Single Leg Stability
by Dr. Matt McGowan D.C.
When I look at patients’ current workout plans, a very common theme is a lack of “unilateral training” especially with regards to the lower body. What I mean by unilateral training is specific work done to one side of the body at a time to address any imbalances you may have side to side. Often patients’ programs will contain a wide variety of squats, deadlifts, lunges, etc. – all wonderful movements on their own. But think about the fact that every time we walk or run we are doing hundreds of thousands of single leg balances. Where is this reflected in our training? And it’s not just my patients. I have seen many accomplished athletes who can barely pass single leg balance tests. Unsurprisingly, patients who ignore unilateral training frequently present with lower back pain or hip problems. How do I test in office to see if you have an imbalance? Two very good screening tests can be done quickly at home to see if you have some issues with single leg balance:
1. In bare feet, stand facing a mirror; raise one leg up to 90 degrees at the hip so that the top of the thigh is parallel to the ground. When doing so first observe the overall ease of movement. Is it hard to do? Are you wobbling or shaking? Next look at your ankle, does it cave inward? Does it want to roll outward? See how long you can hold in that position with minimal ankle wobbles. If you can hold for 30 seconds and remain pretty still, that would be a passing grade. Then repeat on the other side.
2. The second test is a Step-Out Lunge. Again, do this in front of a mirror and perform three step-out lunges out and back per side. In this test again notice the ease of both the movement stepping out as well as the ease at returning back to a standing position. Next look at the knees, as you lower into the lunge. Does the knee stay in line with the second toe? If it moves medially or inwards then that is a big issue. Lastly look again at the ankle, does it collapse inward? Does it roll outward? If you struggle with any of these tests then you are doing yourself a disservice by not including specific programming for these weaknesses. There are hundreds of corrective exercises out there to work on these issues. Some of the more common ones are:
Single Leg Box Step-Ups
Walking or Step Out Lunges
Single Leg Hinges or Deadlfts
Balance Beam Work
Skater or Heiden Lunges
(A quick youtube search will find hundreds of videos if you are unfamiliar with these.)
If you think you might fall into this situation, feel free to come in and be evaluated. We
can certainly get you on the right path to optimal function.