Exercise Additions to Prevent Injury
There's 2 main types of exercises you can perform to decrease your risk of injury. Joint stabilization & joint mobility. The below exercises are the movements I've found most of my patients respond the best to & would be relevant to the physical demands placed on you as a Soldier in The Old Guard.
Joint Stability Exercises
Note: This resource has been made with the assumption that you are performing a normal whole-body strengthening & cardiovascular routine. There is nothing that will help you prevent injuries more than being strong & fit.
I recommend performing each exercise for 3-4 sets, 2-3x/week. An easy way to integrate this would be performing the 2 lower body exercises on Monday, the 2 upper body exercises on Tuesday, and repeating the same pattern on Thursday and Friday.
Because these are "joint stability" exercises, it's recommended to perform these exercises at the END of a workout vs the beginning (you don't want to fatigue your stabilizers before you need them to work).
1) Hip abduction
How to perform:
Stand with an elastic band anchored to a squat rack or anchored by standing on it with your opposite leg.
Next, move your leg out to the side, hold 1 second, and then SLOWLY move your leg back to neutral. Try to stay perfectly upright.
Only use your hand for balance if needed. Keep your toe pointed straight the entire time.
Why: This exercise works the muscle on the side of your hip called the gluteus medius. This muscle is responsible for controlling the motion of your knee (namely, not letting it collapse inwards). This helps prevent knee pain when running & squatting and decreases your risk of traumatic injuries such as ACL tears when playing sports.
Alternatives: If you don't have a band, you can perform this exercise while lying on your side as noted in ATP 7-22.02. I'd recommend having a battle buddy apply resistance to your leg to make the lift more challenging. You can also perform this exercise with a cable machine for added resistance (requires an ankle strap attachment).
Programming: 8-10 reps per leg. Recommend alternating sides with each set.
2) Low Back Extension Hold
How to perform:
Secure your lower body in a back hyperextension bench or glute ham developer machine.
Hold a weight plate close to your chest and maintain your body in a straight line (don't hyperextend).
Hold for time.
Why: This exercise works the erector spinae and glutes, which are the main muscles that stabilize the spine.
Alternatives: If you don't have equipment, perform the superman hold in the second photo. Lye on your stomach and contract your glutes and low back to cause your legs and arms to lift from the ground. The height you lift your legs/arms isn't important - focus on a high-quality contraction in your glutes and back.
Programming: Hold for max time (aim for about 30 seconds - if this is easy, increase the weight)
3) Deep Neck Flexor Hold
How to perform:
1) Tuck your chin back & down
2) Lift your head 1 inch from the floor
3) Hold this position for time, ensuring you don't let go of your chin retraction in step 1
Note: You should feel the burning on the front of your neck, not the sides. If you feel it on the sides you are likely either A) not performing enough of a retraction/chin tuck or B) lifting your head too high.
Why: The deep neck flexors are the abs of your neck. Having strong deep neck flexors helps prevent neck pain, tight/painful traps, and even headaches. Plus, who doesn't want neck abs?
Alternatives: If this is too difficult, start with just holding the chin tuck/retraction while keeping your head on the ground.
Programming: Hold for max time (if you can hold for over 60 seconds, you can add some resistance by pressing down on your face with a hand)
4) Shoulder external rotation
How to perform:
Keeping your elbow in place (viewing it as a pivot point), externally rotate your arm against the resistance of the band.
It's important that the upper arm only rotates during this motion - it should not move forward/backward or side to side. You can use a towel pinned between your elbow and body to help you remember to keep your upper arm stationary if needed.
Externally rotate your arm as far as you're able. Hold for 1-2 seconds before slowly returning to the starting position.
To anchor the band you can tie a knot in it and place it in the crack of a door or simply hold it with your other hand.
Why: This exercise activates the 2 most neglected muscles of your rotator cuff. These muscles are crucial for preventing shoulder impingement during upper body lifts such as the bench press and for preventing traumatic injuries such as labral tears while playing sports.
Alternatives: As performing this exercise as shown in the first picture becomes easily controlled, abduct (side raise) your arm in varying degrees between neutral (first picture) and 90 degrees (second picture). This activates your rotator cuff in positions that your shoulder is normally unstable in, thus further preventing injury.
Programming: 8-10 reps per arm. Recommend alternating sides with each set.
Joint Mobility Exercises
This routine consists of repeated end-range movements of your joints.
Some positions will feel very similar to a stretch (and some will indeed be stretching your muscles), but the intent is to cause a gliding motion in each joint and to stretch the joint capsule. This also works to "flush out" the joint and pump in new joint fluid - I like to think of it as an oil change for your joint.
This routine is, in my opinion, the single most effective way to prevent the arthritic joint pain that is so prevalent in the military population.
In case you were curious, these joint repeated movement are actually the 7 most common exercises that are effective of the 18 exercises in the joint PMCS self-treatment resource.
Instructions:
➤ It's important that you push each movement as far as you feel comfortable. The "magic" of these movements happens at the end-range.
➤ Each movement should be performed for 10-15 reps and each rep should be held for 1 second. It's recommended to exhale and try to relax your body as much as possible. Perform these movements slowly.
➤ I recommend incorporating this exercise sequence into your daily routine - whether that be as part of your morning routine, during a lunch break, or as warmup or cooldown during your workout.
➤ We'll work through the exercises from top down, but they can be done in any order and even as a stand-alone exercise if any of your joints start to ache throughout the day.
1) Neck retraction into extension
How to perform:
This first movement is actually a combination of 2 movements. First push the chin straight back without tilting the head / chin (first picture). Then, push the head back into extension (second picture).
2) Shoulder extension
How to perform:
With the painful arm behind you, grab a stick and make the painful arm move into extension by pushing the stick with your non-painful arm
3) Mid back extension
How to perform:
With the foam roller in various locations of the mid back, bend backwards and exhale to cause extension
4) Low back extension
How to perform:
Lie flat, then push-up while exhaling and relaxing the glutes
5) Hip extension
How to perform:
With the targeted leg back, push the hips forward to cause hip extension
6) Knee extension
How to perform:
With the targeted leg forward, place your hands above the knee and push backwards to cause knee hyperextension
7) Ankle dorsiflexion
How to perform:
Cue: Kneel with the knee of the non-targeted leg on the ground. Drive the knee of the targeted leg forward (keeping your heel on ground) to cause ankle dorsiflexion.
Tip: I recommend holding onto something while you do this to allow you to concentrate on driving your knee as far forward as possible.
Bonus) Deep Assisted Squat Hold
How to perform:
Hold onto something stationary and sit down into as deep of a squat as you can manage.
Unlike the other exercises, you'll hold this one for time. Around 30 seconds.
During the hold, bob around finding points of tightness. After 30 seconds, stand up, shake your legs out, and perform a few more times.