Clinical Pearls: Function Applied : Pre-positioning in Ankle Rehabilitation
Although I developed TRI-STRECH® for tri-planar stretching of the calf, hamstrings and iliotibial band, it has become one of my favorite tools for functional strength training progression through the use of pre-positioning.
Pre-positioning is exactly what it says it is. Placing the joints and muscles in a pre-postion..a position that is held while performing the exercise. Pre-positioning allows the therapist or trainer to put a joint or a muscle at a mechanical advantage or disadvantage. TRI-STRETCH® puts numerous pre-positioning possibilities in to the hands of the clinician. TRI-STRETCH® allows the clinician to have a methodical progression to a functional strengthening and rehabilitation program.
An example of pre-positioning for a rehabilitation program could be:
Diagnosis: 6 weeks post right lateral malleolus avulsion fracture and anterior talo-fibular ligament sprain
Exercise: Single leg balance opposite foot reaches at ankle height
Progression: 1- Begin with right single leg balance on TRI-STRETCH® with TRI-STRETCH® in preposition of tipped inward (calcaneous everted-protecting the lateral ankle structures).
2- Perform first left posterior lateral reaches which allows more hip flexion and therefore posterior hip muscles assisting the lower leg while keeping the right lateral ankle structures in a protected position.
3- Progess to left lateral reaches which will lessen the assist from the hip yet still keep the TRI-STRETCH® tipped inward to protect the right lateral ankle.
4- Then progress to left anterior lateral reaches further lessening the assist from the posterior hip.
The pre-positioning concept can be used to progress the lower extremity reach program to methodically add greater stress to the lateral ankle structures.
To learn more about TRI-STRETCH® for rehabilitation: click here.