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Top 10 Exercise Guide for Creating a Stronger You
By: Dr. Sarah E. Ellis, DPT, PT, CPT, CNC
Welcome to Core Exercise Solutions! Congratulations on starting this ebook. In it you will find an amazing set of exercises that enhance the way your body moves. Looking better and feeling better are one in the same. Each exercise should leave you feeling better than before! Having a healthy strong body is important for enjoying life to the fullest and staying fit well into your golden years. No one wants to think about not being able to do the things they love and that especially includes me! I want to be that 90-‐year-‐old out there rocking the world. You can join me! It's not always easy to stay in shape, responsibilities take up a considerable amount of your time. Then with what little time you have left you try and squeeze in exercise. I know it's crazy to have a Physical Therapist wanting to make you look better but let's face it I rarely see a 35 year old in my office worried about keeping a healthy spine. It's not until they are 50 and their backs are killing them that they are ready for my help. That's why my goal is to prevent those type of injuries from ever happening. Having a strong, fit waist is likely to keep you from injuring your back. The same applies for your hips, neck, shoulder, etc. So, if I can get you doing the right exercises today, then you will look great AND be injury free tomorrow!! Win win! If you have questions about any of the exercises simply email me at [email protected]. I'm always here to help!
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I find that despite our best intentions, injury happens. Our bodies breakdown, they can’t sustain the wear and tear of improper overuse. (Back pain, neck pain rotator cuff tears, ITBand Syndrome, Knee Pain, Hip Pain, Plantar Fasciitis...) Have you had any of these? Or is an area just tight? If yes, then let's catch it before it turns into a full blown debilitating injury. I’ve taken tons of pictures for you. Pictures with perfect form and pictures with bad form so you can see the difference. I encourage you to be your own coach. Take pictures and video of yourself and work on perfecting technique, the results will speak for themselves. The exercises listed below are based on a mid-‐level athletic ability level. They are written for the person that already has a base level of strength. If you are finding the exercises difficult, do not do them, stay tuned for simpler versions that will help you build a base and work up to these. Likewise, if they are super easy, stay tuned for harder versions. Shoot me an email and let me know they are too hard or easy. Although some of them we should all be doing all the time for prevention! In the words of Tina Fey:
Disclaimer: This exercise program is not designed to diagnose or treat any injuries or illnesses. Please consult a physician before starting any new workout program.
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Side Plank with Feet on a bench
Why do this exercise? Because it will create a rock solid core! It’s also one of the best exercises for stabilizing the SI Joint and preventing back pain. I love planks, and this exercise is even better because it takes the shoulder completely out of the equation. Creating shoulder stability takes lots of specific work, and in my opinion core strength needs to come first to protect your spine. I find with regular side planks clients will either have an unstable winging scapula or they will try and push up with their shoulder using their delt muscle and under-‐using their core. This exercise is a great way to maximize core strength without worrying over shoulder positioning.
Coaching Tips:
• Head back in line with your body. • Entire body in a straight line. • Lift using your stomach muscles (obliques and TAs). • Make sure you don’t roll backwards, I don’t want your back muscles getting too
involved. • Make sure you do not bend at the hip. Your body should be straight as a board.
Especially the front of your hip! • If you have wide shoulders or a tight neck place a towel roll under your head to
support your neck. • The more leg you place on the bench the easier it is to do. • Work up to holding 30sec x 3
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Advanced Version Your inner thigh (adductor muscle) plays an important roll in creating strong hips. Without a strong adductor muscle you can suffer from knee pain, hip pain and low back pain. These muscles make you more agile and less likely to strain something playing in the yard with your kids. Plus, they will give you great looking legs!
Do one set with both feet on the bench (or chair) getting the bottom leg hip muscles (squeeze your bottom glute), then do a second set with just your top leg on the bench holding your bottom leg up. This will work your top adductor muscle.
• Be careful with the top knee if you do not contract your adductors (inner thigh) muscles enough you can strain your MCL in your knee.
• Work up to holding 30sec x 3 If this exercise seems beyond your current ability level, then stay tuned. I have a future newsletter planned on nothing but building a base of core strength. This will start you at the beginning and work your way up.
