exercises

Some exercises to consider for your pre- and post-SDR rehab. Always modify according to your abilities. Some of these exercises apply to more than one category, so feel free to mix and match too! You can also do a lot of these on a vibration plate, or add the vibration plate before or after your exercises to strengthen and loosen your muscles. The videos aren’t mine; I’ve just linked them as examples.

HIP EXERCISES

If the exercise is in orange, you can click on it to go to an example video!

 

  • SIDE LEG LIFTS (3 types): Lie on your side with both legs stacked on top of each other (bottom leg can be straight or bent according to your preference). Lift your top leg straight up; you can do repetitions or holds. Then repeat exercise with your top leg forward. Then repeat with your top leg behind you. Each version targets the abductor muscles slightly differently. (The video shows only the front and back version, but also do them straight up and down.)
  • SIDE LEG SLIDES AGAINST WALL: Lie on your side with your back a few inches from a wall. Remove your shoes so you’re just wearing socks or place a pillowcase over your shoe to prevent scuffing the wall. Move your top leg back so that your heel is touching the wall, and slide your leg up and down the wall for as many reps as you can. Try to reach as high on the wall as you can.
  • SEMICIRCLE SIDE TAPS: (not sure of the official name of this one) Lie on your side and move your top leg forward, tapping the ground in front of you with your toe. Then swing your leg all the way behind you, tapping the back of the ground with your toe, and repeat. Try to arc your top leg as high as possible as it moves over the bottom leg, oscillating between front taps and back taps. (Be careful not to swing too “hard” or too fast so you don’t pull a muscle!)
  • STANDING ABDUCTION: This is less effective for me, because other muscle groups kick in pretty quickly, but you can try just standing and moving your leg out to the side. When I do this, I need my supporting leg to be standing on something raised a little off the ground, like a small step, so that my other leg can stay fully straight. Add ankle weights for a challenge.
  • CLAMSHELLS: Before doing this exercise, I find I got best results if my PTs do hip mobilization stretching on me (rotating my hip in its socket and applying gentle pressure to release tightness). When you do this exercise, make sure that someone holds your shoulders to prevent your body from compensating and shifting your weight backward; if this happens, the correct muscles won’t be used. Even better, do this exercise with your back and backside pressed firmly against a wall. Also be sure to “control the negative”: after you’ve reached your maximum clamshell height, move your top knee back down as slowly as you can.

Clamshell modifications: Have someone move your top leg for you to achieve the range-of-motion you lack. Then, see if you can hold it there after they let go. If not, see if you can hold it there with them giving as little support as possible (ask them to help hold your leg with one finger first, for example). If you can’t hold that position at all, you can also just work on “controlling the negative” (bringing your leg back down with as much control as possible).

For a greater challenge, you can try using resistance bands or an ankle weight on your top leg.

 

  • FIRE HYDRANTS: These aren’t great for me; they’re really challenging, and I don’t feel them as much as the other exercises because I can’t get this motion in my leg. But I’m adding them here because some people like them!
  • PILATES RING ABDUCTION: Lie on your back with a Pilates ring around your feet. Lift your legs up a few inches while focusing on pressing your feet outward to keep the ring from falling. Hold as long as possible. (Sounds simple, but it makes my legs shake from the effort!) For a modification, you can have someone help you hold the ring steady, or you can do the same exercise with a resistance band around your feet. You can also try just lifting your legs up and holding as long as you can without anything at all. (If you feel low-back pain during this exercise, stop.)
  • SIDE-STEPPING: Put a resistance band around your ankles (challenging) or thighs (easier) or somewhere in between. Side-step across the room with the band on, or around a table or countertop for balance. Try to always keep SOME resistance in the band, so don’t step all the way in each time. I also do this exercise holding on to a TRX pulled taut for balance; I place the band around my ankles, do a 90-degree squat, and then side-step back and forth as far as the TRX will let me go.
  • SQUATS, WALL SITS, and LEG PRESS: All three of these are variations on the same exercise. Try to *really* focus on keeping your knees apart during these exercises. Ankle weights sometimes help with this. You can also try putting something between your knees, but I find that my hips work the hardest when I don’t have anything between my knees. For an added challenge on the leg press machine, you can try pressing with just one leg (use a REALLY light weight, especially if you’re just starting…and not too many reps; this exercise will make you sore fast!); this will activate many different muscles at once.
  • BULGARIAN SPLIT SQUAT: If this is too hard, you can try modifying it by placing your back foot on a lower surface, like a free-standing PT step, and then dipping down into a squat (always hold on for balance).
  • RESISTANCE BAND LEG ABDUCTION: Place a resistance band around your knees while sitting in a chair and focus on pulling your knees apart. Try to do the motion with your knees, not your feet. (If only your feet move to pull the band but your knees actually cave in, you’re using your internal rotators instead of your abductors, which is counterproductive!) You can also combine this with a bridge, placing a resistance band around your knees and bridging while pressing your knees out.
  • RESISTANCE BAND FOOT ABDUCTION: Sit on a higher surface so your feet are swinging, and place a resistance band around your feet. This time, focus on pulling your feet apart. If one or both of your feet turn in during this exercise (pigeon-toe), consciously try to keep them straight.
  • SIDE PLANKS: These really activate the glutes and abductors. Try them with your knees bent, and if that’s too easy, straighten your legs. For an even greater challenge (I can’t do this yet, but I’m told it’s possible….), lift your top leg while you side plank, combining side leg lifts with planking!
  • BOSU KNEELING: Kneel on a Bosu ball. I like to do this while I work on puzzles, and it’s a great way to activate glutes (and abductors, but glutes in particular)! Just be careful not to overdo it; start slow. I usually don’t realize how much my glutes worked until I wake up the next morning and can hardly walk, haha. For an added challenge, you might try kneeling on the Bosu without your toes touching the floor (it’s tough balance work!) and/or while moving your arms (out to your sides like a bird, then in front of you, then over your head, then repeat).
  • HALF KNEELING: Really targets the hips, especially if you focus on keeping your front knee from caving in and try to balance in that position with as little support as possible. As you progress with this exercise, try transitioning from half-kneel to standing while holding on as little as possible, or try add an exercise for your upper body, like moving your arms while half kneeling or catching a ball.
  • TRX V-OUTS: If you have access to a TRX, lie on your back and place your feet in the straps (you might need someone to help you do this or lengthen the straps so they’re almost reaching the floor). Then press down with your hands to lift your body a few inches off the floor, keeping your core tight, and move your legs out in a V. You can do this with reps or just hold it in the V. My trainer gently moved my legs out even further, slightly past my active range of motion, and had me hold that position, and I felt a new part of my adductors activate for the first time ever! (This can also be done in a plank position, like this. But you’ll probably need someone to help you place your feet in the straps.)
HAMSTRING EXERCISES
  • CHAIR HAMSTRING CURLS: Lie on the floor with your legs straight and place your heels on the seat of a chair. Bridge up and pull the chair toward you, bending your knees.

