PART 1:
Exercise: Rotating tuck crunch on swiss
ball
Muscles worked: Erector spinea, quadratus lumbar, internal and external obliques,
transverse abdominals, rectus abdominals, deltoids
I chose this exercise for Tom because it puts him
in a prone position (face down, body parallel to floor) while challenging his
balance, which is essentially what he has to do while riding. The goal is to
use the deltoids and pecs to stabilize the shoulder complex, and then to pull
the ball up and to the side using the abdominal muscles. This is a fairly advanced move, and I have only had
Tom doing twisting motions in the past 10 days. Before that, we worked
entirely on muscle activation of the transverse abdominals (TVA), stretching
of the rectus abdominals, and overall stabilization of the lumbo-pelvic-hip complex. Now
that he has established the ability to initiate movement from the abs without
involving the low back muscles, I’ve moved him into some transverse plane
(twisting) exercises.
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When doing this exercise, be sure to keep the hips
and shoulders parallel to the ground and avoid piking (pushing hips up towards
ceiling) or excessive lumbar lordosis (sway back). Start in a push-up position with feet on the
ball, then pull the ball up and to the right side, return to push-up position,
then pull ball up and to the left. Start with one set of 5 reps on each
side, and progress to two sets of 10 reps on each side.
Exercise: Single leg bridge on swiss ball
Muscles worked: hamstrings, gluts
Besides building a strong core, the other area
that Tom really needed some strength was gluts. The gluts are an incredibly powerful muscle group,
and if they aren’t firing correctly then the work load will be distributed
to the synergist muscles (muscles that assist prime movers). Frequently
what happens with cyclists is that the workload gets distributed to the muscles
of the low back, which aren’t equipped to handle that kind of demand, and
eventually they break down and get injured.
The single leg bridge really isolates the gluts
and forces them to do the two things they do best: stabilize the lumbo-pelvic-hip
complex, and extend the hip. I originally had Tom perform this exercise without the ball, simply
lying on his back and extending one leg out with the other leg bent at 90 degrees
and foot planted on the floor. Keeping the extended leg straight, you then
lift your hips off the floor and slowly set them back down. As with the
tuck crunch, start with one set of 5 reps on each leg, and progress to two sets
of 10 reps on each leg.
A word from Slipstream team doctor, Dr.
Shannon Sovndal about Tom's injury:
"After pulling out of the Tour of California because
of back pain, Tom came back to Boulder Colorado. Here he was diagnosed
with a bulging disk and inflamed facet joint. Because of the intricate
network of nerves and muscles in the back, he was having extensive pain and leg
weakness. Fortunately
the diagnosis was promptly made and we were able to focus on a solid recovery
and training program. Tom is a true professional. He approached his
recovery with focus and determination. He now has a much stronger core
and is feeling great. Because he’s riding pain free and with full
power he has had excellent training days. He’s really coming into
form. I’m excited to see him race in the weeks to come."
– Dr. Shannon Sovndal
Team Slipstream
PART 2:
Exercise: Single leg step down
Primary muscles worked: Glut medius, vastus medialis, vastus lateralis, glut
maximus
One of the many side effects of having a herniated disk
is that the pelvis will begin to laterally shift (one hip bone is higher than
the other), thus created altered neuromuscular recruitment in the muscles of
the entire lumbo-pelvic-hip complex. As the pelvis shifts, the muscles responsible
for stabilizing it will begin to tighten and lengthen in inefficient ways. Something
I noticed on Tom was that his right leg tends to go into a valgus position (knee
travels inward while foot pronates) when he performs single leg exercises. A
very effective exercise to correct this muscular distortion is to do a single
leg step down off a raised platform or step.
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As you can see, Tom begins by standing tall with only the right foot on top
of the step. Keeping the chest lifted and belly button pulled in towards the
spine, he slowly steps down with the left foot and gently taps the left heel
to the floor. Keeping the right heel firmly planted on the step (do not let the
heel raise), he returns to standing position. I have Tom complete 2 sets 15 reps
on each leg.
Exercise: Isometric oblique ball transfer on decline bench
Primary muscles worked: Internal and external obliques, transverse abdominals
Tom has really progressed with his core strength over the past four weeks.
He is now able to completely stabilize his lumbar spine using the muscles of
the back (spinal multifidus, quadratus lumborum, erector spinae) and the abdominals
(internal and external obliques, rectus abdominus, transverse abdominus). By
having Tom perform an isometric abdominal exercise on the decline bench, he is
forced to recruit all of the muscles necessary to stabilize not only the lumbar
but also the thoracic and cervical spine.
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The key to this exercise is to keep the spine neutral
and avoid falling into cervical kyphosis (shoulders rounded forward and upper
back hunched) or lumbar lordosis (excessive arch on the low back). Notice how
Tom keeps his shoulders pulled back and chest lifted in order to engage the core
musculature. He starts with the medicine ball held directly out in front of the
body, then transfers the ball to the left hand and brings the arms into a “T”. Then the
ball is brought back to center and transferred to the right hand and once again
both arms are taken out into a “T”. I have Tom do 2 sets of 20 transfers
from hand to hand.
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