Overcoming asymmetrical quad weakness is essential when attempting to optimize or restore knee function following an injury, surgery or as part of a training plan. Sometimes pain interferes with traditional pistol squats, split squats, lunges etc., and this exercise variation provides another way to improve strength and limb stability.
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Execution:
Use a smaller fully inflated stability ball (ideally 55 cm) and place it in the small of the back. Position the feet slightly out away from the body allowing for a small amount of recline into the ball initially. This can be increased or decreased based upon comfort, strength and stability.
Next, slowly squat down on the left leg while allowing the right foot to trail behind the body. Pause for 2-3 seconds at the bottom, and then return to upright. Perform 8-10 reps and then switch legs. Modify the depth of the squat and/or height of the ascent based upon comfort while avoiding painful ranges of motion. Perform 3 sets on each side.
Regressions:
1. Allow the toes of the unsupported leg to remain on the floor to add stability and offload the weight on the working leg to the degree necessary
2. Isometric version with holds for 5-10 seconds at a comfortable depth
Progressions:
1. Fold the arms across the chest to reduce stability
2. Increase time under tension via a slower cadence on descent 3. Add external load (dumbbells or weight vest)
Note: It is important to maintain proper alignment (knee points at 12 o’clock during movement)
Application:
This exercise variation is often effective in helping clients with anterior knee pain perform an effective single squat with much less to no discomfort by modifying depth, shin angle and the level of available support. Using the ball allows for incremental and progressive change in ROM that can be done rep to rep. Most importantly, this is an effective way to improve quadriceps strength and resolve limb symmetry imbalances if they exist.