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Thoracic Spine Stretch
Fix Hunched Forward Posture and Rounded Shoulders Why do this exercise: Having greater confidence is linked to having great posture! Who doesn’t want more confidence these days? Hunched forward posture increases your risk of neck pain, midback pain, low back pain and incontinence. Yep, I said incontinence. Crazy right! Your posture affects so much more than you think!
Before we start into any upper body exercises to fix hunched forward posture and rounded shoulders it’s important to make sure you have mobility in your thoracic spine (midback). A mobile thoracic spine supports fluid, correct movement of your scapula, which is needed to prevent shoulder pain. Because we sit a lot and complete forward tasks, almost everyone’s midback is tighter than it should be. This leads to neck pain, muscle tightness and shoulder pain. Simply lie back on the foam roller, hands supporting neck. Roll and stretch back from the bottom of your scapula to the top. (Midback to top of shoulder) Try not to hyper extend your neck or low back, this exercise is meant to stretch the midback only.
Coaching Tips: • Start at your midback (around your bra line) • Lean back and hold for a second or two • Roll up, moving the roller toward your head an inch or two and lean back again. • Repeat until you have made it all the way to the top of the shoulders, or about where
I am in this picture • Repeat any tight spots again
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Great stretch to add to your post-‐work routine, especially if your job is forward and stressful, then this stretch will feel amazing! If you have osteoporosis, check with your doctor. Severe osteoporosis is a contraindication for the foam roller, and it is not worth the risk of a fracture. I usually find most people with osteoporosis feel a stretch just lying flat on the floor anyway, which is risk free. If you have really hunched forward posture, simply start by lying flat on the floor and supporting your head with your hands. This would be a great time to incorporate a chin tuck! Once that feels comfortable, use a small towel roll or soft yoga mat instead of the roller and be gentle on your back. The foam roller can be rather aggressive so you want to work your way in slowly. There are some great shoulder mobility exercises you can do with the roller as well as foam rolling key areas like the ITBand, so hang on to that roller because we will get into more later.
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Executing the Perfect Push-Up
Why do this exercise: Great posture, perky pecs and a lean waist! Creating a strong pec major makes your chest bigger. This gives you a balanced look to your posture along with making you stronger. There will never be a piece of furniture that you cannot push across the floor by yourself! Push-‐ups also build scapula control, which can be immensely helpful for preventing shoulder pain. Push-‐ups are a great catch all for a lot of the upper body muscles. You get chest, triceps, delts (shoulders) and scapula (shoulder blade) muscles if they are done correctly. You also need a great deal of core control since a push up is simply a front plank with arm movement. Since there are so many muscles working, doing a push up correctly can be difficult. One of the biggest problems I see is weak scapula (shoulder blade) muscles. Key muscles in the scapula help to control the eccentric motion of this exercise (slowly lower you down). If your scapula muscles are weak (particularly your serratus anterior-‐more on that later), then you will collapse into your shoulders without the assistance of the back muscles. This can be very bad for your rotator cuff and biceps tendon.
Coaching Tips: • Hands up about a foot wider than shoulder width • Fingers spread out and connected to the floor, I want your hands to look strong. • Head up, chin tucked in line with your body. Do not let your head lead the way. • Keep your core tight, pretend there is a plank of wood on your back, or better yet
that your spine is a plank of wood and it cannot bend, give or move. • Bend your elbows before lowering; this will keep you from collapsing through
the core or scapula.
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• Think about lengthening in the shoulder or pulling out on the elbows to keep it
out of your neck and upper traps. • Stop at 90 degrees of elbow bend. Do not touch your chest to the floor unless you
want to put strain on the shoulder joint rather than your muscles. • And for Pete’s sake (that’s my granddad), do not look up. This hyperextends your
neck. • Come all the way back up each time to make sure you work the serratus anterior.
If you miss one of these pieces, you are more likely to injury your rotator cuff or biceps tendon during push-‐ups. They are difficult to do correctly but produce amazing results when done right.
