Fitness Class

This is one example of a class plan that helps with posture and gait retraining. Watch for others in this series.

 

Standing warm up

Lateral arm arcs + breathing to open upper body and allow people time to settle

Crossover leg swing

Cat stretch with hands on thighs

Waving cat with hands on thighs

Standing crossover leg swing – to mobilize ankles for better stability

Standing relevé with ball between heels (ball is optional) (strengthens muscles that lift the longitudinal arch of the foot – tibialis posterior and peroneals

Squat to mobilize leg joints and find first ray

 

Transition to floor onto hands and knees…

 

On the Mat

 

1. Quadruped

Quadruped pelvic, spine and rib mobilization

Cat/cow

Rib lateral slides

Rib circles

 

Sit back to heels and turn to sit and roll back to supine…

Have people breathe a few times to just notice it; no judgment, so specific instructions

 

2. Supine

Pelvic motions: tilts, rotations, circles, figure 8’s to mobilize pelvis and spine; ideally but not always, the rib cage and t-spine will settle toward a more neutral convex curve

 

Thoracic motions: thoracic rotation in three ways: head going with upper body, head stays still, head goes opposite

 

Neutral bridge – press outer heels and first rays into the floor; if you can describe a diagonal line of support under the foot from where you are pressing down through the first ray and outer heel;

feel for glutes and upper hamstrings working; this can help pronated feet because these muscles play a supportive role at the pelvis and can help lift flattened arches

 

Hip fold – this exercise activates the anterior oblique system (hip adductors, internal obliques and opposite external obliques); the obliques are important stabilizers of the spine, ribs and pelvis; part of “good posture” is balance of ribs over pelvis.

 

Neutral bridge – outer heel and first ray focus again; you want to see neutral foot alignment if possible (remember this is a work in progress so baby steps!)

 

Hip fold – obliques and add cues for weight in ribs and lower part of t-spine; when ribs and lower t-spine can release into the floor the entire “core” is working more efficiently; as this part of the spine neutralizes in terms of its curve forward head carriage improves and movement in the entire body is more efficient…especially when people walk!

 

If the group is strong enough do variations on the hip fold to increase the stabilizing challenge to the obliques…work towards single leg stretch, double leg stretch, double straight leg stretch, 100 (remember to always watch the anchoring of the back ribs and t-spine)

 

3. Side Lying

Side lying hip abduction L – to strengthen gluteus medius (and gluteus minimus and TFL); these muscles are integral to efficient gait mechanics and weight bearing on one leg; gluteus medius should fire first, then gluteus minimus, TFL, QL, piriformis and erectors

 

Side bridge R – focus on ribs and pelvis being aligned over each other

 

Side bridge L – this is one of the best core exercises to do; it can be difficult if there are neck and shoulder issues but even two or three can be enough to create better support for the spine, ribs and pelvis; it recruits obliques, QL and erectors as well as gluteus medius, maximus, minimus and TFL…and serratus anterior in the shoulder girdle if everything is working well; when the ribs become more balanced over the pelvis and the lower t-spine curve neutralizes posture and gait can only get better and better!

 

Side lying hip abduction R – focus on gluteus medius reruitment

 

Neutral bridge – outer heel and first ray focus for functional weight bearing; glutes and upper hamstrings for pelvic support; another point about glutes and upper hamstrings is that they are important hip extensors and therefore integral to the gait cycle

 

If the group or individual is strong enough do variations on the neutral bridge to increase the challenge to holding efficient weight bearing in the foot and recruitment of glutes and upper hamstrings…work towards bridge with hip fold, and bridge with leg arc

 

Transition to sitting with a roll up…(or anything else); turn over to quadruped

 

4. Quadruped

Quadruped arm leg reach – this exercise targets the posterior oblique system (gluteus maximus and opposite lats primarily); this cross pattern provides stability for the spine and sacroiliac joints; this is integral to efficient gait mechanics and standing up in neutral posture

 

Add variations to quadruped arm leg reach if the group is strong enough. Build toward plank, leg pull front and push up; in the variations where the toes are curled back remind people to anchor through the first ray on each foot

 

5. Return to standing

Downward dog – first ray and outer heel (even if the heel is not touch the ground)

Walk hands back to feet and roll up to stand

 

6. Standing cool down

Cat stretch with hands on thighs

Waving cat with hands on thighs

Standing crossover leg swing

Relevé with ball between heels (ball is optional)

Standing crossover leg swing – to mobilize ankles for better stability

Lateral arm arcs and breathing