  • BALL HAMSTRING CURLS: Lie on the floor with your legs straight and place your heels on an exercise ball. Bridge up and pull the ball toward you, bending your knees. (To make this exercise easier, have someone hold the ball and gently guide it toward you as you move it.)
  • LYING HAMSTRING CURLS: Lie on your stomach, bend your knee, and move your heel toward your bottom. Make sure to keep your quad (thigh) pressed into the table as much as you can; if it pops up, your quads are taking over for the exercise. For an added challenge, add light ankle weights. You can also try with a resistance band or have someone gently hold your heel down while you try to resist them.
  • HALF-KNEEL TO STAND: I really struggle with this one, but it’s a great way to build hip and hamstring strength at the same time! To make this exercise easier, hold on for balance (with one hand or both, depending on your needs), and put a foam pad or stacked blankets underneath your knee.

  • TERMINAL KNEE EXTENSIONS: These strengthen the lower part of the quad muscle and can help with knee straightening. They can be done seated or lying down too, or by pressing a ball into a wall. If you’re trying these with weight or resistance bands, be careful not to use too much weight or resistance, as this can put too much stress on the knee joint and cause pain.
  • SQUATS, WALL SITS, AND LEG PRESS: (See HIP EXERCISES tab above)
  • INCLINE TREADMILL WALKING: The higher the incline, the more you’ll target your hamstrings.
  • LEAPING: This one helps with balance and quad strength too! Jump across a room. You can focus on different aspects of your jumping for each lap, like jump height and jump distance. It may be helpful to have someone nearby to catch you if needed. You can also try jumping in and out, kind of like this (although my version doesn’t look nearly as graceful…).
  • CRAB-WALKING: If you need help figuring out how to coordinate this movement, it helps to slow the video down.
BALANCE EXERCISES
  • TANDEM STANCE: Place one foot in front of the other and try to stand in place. Make sure to have something sturdy next to you for balance if needed. To make this easier, widen your stance so that your feet aren’t directly in front of each other.

  • BALL BALANCE: If standing on one foot is too tricky, place your front foot on a ball. A large, firm ball will be easier than a small, squishy ball, so you can adjust the exercise according to the challenge you need. As with all balance exercises, I recommend standing next to a table or other surface to grab for balance if needed.
  • MARCHING: March in place, or if that’s too easy, march across a room, bringing your knees up as high as possible.
  • CONE TAPS: Place cones around you and tap each cone with your toe. If the foam pad makes this exercise too difficult, do this on a regular floor surface. Other ways to make this exercise easier: Place the cones closer to you, use taller cones, and/or hold on. Have someone standing nearby to catch you if needed. You can also try sidestepping or front-stepping over the cones.
CALF EXERCISES

I find that it’s especially helpful to stretch my calves before I exercise them; it helps me get a lot more range-of-motion, so they’re more sore the next day. Also, many people with CP find that their calves are particularly easy to pull or overwork, so start slow and be careful.

  • CALF RAISES: You can do this on the floor or on a step. I feel them most when I do them on a step.
  • LEG PRESS CALF RAISES: Be extra careful with this one. It’s really easy to pull your calf muscles if you use a lot of weight, especially for people with CP. I do this one with no weight or the lowest setting.
  • SLED PUSH: (Tip: if you have a manual wheelchair, you can add weight to your wheelchair and use it to do sled pushes.)

I also find my calves work hard when I try activities like doing squats and treadmill walking on my tiptoes. But unlike many people with CP, I don’t struggle with toe-walking at all. If heelcord/calf tightness is a significant issue for you or you have a habit of toe-walking, I would not recommend exercises that involve tiptoeing unless your PT feels they would help.