Part four of the Functionally Fit knee miniseries analyzes the anterior medicine ball lunge with trunk rotation, a great exercise for countering valgus overload and improving motor and muscle function.

See 'Related Resources' below for past Functionally Fits (including the knee series) and other exercises and training tips.

Execution


Holding a medicine ball, lunge forward and simultaneously rotate the arms/trunk to the same side as the lunge leg.


Return to the start position, and repeat on the other side.

Perform two to three sets of 10-12 reps on each side. As a progression, advance to walking lunges, using a similar rep scheme.

Note: Instruct the client to maintain a neutral lordosis, and use full range of motion, provided it is pain-free.

Application
Most of your clients have gluteus medius weakness and perhaps inherent valgus overload (knees cave inward with squats and lunges). Rotating the trunk and arms to the same side of the lunge leg naturally reduces or eliminates the valgus moment at ground contact and is helpful for improving motor learning and muscle memory.

More importantly, the exercise activates the entire posterior chain as you decelerate the body against gravity and builds solid glute/hamstring strength. Adding in the rotational component will improve knee stability and encourage proper movement dissociation between the spine and hips as well, which may be beneficial for athletes with mobility issues (particularly golfers).

Some trainers may question, "Why not do it the other way, too?" I am not opposed to that per se, but the client must have much better strength, core stability and neuromuscular control to avoid a valgus moment at the knee. You will also notice females struggle more because of their wider hips and higher Q angles. If you elect to do it this way, I would simply suggest letting the client get into a fuller lunge prior to initiating the trunk rotation to reduce the chance of losing proper form.

I also routinely include this exercise as a dynamic warm-up for all my field and court athletes (sans medicine ball). It can effectively be done using just the arms and is very useful for improving hip mobility and dynamic hip/knee control with deceleration of the body.

Brian Schiff, PT, CSCS (www.brianschiff.com) is a licensed physical therapist, respected author and fitness professional. He became a Certified Strength and Conditioning Specialist (CSCS) in 1998. In 2000, he opened his own personal training and sport-specific conditioning facility, Fitness Edge, in Dublin, Ohio. Brian has presented at several professional conferences and seminars on injury prevention and sport-specific training.

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