• Strong hands create a strong foundation • Make sure you maintain the arch in your hand and connect your fingers to the
floor.
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Correct and strong push-up.
Do you do zillions of push ups but still seem to have no chest muscle? This is probably why. Check out all my bad example pictures for comparison…
• Do not internally rotate your
shoulders • Turning your hands in increases the
strain on your shoulder and decreases the work done by your chest and triceps.
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More pictures of fun things done wrong:
Get your butt out of the air!
• Do not let your head lead the way! Tuck
your chin and get your head up in line with your body.
• Have someone take a picture of you at the bottom of the movement to see if your head is lower than your body.
• Your ears should be up in line with your shoulders.
• Do not let your belly sag. • Remember a push-‐up is a plank
with arm motion. • Keep your core tight and your
back straight as a board.
Lastly, I don’t have a picture here, but do not look up! This hyperextends your neck. Keep your chin tucked and in-‐line with your body. Good luck with your perfect push-up!
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Increase Pull Up Strength with Lat Pulls
Why do this exercise: Because fit strong women do pull-ups! Also, it protects your back and shoulders from injury while giving you a V-shape that makes you look killer in a strapless dress. I’m going to go crazy and call the lats a core muscle. Yes, you are thinking correctly I said lats, the muscles you think of using for pull ups. They are very, very large back muscles. These muscles come down and attach into your thoracolumbar fascia, which is also where your transverse abdominis attaches (main core muscle for spinal stability.) Having strong lats goes a long way for protecting your back. Not strong enough to do pull-‐ups yet or want to increase the number of pull ups you can do? You are going to love lat pulls.
Coaching Tips:
• Place a heavy band over the door and
close it. • Stand tall in an athletic ready position.
This means a small squat through your hips not your knees.
• Knees should not extend over toes. • Lock your corset in place. I like to put
my hand on the opposite side of my stomach to feel for tight core muscles.
• Do not scrunch your back!! No substituting QL and Paraspinals for Lats.
• Pull down using your lats 100% and not your shoulder.
• Elbow stays forward, inline with body. • Focus on working your lats! • If you are having trouble isolating your
lats then loop the band around elbow. Taking your grip out it makes it easier to recruit the right muscles.
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Trouble Shooting:
• Make sure you do not pull too far down. • Do not scrunch your back. • See how my elbow is going back and
my shoulder is going forward? This is wrong.
• Keep your elbow forward in line with your body.
• If you look closely in this wrong example you can see how my lats are not firing as much as above and my rotator cuff is taking over. This is how rotator cuffs get over worked!!!
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Chin Tuck with a Head Lift Why do this exercise: Gives you amazing posture by fixing forward head posture. It also relieves neck and midback tension and pain. You need a strong neck to stand up straight and hold your head in line with your body. Due to forward head posture, most people have overused and tight muscles in the back of their neck. These muscles have to strain to constantly hold the head up all day. To offset this overuse, it is important to build the muscles in the front of the neck. The muscles in the back of the neck get strained and overworked with forward head posture, and this is a great exercise to bring about balance, creating a loose, tension free neck, and most importantly bringing your head back in line with your shoulders!
Coaching Tips:
• Lie on your back, knees
bent, shoulders back, palms up
• Stretch your head, lengthening your neck, like someone is pulling on your head
• Slightly tuck your chin • Pretend someone is
pulling on your hair so hard that it lifts your head no more than 1 in off the floor
• Hold it there for 5-10seconds. Repeat 5 times.
No one looks good with slouched posture and a forward head.
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Trouble Shooting: When you first start this exercise, your neck might be too weak to do it properly. If you find yourself lifting your head too high or sticking your chin out, try helping your head by either pulling on your hair or giving your head some gentle support. By pulling on your hair, it really gives you the feeling of lengthening through your neck that you need to do this exercise correctly. Try this exercise after a hard day at the office. It will make your neck feel wonderful! Don’t forget to take a picture of yourself and analyze it so you can make sure your neck is in the proper place.
