Maintaining your body’s strength and muscle mass is important for your overall health, especially as we age. As movement experts, physical therapists are familiar with which muscle groups are commonly weak and what areas should be strengthened to reduce chances of muscular imbalances. Try out these 7 physical therapy strengthening exercises and find which are most difficult for you. Keep working on them to help strengthen your weaker areas and reduce muscle imbalance throughout the body!
**This is not medical advice. Please consult your medical provider for more information.
Chin Tuck
The chin tuck is an important foundational strengthening exercise in physical therapy. It is an integral part of understanding proper seated and standing posture.
This exercise targets the deep neck flexors, placing the neck in a good position to reduce forward head posture.
To appropriately target the deep neck flexors, sit up tall and think about pushing your chin straight back as if you were creating a double chin. At the same time, imagine a string is pulling the top of your head towards the ceiling. You will feel a slight rotational movement of the head and neck from the combined movements of creating the double chin as well as “lifting” your head/neck towards the ceiling. Think like you are elongating your spine upwards. Make sure to avoid flexing your neck forward and looking down towards the floor when performing your chin tuck.
You may feel a stretching feeling along the back side of your neck. This is normal as this movement is activating the deep neck flexors (deep layer of muscles in the front of the neck) and allowing the cervical paraspinals to relax (back of the neck). We usually find ourselves in the opposite position with weak deep neck flexors, which then places increased activity and strain on the muscles of the back of the neck, leading to stiff necks, headaches, and pain along the neck, shoulders, and sometimes to the upper back. Strengthening exercises for the deep neck flexors are great for improving your posture!
Bilateral Shoulder External Rotation
This exercise is another go-to for postural corrections. It will target the back of your shoulders near your shoulder blades.
Hold a resistance band with your palms up and elbows at your sides. Make sure your shoulders are not rounded forward throughout the duration of the exercise. Without moving your elbows from your sides, pull the band apart, briefly pause at the end of the movement, and slowly bring your arms back to the starting position. You should feel the muscles working on the back of the shoulders near the shoulder blades.
Sidelying Clam
The clam exercise is a staple for physical therapists when it comes to strengthening the glutes. Largely because anyone from any level of physical fitness or any age can perform this strengthening exercise. It is also great to teach people where the gluteus medius muscle is and to help with activation. If you cannot activate the muscle and “find it,” you will not be strengthening that muscle.
To perform the sidelying clam, place a resistance band just above your knees and lay on your side. Bend your knees so your hips are flexed at a 45-60° angle. Keep your feet together and lift your top knee up towards the ceiling. Be sure you are not rolling backwards; if so, you will be cheating with your low back. This is a gluteal exercises, not a back exercise. You should not be feeling this exercise in your low back. If you are, you are performing the exercise incorrectly. Take your top hand and stabilize yourself on the surface you are on if you need a little more help with stabilization. You want to feel this exercise on the side of your hip or slightly backwards towards the gluteus maximus.
I like to hold this position for 30-60 seconds at a time, but repetitions also work. If it is too difficult to hold the position, perform repetitions of 10-15 with feeling the appropriate muscular activation to help build strength. Once this becomes easy for you to perform and it doesn’t feel as challenging, start holding the position for 15-30 seconds and build upwards as you get stronger and stronger!
Fire Hydrant
Physical therapy strengthening exercises, when performed correctly, can be some of the most difficult exercises to perform, leading to great strength gains! One of my favorite exercises is the fire hydrant. There are many variations of this exercise to fit your needs. Most people may be familiar with this exercise, however many perform it wrong. Here, we will go over the 3 components needed to create maximum strengthening of your gluteal muscles and common pitfalls to avoid.
The gluteus maximus is a very large muscle on the back of the hip… the bum, the butt, the derrière! This muscle performs three different actions of the hip – hip extension (when the leg goes behind you), hip abduction (moving your leg to the side away from your body), and hip external rotation (rotating the leg outward). The fire hydrant exercise is commonly performed with only one or two of these movements. If you perform all three at the same time, you recruit more muscle fibers and get a greater muscle contraction. And you know what that means… more strength!
To perform this exercise correctly, start on your hands and knees. Move your right knee at a 45° angle behind you, NOT DIRECTLY TO YOUR RIGHT SIDE. This allows you to incorporate the extension and abduction movements. The final movement is external rotation. Try to rotate your right leg outwards like you are trying to drop your foot to a lower level than your knee. This movement can be quite difficult to hold, but when you do it right, you will know!
Common faults involve arching, lifting, or rotating the back. Try to keep your low back still, only moving from your hip joint. If you feel the muscles working in your butt, you’re doing it right. You should not feel this exercise in your low back if you are doing it correctly.
Abdominal Brace with March
Abdominal bracing targets the transversus abdominis which lays in the deeper muscular layers. Strengthening exercises for this large muscle helps protect the low back and works great for those suffering from low back pain!
You will start by lying on your back with your knees bent. To ensure you are activating the correct muscle, find your hips bones with your fingers and bring them slightly inward towards your belly button. Cough once. The push you feel against your fingers is the same thing you want to feel when you are performing this exercise. You must be able to maintain the abdominal pressure while breathing normally at the same time, which is honestly the hardest thing today. It takes practice, but this step is crucial before continuing forward!
Once you are able to feel and hold the activation of the transversus abdominis and able to keep breathing at the same time, take a deep breath in, feeling your belly rise. Maintain that abdominal pressure by activating the transversus abdominis and breathe out. Your belly should not fall with exhaling if you are able to keep the abdominal pressure constant. Keep that transversus abdominis activation going!
Next, you will march in place. Keep your abdominals activated and bring one knee up towards your chest, then lower it back down. Repeat on the other side. The abdominals should be activated throughout the entirety of this exercise. You should feel the abdominals working and no pain in your low back. Remember to keep your ribs down and avoid arching the low back to ensure proper abdominal activation.
Squat
There is a lot that can be unpacked in the squat. The squat is a compound movement that involves many muscles and multiple muscle groups. For our purposes, we will be focusing on the basics and focusing on form and common mistakes with form.
Your feet should be placed right under your hips or just slightly outside your hips. Point your toes forward or slightly outward. It is important to keep your back in a neutral position by trying to avoid excessively arching your low back or flaring your ribs. Drop your bottom down towards the floor, bending your knees until they are parallel with the ground or almost parallel. Squat to a depth that is comfortable for you.
When you stand back up, imagine pushing your weight through your heels and driving your hips forward. This will help activate your posterior chain, increase gluteal activity, and reduce the chances of using your low back to stand back up. Remember to avoid arching your back as you return back to a standing position. This is a compound movement so you may feel multiple areas of your body working. Common areas to feel are the quads, hamstrings, and glutes.
Single Leg Eccentric Heel Raises
The key to this strengthening exercise is a slow controlled movement. During eccentric movements, the muscle actively lengthens against resistance. You can really improve your ankle strength by incorporating eccentric movements into your routine. Try this out and feel the burn!
Push up into a heel raise by standing on your toes. Lift one of your legs up so you are only standing on one leg. Slowly lower your heel back down to the ground over a count of three. Remember, SLOW COUNT! The movement is supposed to be performed slowly. Stand back up on your toes and repeat.
If you need to make this exercise a little bit easier, either grab onto a stable object to provide you with some more stability or lower back down to the ground on two feet instead of one.
More Strengthening Exercises to Try
TL;DR
These 7 physical therapy strengthening exercises target the full body and include some of the mot commonly found weak muscles throughout the body. Try all 7 and find which were most challenging for you! This may give you clues to areas you may need to target.
