Here’s our latest in the Sports Health section from Dr. Jonathan Hartman and Dr. Marshall LeMoine. This topic has been broken out into 4 parts due to its’ length so keep an eye out every Wednesday of this month to stay on top of this great article.

If you missed the part 1 & 2, here are the links to review: Lunging Into Stride Length Part I:  Introducing the Benefits of a Functional Lunge & Lunging Into Stride Length Part II:  Research Based Evidence of Benefits of the Lunge for Strength and Sport Adaptations

Lift Progression

Using current evidence one possible version of a graded progressive treatment protocol for the lunge could focus on first and foremost the unweighted form of the movement, which is an aspect I feel is constantly rushed through with higher level athletes as most of them have done this type of exercise before. But just because you have done something a thousand times does not mean it was done right. In this respect our focus should be to foster athletic intellectual training in order to improve the athlete’s understanding of the correct body movements during this motion in order to enhance performance. Take the time to explain to them the purpose and the benefits of each form correction, and let them feel what each correction can do so that as the weight and variables increase they can problem solve through form corrections themselves. When training high level athletics the lift intention and athletic optimization go hand in hand as the athlete should have an in-depth understanding of how the lift connects to the exact sport movement as this will allow them to picture how it will transfer over into function and may give the seemingly separate esoteric lift a more meaningful sport specific connection.

Focus from bottom to top during starting stance position, then onto the initiation of the motion as this will set up the entirety of the descent phase. Then shift the focus to the anterior open chain moving leg for the forwards lung or the anterior closed chain stationary leg for the reverse step back lunge as it will accept the majority of the force throughout the descent phase. Finally watch the athlete’s power leg stability and trunk control as they push back up during the ascent phase ending in the starting stance position. The movement guide focuses on the dynamic step back / reverse lunge but it can be applied for any lunge variation. Please use the movement fault guide below to guide the common faults seen with this exercise. Next focus on the athletes closed chain weight accepting foot / arch control and knee positioning using small external cues (such as an anterior mirror with a vertical trunk alignment tape, or by having the patient lunge next to a wall for a lateral trunk or knee alignment cue). Next, progress to a multiplanar lunge if applicable to the athlete’s sport specificity. You can also shift the focus on cueing specific muscles with a TheraBand loop around thighs in order to promote the athlete’s femoral eternal rotation and abduction.

We can optimize performance faults of the closed chain limb at the forefoot, knee, and hip with the use of TheraBand by having the athlete put the band under the great toe metatarsal head to a loop around the contralateral hand or by wrapping the band from the great toe metatarsal head coursing laterally over the TCN joint then medially behind the gastrocnemius bellies/ knee / thigh ending in a loop around the contralateral hand. The athlete can also perform this motion with bilateral upper extremity patterning or contralateral upper extremity patterning matching their sport specific motions. Perhaps a goalie or a jumper would use a bilateral upper extremity flexion and extension pattern while pushing off one foot in order to catch a ball or create momentum while a sprinter will use contralateral upper extremity patterning to counterbalance lower extremity push off and for full body force transmission. We can also use higher level resistance bands to further challenge the trunk via trunk wrap used to pull the athletes center of mass out of neutral while the athlete resists this force. We can add instability components to the stance leg via Bosu-Ball, Airex-Pad, sand, or external perturbations. Increasing speed or adding a flight phase as seen with an alternating jumping split lunge can also increase the challenge of the exercise. Another progression I do not see frequently performed but is of extreme importance is incorporating sport related equipment such as holding balls, bats, or racquets, as well as starting the movement to a “start” buzzer or pop noise can greatly enhance the sport specificity with quick reactions. Even such things as putting on skis or boots of the sport can be incorporated as some equipment limits specific lower extremity joint motion and thus performing these exercises in and out of this equipment can change kinematics dramatically. Finally, try performing all of these progressions under systemic fatigue as it will highlight any fatigue related movement faults.  “Practice how you want to perform”

As you can see, this progression can be extensive, creative, and individualized per athlete and sport. At any point in this progression, extra weight can be added, if hypertrophy or strength is the goal, via kettlebells, dumbbells, or a barbell as well as with many other methods. Using the above evidence we can see holding the weights in differing hands or positions will vary the athlete’s trunk activation. It is suggested to start with lighter weight and then work upwards within the session or throughout sequential sessions based on the form and function of the previous lift or session.

It is slightly controversial when it comes to adding a lot of external cueing and bands to an athlete performing a strength or hypertrophic lift. There are some schools of thought who think this will take away from the lift, but there is value in targeting movement faults or areas of possible future fault in order to maximize athletic function. Thus we can use band wraps as described above but instead of attaching them to the contralateral hand they can be attached to the squat rack on the contralateral side for lower extremity positioning and cueing. We can also challenge the trunk by use offset weight stacks or by adding hanging weights from the barbell via Monster-bands leading to further weighted instability. We can also further challenge the system as a whole by performing lunges with barbell or dumbbells held extended overhead on the ipsilateral or contralateral upper extremity.

Hopefully this article has shed some light on what research has to say about the lunge, as well as taught you a couple of key ways to challenge, progress and modify the lunge exercise to target key muscles for your athletes. Just remember small movement optimization holds immense value with the athletic population and this can be enhanced through a progressive evidence based sport specific training and rehabilitation program.

Stayed tuned for the final section of Lunging into Stride Strength with a complete recap, movement fault guide and references for your review!

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