthe stomach. May need a towel orpillow under the bellybutton. Make sure abs engagedbelly button moves upand in. 20. Hip External & Internal RotationQuadruped & Prone 21. Strength Iliopsoas Seated Iliopsoas (fig 9) Sitting tall, back straight Tighten abs Lift one leg as high as possibleto chest with no motion inback Grab under the leg and lift allthe way to chest, no motion bk Let go with hands and hold 5sec Lower 5 sec x10Figure 9 22. Prone Knee Bend Get the buttock muscles to workinstead of the hamstrings Prone knee bend (fig 11) May need a pillow underbelly button Squeeze belly so back isflat (tighten from 70-60using the blood pressurecuff) Slowly bend knee tobuttock without motion inhips or arching at the lowback (keep at 60 usingthe blood pressure cuff)Figure 11 23. Prone Knee Bend Lift Prone knee bend lift (fig 12) Start with prone kneebend, turn 1 footinward in figure 4position (tighten from70-60 using the bloodpressure cuff) Keep abs tight and nomotion in low back orhips slowly lift knee upof the ground (keepingthe cuff btw 80-100) Hold 10 sec x10 NO ARCHING 24. Hip & knee control Squatting (card pickups near wall) Both legs Create arch Hinge from hips Bend straight down Knee inline withsecond toe 25. Stick drills Spine through the roof of the mouth,allow the knees to fall forward as youfold from the hips. Jump off a block thinking ofkeeping the neck relaxed. Absorb the landing; landing toeto heel and allowing the knees to fallforward, the head to lead the bodyin folding as land. X3-5 3x/wk Add back jump stick, Front tuck stick Back tuck stick Remember keep the head in and let kneesgo forward. 26. Single Leg Standing Standing on two feet shoulder widthapart. Fix your knee so that it is inline with thesecond toe using your hip rotators. Fix the anklebones so they face straightforward, holding your arch up. Begin to lift 1 heel gradually, lifting onlyas high as you can keep yoru pelvis level,knee in line with yoru second toe andyour keep your arch. Hold 30 secs Repeat each time taking more weight asyou can without loosing form. Repeat x5. Before running 27. Active Single Leg Standing 28. Single Leg Standing squat Single leg standing squat) (fig2) Standing on one leg, hips level Knee must stay over 2nd toe and nomotion at the hips. Weight evenly through the foot Maintain control as do a squat DO NOT let the arch of foot collapseor hip drop or hike 2x20Figure 2 29. Golfer Squat 30. ASLR: Exercises Standing on one leg, hips level Place a stick touching at the head andlow back Hold the stick at the neck with the samearm and foot thats in the air. Bend forward hinging at the hipskeeping the stick on the head and back Back to start position Rhythmically breath with exercise Knee must stay over 2nd toe and nomotion at the hips. Weight evenly through the foot DO NOT let the arch of foot collapse X20 on each legGolfer withStick 31. These exercises can lead up to landingdrills: Make sure the gymnasts arch is notcollapsing when landing May start with just a jump to a stick. Then jumping from the beam or vault to astick. 32. When doing plyos and other conditioningthe key is for the gymnast to control theirfoot and knee on push-off and landing. Do NOT allow the arch to collapse or beloose. Do NOT allow the knees to come togetheror inward. 33. Stretch hip muscles Stretch the hip flexors(fig 12) Pull one knee to chest Tighten abs Slowly slide the other legout without any motionin hips or low back Gently Squeeze bottom Trying to gentlystraighten the leg andpush down into the floor Hold 30 secFigure 12 34. Stretch hip and Quad muscles Hip/Quad stretch (fig 13) Off the edge of a block Pull one knee to chestwith flat back Let the other leg hangdown Can add 2 poundweight to hanging leg Follow with gymnastsqueezing her bottomand pushing down intocoaches hand throughher thigh (no arch inback) Make sure hip flexorsDO NOT contract Hold 30 sec-1 min andrepeat 3-4 times goinglower each timefigure 13 35. Hip Flexor Stretch Kneeling Place the back knee directlyunder the hip. Keep rib cage in line with pelvis Place front foot directly in frontof the same hip with knee bentto 90 degrees Keep weight through back kneeand kneel tall Maintain ribs inline with pelvisas press the hip of the kneelingknee forward. Breath while maintainingbalance. Hold 1 min May use a stick for balancekneeling 36. Quad Stretch Kneeling Place the back knee directly underthe hip. Keep rib cage in line with pelvis Place front foot directly in front ofthe same hip with knee bent to 90degrees Keep weight through back knee andkneel tall Maintain ribs inline with pelvis aspress the hip of the kneeling kneeforward. Grab the back ankle and pull ittoward your buttock. Only as far ascan maintain a straight spine and tothe point of discomfort, not pain. Balance with the other hand on thesame knee or a mat. Breath while maintaining balance. Hold 1 min 37. Hamstring Kneeling Place the back knee directlyunder the hip. Keep rib cage in line withpelvis Place front foot directly in frontof the same hip with knee bentto 90 degrees Maintain ribs inline with pelvis,straight spine, as hingeforward at the hips. Breath while maintainingbalance. To the point of discomfort, notpain. Hold 1 min 38. Hamstring Stretch Standing Place foot of 1 leg outin front. While keeping kneeand back straight, bendforward from the hipsuntil you feel a stretchin the back of the leg. Hold for 1 minute andrepeat on other leg. Stretch to the point ofdiscomfort, not pain. 39. Quad Stretch Standing Hold foot or place footof involved leg onchair. Engage abs tomaintain straightback. Keep knees even.Gently squeezebuttock. Hold stretch for 1minute and repeat onother leg. 40. Priformis Stretch Lie on back 1 leg straight,other bent halfway to chest. Use same hand as bent kneeto push the knee halfwayacross the body. Use other hand to gently pullthe shin toward you. Should feel deep stretch in thebottom of the lifted leg. NO pinching in front of hip. Ifyou feel pinching do NOT pullknee as close to chest. Make sure both sides of pelvisstay in contact with the floor.Spine in neutral with tail boneon ground. Hold 30 sec to 1 min. Repeatboth sides 41. Gluteal Stretch Lie on back with right footcrossed across the leftknee Reach right hand throughthe window made by rightleg and your left handaround the thigh. Gently pull the left thigh intoward your tummy. Keep the spine in neutraland deep core engaged. Shoulders stay relaxed andhead remains in contactwith the floor. Hold 30 sec- 1 min repeaton other leg. 42. Contact InformationPerfect 10.0 Physical Therapy& Performance Trainingwww.perfect10physicaltherapy.com perfect10pt@gmail.com 512-426-6593Follow Perfect10PT on gymanstike, facebook, and twitter 43. All information from: The Manual Therapy Institute www.themanualtherapyinstitute.com Shirley Sahrmann. Diagnosis and Treatment ofMovement ImpairmentSyndrome. Gray Cook Functional Movement System