GHD: A Secret Weapon for Bilateral Above Knee Amputees When performing strength assessments on bilateral above knee amputees, it should come as no surprise that we find a major weakness in the athlete’s glutes and hamstrings. For the most part, this is to be expected, as these once powerful body parts undergo significant damage and muscle loss post-amputation. Once more, there are very few exercises that bilateral AKs have at their disposal to force significant strength gains in these areas. While hip bridges, superman, abductor/adductor work, and all their modifications do help, few exercises pack the physical and mental punch of GHD (glute-ham developer) hip extensions (GHDs for short). If you are fortunate enough to have access to a Glute-Ham Developer, this may be one of the most effective exercises you can do to build stronger and more powerful glutes, hamstrings, and hips. It’s not uncommon for BAKs to report marked improvements in run, bike, and swim times and overall performance after several weeks of including GHDs in their strength training program. They are also a potent prescription for strengthening your lower back, which may reduce lower back pain and/or prevent injuries. Here’s How it Works: As you can see in the video, a GHD allows a BAK to lock their prosthetics into the foot rest, while resting their hips on a padded surface. In this position, with arms held across chest (or at sides) and torso parallel to the floor, the glutes and hamstrings (with assistance from the lower back) become the primary muscle groups responsible for holding the athletes’ body in place. This is the starting position. Once this position is stable, the athlete begins to lower their torso (with a flat back, no rounding!) until it is nearly perpendicular to the floor, which forces a deep stretch through the hamstrings and lower back. From the bottom position, the athlete squeezes their glutes and hamstrings hard to forcefully drive the torso back up to the starting position. That’s one rep. Throughout this motion, the glutes and hamstrings are stretched and then tightened over a broad range of motion, leading to greater strength, power development, and functional movement. A Measure of Caution: It is relatively easy to perform GHDs with incorrect form, an inappropriate rep range, and a less than desirable tempo. All of which can lead to injury. Even for seasoned athletes, this is a very demanding exercise and should be approached with a measure of caution and attention to detail during execution. How to Use GHDs Safely in a Training Program: For beginners with very weak glutes and hamstrings and/or underdeveloped body awareness, we may use GHD static holds in the early stages of their training program. This exercise merely requires the athlete to hold the top position for a prescribed time, or for as long as possible (even if that is only for a few seconds). We generally begin by testing the amputee’s ability to hold the static position until they become uncomfortable. If they can exceed 90 seconds and demonstrate good technique when performing the full exercise, then we may begin prescribing sets, reps, and tempos (tempo dictates the amount of time that the primary muscle groups are exposed to tension during a set). Here’s a Few Common Mistakes to Avoid: 1) Not squeezing your butt and hamstrings hard enough in the set-up. After your prosthetics are set in the foot rests, be sure to squeeze your glutes and hamstrings hard before you begin the movement. This will help you keep your spine neutral and prevent you from over-loading your lower back (as opposed to your glutes and hamstrings). 2) Hyper-extending your spine in the set-up. Be sure not to raise your chest up too high during the set-up. We want to see a tight, flat, neutral back at the top position, not a half-pipe! 3) Lowering your torso with a rounded back. This will completely change the exercise! As shown in the video, be sure to keep your back tight by sticking your butt out as you lower your torso. Think about keeping a ‘ski slope’ in your lower back on the way down. 4) Not lowering your torso low enough. With most athletes, we want the torso near perpendicular to the floor in the bottom position. 5) Leading up out of the bottom by ‘throwing’ the chest up. Throwing your chest up out of the bottom can hyperextend the spine and put unwanted pressure on your lower back. Instead, lead out of the bottom by squeezing your glutes and hamstrings hard while keeping your back tight and neutral. 6) Performing GHDs with no tempo. We generally prescribe tempos to build body awareness, force greater strength gains, and prevent injury. Lowering your body over 3 seconds with no pause in the bottom (other than to make sure your back is in a neutral position), rising fast, and holding the top position for a full 3 seconds is a potent method for accomplishing all of the above. What if I dont have access to a GHD? If you don’t have a GHD, there are many substitutions that are beyond the scope of this post. But one simple modification deserves your attention. You can find a 45 degree hip extension or ‘Roman Chair’ in most gyms. While it is far less taxing than a GHD, it is a worthy substitute, especially if the foot support is raised to simulate the body positioning of a GHD (shown at the end of the video during phase 2 of Roy’s program). Why are APS posts so long? We aim to provide you with a level of detail in our posts (and in the videos themselves) that allows you to apply our methods and benefit from their use. If you ever have questions about how to include GHD Hip Extensions in your training program or would like a quick review of your technique, please don’t hesitate to reach out - post a video of you performing the movement or email us and we’ll be happy to help. And if there’s something specific you’d like to see here, please let us know and we’ll get to work on it! #challengedathletesfoundation #peterharschprosthetics #amputeecoalitionofamerica #woundedwarriorproject #amputeefitness #usparalympics
Posted on: Thu, 06 Nov 2014 15:01:05 +0000
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