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Prone Y’s on Foam Roller Why do this exercise: Because it builds a strong looking back while preventing rotator cuff tears and upper and lower back tightness. Strong lower traps are important for building healthy strong shoulders, enhancing core strength, and prevent scapula pain. Most of my patients that come in with a tight lower back, midback and upper neck pain have weak lower traps. One of the best ways to strengthen this muscle is a facedown exercise called Ys. Doing this exercise in child’s pose with your forehead on a foam roller takes out the paraspinal muscles and prevents you from cheating with your lower back.
Coaching Tips:
• Sit back on your heels in child’s pose with your forehead on the roller
• Place the arm you will be lifting out at a “Y” angle
• Place the non-‐active arm in position stabilize your trunk by your shoulder
• To lift think Reach – Turn – Lift • Reach out lengthening your
arm • Turn your thumb up toward
the ceiling • Lift your arm from your
scapula
• Try to relax your upper traps • You should feel your scapula glide down your back • Don’t try and lift too high, just lifting a little can build strength without kicking in
a bunch of cheaters. As it gets easier you can maximize your time by doing both shoulders at once.
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• Keep your chin tucked and your spine long, you are using the muscles in the front of your neck to help stabilize.
• Open your chest toward the floor. • If you have limited range in your knees, try bending over a table and using a
towel roll or the roller there. • If you have limited shoulder range, shift the roller to the side so your arm hangs
off one side. • Work up to 3 x 10 and when that is easy grab some 1lb weights!
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Learn a Hip Hinge to Build Glute Strength Why do this exercise: To save your lower back and prevent disc injury! Plus, it gives you a butt like JLo. Quick Test for Hamstring Flexibility in a Deadlift As you can probably tell by looking at me, I’m not a bodybuilder. I love lifting to keep me in shape for my sports but I’ve never taken things to the next level. One thing I’ve noticed from going to the gym with girlfriends is deadlifts have been given a bad rap as a bodybuilder exercise. “Normal” people who workout stick to the elliptical and leg curl machine and don’t venture into the area with all the big guys with bald heads. Well, I’m here to tell you that 1. the big guys with bald heads aren’t that scary and 2. even your Grandma needs to be doing a deadlift Learning to accurately execute a hip hinge i.e. deadlift might be the single most important exercise you do to protect your lower back. It works your glutes, hamstrings, core, lats, and teaches you how to correctly pick up heavy things. Being able to pick up something heavy off the floor is life skill. Hamstring Length Test:
Bend over as far as you can keeping your back flat. Feel where your hamstrings catch?
Now I can go further…but it all comes from my mid and lower back! Bad, bad, bad!
See how my low back is rounding in the picture? That is what you want to avoid.
If your flexibility test was less than 90deg of bend at the hip, then you should spend more time stretching your hamstrings. Or figure out which muscle in your hip is weak and causing your hamstrings to tighten up.
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Modified Dead Lift or RDL
Learning a correct hip hinge is the number one thing you can do for your back. I want you to incorporate this motion everywhere, washing your hands, writing a quick note, picking up your purse, etc. There are so many times in life where you come from your back and hunch because the task is light, but this repetitive hunching will catch up with you and eventually damage your discs! Coaching Tips:
• Stand tall, chin tucked. Head stays inline with body the entire time. Do not look up into a mirror at the bottom. That causes your neck to hyperextend and your core to relax.
• Engage your lats be by squeezing your arms in.
• Hinge at the hips shifting your weight backwards, keeping your back completely flat.
• When you feel a stretch in your hamstrings stop, anything further could come from your lower back and damage your disc. We do not want to lose that flat back position for the sake of getting closer to the ground.
• Engage your glutes to come back up and stop at an athletic position.
• Do not come so far up that you shove your hip forward in the socket and hyperextend your back. This is not a safe position!
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Do not hyperextend the finish! This is bad (I know all you power lifters are gasping right now.) But it’s bad for your hips, so don’t do it. Stop at athletic! See first picture for athletic start.
