4 Steps to improving hamstring strength and flexibility (beyond mere stretches).

Here is a basic progression we’ve developed to correct low scores on the Active Straight Leg Raise. The general idea is to progress from isolation exercises to integration exercises to functional exercises.

Of course, the first step to improving poor performance on the Active Straight Leg Raise is releasing any scar tissue in the hamstrings and hip flexors with Active Release (Dr. Glenn is standing by). Then add in the following therapeutic exercises.

In reality, a corrective exercise program is tailored to you, based on your personal condition and your score on the Functional Movement Screen, from which the ASLR was extracted.

Single Leg Contract-Relax Stretch (isolation). Start on your back. Your right leg is the one doing the stretching, so with a slight bend at the knee, bring it up until you feel a bit of a stretch in the hamstring. Grab a hold of the leg as shown and push the leg into your hands for about as long as it takes you to take 3 slow deep breaths (this is the contract part). When you exhale that third breath, relax the hamstring and slowly stretch further by bringing your leg closer to chest. This takes advantage of 2 types of reflexes, the relaxation that comes with a deep exhale and the relaxation that comes after a prolonged contraction. Together, these two activities help your nervous system learn a new resting length for the hamstring. Repeat 3-5 times on each side.


Single leg stretch with opposite terminal extension (isolation/integration). While we would normally use an isolated leg stretch for a few days, for our purposes here we’ll move right into an integration exercise. Here, we’re basically combining a the contract-relax hamstring stretch above with active hip extension on the other side. So start with your left leg flattened out leg onto the ground while gently pulling the other one into the stretch. As you start to feel the right leg reach a stretch, actively push the left leg into the ground. Pay attention to what each leg is doing and hold the extension during the stretch on that third exhale. Do 3 reps on each side. Same picture as above.

Combining hip extension with hip flexion on the opposite side is a pattern that’s fundamental to many sports. This rehab activity helps restore and reinforce the fundamental pattern. It’s a stepping stone to the more complicated activities below.

Quadruped hip extension with opposite flexion (integration). Taking the idea of combining opposing hip flexion and extension farther, we have this excellent little move. Get down on all 4’s. Extend your right leg straight behind you making sure you fully engage the right glute.


While maintaining the extension of the right hip, drop your left hip further into flexion- moving your whole body toward the floor. You must keep that right glute contracted and that right leg straight. Watch what happens with my left (bent) leg below. It’s tougher than it looks.

quad 2

This exercise lets you improve your neuromuscular control and directly improves or maintains your Active Straight Leg Raise score and helps protect your back, your hips, and your knees. Remember to work both sides, 3-5 reps.

Stiff-Leg Deadlift with stick (functional pattern). After a couple of weeks of training in the above rehab exercises, it’s time to up the complexity. Now you’ll combine the opposing hip flexion and extension with a whole body balance challenge. Hold a stick in your right hand to help with balance (if needed). First, you’ll tilt slightly forward, arch your back slightly and kick your right leg back into full extension.


Continue moving forward toward the floor by flexing forward at the hip joint. The end range is when your body is almost parallel to the ground.


It’s once again important to maintain hip extension in that right hip. And of course, switch legs. Do 3 sets of 5 reps.

As you can see, we’ve progressed the basic pattern of opposing hip extension and hip flexion and created a greater demand on both legs. This is the essence of the progressive rehab that we’ve added to our treatment plans at Denver Chiropractic Center. Once again, we’ve moved beyond simply treating symptoms, like pain.

We’re looking to correct the underlying dysfunctional patterns that are the underlying cause of pain. This is what keeps problems from coming back over and over. If something’s been hurting you, or if you just feel like certain movements feel restricted or “wrong,” give us a call and come on in. 303.300.0424. Or simply reply to this email.

(BTW-Why am I holding a crutch? Well, it’s Meredith’s after her recent major knee surgery, but that’s a topic for a future email.)

Using the ASLR to prevent back pain, hip pain, knee pain and more

I spent a recent December weekend hanging out once again with some very smart physical therapists in Brighton. We were becoming certified practitioners of the Functional Movement Screen. (Many of you may recall that this past August I went to Brighton to learn about the Selective Functional Movement Assessment. Despite their seemingly similar names, the two are different. End digression.)

I’ve been using the Functional Movement Screen for years, but decided to get officially certified because it’s becoming a key part of my practice- finding the underlying dysfunctions that end up producing pain. It’s about fixing the problem, not just getting rid of the symptoms.

