In this blog, I demonstrate 5 popular physical therapy exercises made better, including bird dogs, bosu ball squats, and posture exercises.
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#1 Bird Dogs
The bird dog is one of the most popular core exercises. It is primarily used to target the hip extensors (like the gluteus maximus), the low back extensors (like the erector spinae), and muscles regarded as stabilizers (like the multifidi).
The bird dog can be an excellent entry point for training these muscles if you’ve recently been injured, you’re experiencing high levels of pain, or you’re new to exercise.
The underlying problem?
The ceiling for mastery is low, and so is the potential for progressive overload.
This is not necessarily a bad thing because you don’t always have to be in the constant pursuit of making an exercise harder. However, we try to add repetitions to push-ups, weight to squats, and shave seconds or minutes off our running distances, so why are we more accepting of low effort bird dogs that no longer challenge us enough to stimulate desirable adaptations?
If bird dogs work well for you and your goals, I’m not suggesting that you stop doing them. But if you’re seeking a suitable substitute because they’ve become stale or too easy for you after months of performing the same hold times, consider the following options:
1. Roman Chair Back Extension.
You can perform these isometrically, with or without weight, or move through a range of motion that is tolerable for you, with or without weight. These can also be performed unilaterally.
2. GHD Back Extension. The same options apply, but these will be more difficult.
3. Back Extension Holds on an Exercise Ball.
This is a great alternative to the previous options that can be done at home with your arms across your chest, down by your side, out in a T, or overhead. You can even alternate arms and legs like a bird dog. For any position, feel free to add weight as well.
4. Bridges and Hip Thrusts.
These movements also train your back extensors, hip extensors, and multifidi, but you can add significantly more load or do them single leg.
Once again, bird dogs themselves aren’t inherently problematic; it’s more about properly matching the intensity of an exercise to your current fitness level and goals.
#2 Bosu Ball Squats
Squats on a bosu ball are a staple in physical therapy clinics and gyms around the world because they can be fun and challenging.
The underlying problem?
Greater complexity is not always better.
If you want to maximize your strength and muscle mass, squatting on a stable surface (like the floor) is superior for both.
But what about those stabilizer muscles?
Well, if we can name them, we can train them.
So if you’re thinking about the gluteus medius and minimus as smaller, stabilizing muscles, include hip abduction exercises that train them directly and more effectively.
Plus, simply adding resistance to squats on flat ground increases the demand on those muscles more than the bosu ball itself. You can also do single leg exercises if you want a balance component, such as reverse lunges and single leg RDLs.
#3 Straight Leg Raises
If you’ve had knee surgery, you’ve probably done straight leg raises. It’s a milestone that almost everyone is expected to achieve, whether you’ve had a Total Knee Replacement or an ACL Reconstruction.
The underlying problem?
The intention eventually stops matching the goal.
Initially, quad sets and straight leg raises are on a short list of must-do exercises because they help with swelling, range of motion, and basic quadriceps control.
However, people often view straight leg raises as a quadriceps strengthening exercise, but except for very early on, they are actually a hip flexor strengthening exercise.
Squats, step ups, step downs, etc. help fill in the gap, but seated leg extensions should be included as well to truly strengthen the quadriceps, whether that’s with a machine or a method to perform them isometrically with the knee bent.
The purpose of your exercise selection should always match your goal.
#4 Doorway Pec Stretch
There are multiple variations of the doorway pec stretch commonly prescribed to patients by physical therapists, but the underlying problem for me is that the stretch often causes more problems than it solves.
It’s difficult to feel and frequently aggravates people’s nerve, shoulder, or neck-related symptoms.
You might describe that as a problem with the teacher or the performer, but if there’s a better option, why not choose it instead?
For example, you can easily lie flat on your back lengthwise on a foam roller, arms by your side, and breathe calmly to relax into this position.
Eventually, you can create a T or Y with your body and arms, move in and out of these positions, perform snow angels, use weights, or slowly move a dowel overhead, with or without weight.
This last option can also be performed on a bench or box. You should feel like you have more control.
Whether it’s a doorway pec stretch, a neck stretch, or a hamstring stretch, you don’t want a movement to feel unnecessarily forced or overly aggressive in a way that might create more problems.
#5 Posture Exercises
Posture exercises come in many forms: chin tucks, wall slides, hip flexor stretches, bridges, and the list goes on.
I don’t have a problem with any of these exercises, but sometimes the simplest solution is the best one.
If your day consists of (1) working at a laptop or computer for 8-12 hours, (2) being glued to your phone while eating, using the restroom, and lying in bed, and (3) plopping into the couch at night to watch television or play video games, (4) all without much movement or exercise throughout the rest of the day, I’d argue that you likely have a lifestyle problem, not a posture problem.
You can do any of the exercises I mentioned, but you might notice a bigger benefit in every aspect of your life, not just as it relates to posture or pain, if you incorporate a few 10-15 minute walks periodically throughout the day.
5 Things Physical Therapy Often Gets Wrong
If you want to keep doing bird dogs, bosu ball squats, straight leg raises, doorway pec stretches, and posture exercises, I’m not here to stop you. But here are 5 things physical therapy often gets wrong:
- Not properly matching the intensity of an exercise to your current fitness level and goals.
- Assuming greater complexity leads to superior outcomes.
- Choosing the wrong exercise for the desired adaptation.
- Prescribing exercises that create more problems than solutions.
- Overlooking the fact that the simplest solution is often the best one.
Looking for rehab or performance programs? Check out our store here!
Want to learn more? Check out some of our other similar blogs:
The Truth About Butt Wink, The Truth About Knee Valgus, The Truth About Shoulder Impingement
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