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Build Single Leg Squat Strength Why do this exercise: Because this exercise creates strong hips! It also prevents knee pain, IT Band Syndrome, Piriformis Pain and helps you master a single leg squat. An email from one of my clients:
"Sarah, those single leg squats with a stool are killer, my glutes were killing me next day, I had to build up the chair height to decrease distance! But boy does it isolate! Thanks for the great exercise, Jane
These build eccentric hip and leg strength. The eccentric or lengthening phase of a motion often gets overlooked. These are the opposite of step-‐ups and half of a single leg squat. They are a great way to progress into doing single leg squats correctly.
Coaching Tips:
• Stand in front of a bench or chair. • Start with a short foot exercise. I want
your foot to be really responsive through the entire process.
• Make sure you maintain a neutral spinal curve, chin tucked, good posture.
• Sit back through your hip, slowly lowering to the bench.
• Keep a 90 degree angle on your hip. You will lose this angle if your hip collapses or your knee caves in.
• Make sure you maintain your lumbar curve the entire way down.
• Lower all the way down until you are sitting on the bench. Use both legs to come back up.
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• After you can comfortably lower all the way down without losing your hip, knee or lumbar positioning then try and pause at the bottom and come back up.
• Note how high my arch in this photo. Your arch and ankle strength helps support your hip.
• Work up to 3 sets of 10
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Trouble Shooting:
Do not let your knee collapse in.
Do not let your opposite hip drop. See how my right hip is dropping in this picture? That has to do with left hip strength.
Do not let your knee go into your toe. Make sure you sit back into your hip. This exercise will hurt your knee if you do it wrong. Lastly, make sure you do not lose your lumbar curve!!! Maintain the same curve from start to finish. All motion comes from your hips, not your lumbar spine.
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Modified Split Squats Why do this exercise: Because it builds awesome leg and hip strength and prevents knee and hip pain. This is one of my favorite ways to build leg and hip stability. This is a great starting point for training eccentric glute loading. Eccentric glute loading is key for protecting your lower back. The advanced version can also be used as a functional hip flexor stretch. This is also a great balance exercise. Once you can do this exercise with no weight, grab some dumbbells and make it harder!
Coaching Tips:
• Place one foot on the wall behind you (or floor if it’s a really big ball.)
• Place ball behind your low back. As you squat, you will sit underneath the ball.
• Stand tall, keep hips square the entire way through the movement.
• Make sure your front foot is far enough forward that your front knee does not go over your front toes. This can cause knee pain!
• Think about dropping your back knee straight down. Then squeeze your back glute to come back up.
• Keep your core tight.
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Trouble Shooting:
• Do not let your knee go over your toe.
• Do not let your knee rotate in. (I’m obviously
exaggerating, but even a small amount of rotation can cause knee pain.)
• Do not let your opposite hip drop. Keep your hips level.
• Both a hip drop or knee rotating signify a weak hip.
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Short Foot Exercise Why do this exercise: To prevent Plantar Fasciitis and knee pain and increase arch strength. Having strong feet builds a strong foundation for the rest of your body!
Strong feet help prevent pain all the way up the chain. They are your foundation for strong knees, hips and torso. Likewise, if your foot is weak, it causes your arch to collapse which can put additional stress on the fascia causing plantar fasciitis. It also causes internal rotation of the tibia (lower leg collapses in) which can cause severe torque at the knee, along with other issues up the chain like hip pain, knee pain, ITBand syndrome, and even back pain. To create a strong arch, practice this foot exercise while standing in the shower. (Most everyone has bare feet then!)
• Stand with your weight on the
middle to outside of your heel, not the inside.
• Keep your toes flat and press down with your ball of your foot under your big toe lifting your arch.
• If you are having trouble not scrunching your toes then lift them, but work toward being able to keep them down and not let them scrunch.
• You should feel (and see) your arch lift
• Hold 3 seconds and repeat. Work up to 10
• Follow with a calf stretch
Strong arches create a foundation for all exercises! Utilize short foot positioning before doing squats, deadlift or lunges and see if you can feel the difference.
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You did it!!! Congratulations on making it through all the exercises in this program. Were any particularly difficult? Did you feel better after doing them? Shoot me an email. I’d love to hear about it.