The Functional Movement Screen (FMS) is a system of 7 movements that are scored on a 3-point scale. 3 is good, 1 stinks, and 2 is somewhere in between. A total of 21 is perfection. Research shows that athletes (of any level) who score 14 or less are three times more likely to get injured than athletes who score a 15 or more.

The idea is that you identify your worst functional movement and then work to correct it, thus improving your score. You then do follow up screens to determine what you need to work on next.

So I’m going to have you check yourself on the movement test considered most important – the Active Straight Leg Raise.

At first glance, this may seem like a test of hamstring flexibility. It is, and more. It also assesses your active hip flexion, and your ability to maintain hip extension on the other side. These are three very important fundamental ranges of motion.

Your hamstrings start at the knee, run up to the “Sit Bone” and then send fibers into the SI joint. This joint is continuous with the spinal muscles.

Poor performance on this test means you’re more likely to experience one or more of The Big Five- back pain, hip pain, sciatica, IT band problems, and knee pain. So scoring your Active Straight Leg Raise (ASLR) is a good place to start if you want to prevent or improve any or all of these.

The ASLR requires a stick, an optional tape measure, and a buddy. For purposes of the description here, you are the one who’s evaluating the test and your buddy is the one performing the test.

Have your buddy lie down on his back. You need to identify two points on your buddy, the kneecap and the ASIS, or point of the hip. (Start on the left side.) The hip point is that bony thing at the waistline right above where the hip flexes. Measure the distance between the two points to find the middle of the thigh. The middle of the thigh is the reference point for this test.


Once you’ve found the middle of the thigh. Stand the stick up to mark the spot.


Your buddy is still on his back. (If you are a woman and your buddy is a guy, he’s probably making smart-ass remarks at this point because he knows he’s about to do a really bad job on this thing. Try to take pity on him.) Your buddy’s head must stay on the ground, his arms at his sides, and his palms UP, to avoid cheating.

So, your stick is at mid thigh on the outside of the left leg. Have your buddy raise the left leg – with the knee straight – as high as he can. The right leg MUST stay flat on the ground. If your buddy can get his left ankle (the bumpy bone on the outside of the ankle) above the stick, he gets a 3. If he can get his ankle between the stick and the left kneecap, he gets a 2. If he can’t raise the ankle past the level of the left kneecap, that’s 1.  (3 pics)


Erin gets a 3 for this effort, her heel is above her mid-thigh


With her heel between the stick and her right knee, Erin gets a 2.


Erin couldn’t raise her foot past her right knee, so she gets a 1. Boo.

Now test the other side. When scoring, a 3 on each side is ideal. 2 on each side is OK. 1 on each side is bad. Different scores on each side is considered an asymmetry, and that’s bad.

If you’re interested in getting a baseline score for how your body is functioning, call up and make an appointment. We don’t charge any extra fees in conjunction with a treatment. The idea is to figure out which Functional Movement you score lowest on and take steps to improve it. We’ve developed rehab protocols to improve each pattern and improve your overall score. This reduces your likelihood of getting injured.

Triathlon season, 2011- Denver Chiropractic Center Triathlon Team schedule

Well, It’s time to get back to training and get back to blogging about training. The Denver Chiropractic Center Triathlon Team’s race schedule for 2011 looks like this:

June 11: Winter Park MTB Race- Hill Climb (www.epicsingletrack.com)

June 25: Tough Mudder Beaver Creek (an obstacle course race on foot www.toughmudder.com)

July 9: Winter Park MTB Race- Valley Point to Point (www.epicsingletrack.com)

July 16: Xterra Beaver Creek (Tri) (website currently down)

August 6: Xterra Indian Peaks (Tri) (www.digdeepsports.com)

August 27: Xterra Lory (Tri) (www.withoutlimits.com)

I’m working with Xterra pro Cody Waite as my coach. We’re also proud to announce that Denver Chiropractic Center will be a proud Cody Waite sponsor for 2011 (www.epcmultisport.com). More to follow….

Yes, we accept Med Pay for patients in auto accidents

We get a lot of questions about whether or not we accept Med Pay for patients who’ve been in car accidents. The answer is yes. The truth is that our approach, which combines Active Release, chiropractic, and physical therapy (all here in the clinic) is probably the best way to recover from your injuries and get back to your life. Call us @ 303.300.0424 or email us to make an appointment today.