Brian_6

Whether recovering from an injury or simply looking to eliminate asymmetries and enhance function, I often incorporate single leg reaching progressions. The ability to balance and reach in a dynamic manner while avoiding medial knee collapse (valgus) is a challenging task for many. Using a cone while dynamically reaching on one leg provides visual cuing and additional kinesthetic feedback to the body to guide motor learning. I feel using gravity and a person's body weight is a great way to train in a proprioceptive manner. The cone reach is a 'go to' exercise progression in my rehab and prehab routines..
 
Execution:
Begin standing on one leg and slowly reach both hands forward and down toward the cone. Allow the free leg to move behind you and keep the stance heel on the ground. Lightly touch the cone at the bottom and return to the full upright position each time. Perform 10 repetitions and repeat on the other side. Repeat for 2-3 sets.

Be sure to keep the knee tracking over the second toe. I often cue clients to imagine a laser beam pointing out from the center of the kneecap and over the second toe as a cue. Discourage any excessive valgus or hip internal rotation/adduction during the movement, and watch for overpronation as well. The exercises can be done in front of a mirror to offer visual feedback. Additionally, I will place my hand medial to the stance leg and tell the client not to let the inside of his/her knee touch my hand on the way down to offer kinesthetic feedback as well.

Progression:
1. Use a shorter cone and/or reach to the floor
2. Stand farther away from the cone
3. Alternate hands as you reach toward the cone
4. Stand on an unstable surface (foam or pad) and use the aforementioned progressions

Regression:
If clients struggle with limited mobility or stability, simply start by using a tall cone or other object they can reach toward while maintaining heel contact with the ground and good form. You may also opt to stand closer to the cone or simply reach part of the way down.

Application:
This exercise offers several benefits including: strengthening the entire lower chain, increased proprioception, improved dynamic stability, improving ankle mobility and reducing injury risk. It is appropriate for all ages and abilities, and serves as an excellent way to assess and train single limb balance and stability.


Brian Schiff, PT, OCS, CSCS, is a licensed physical therapist, respected author and fitness professional. Currently, he serves as the supervisor for EXOS API at Raleigh Orthopaedic. Brian conducts live continuing education webinars and presents nationally at professional conferences and seminars on injury prevention, rehab and sport-specific training. For more information on his products and services, visit
www.BrianSchiff.com.

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