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The Single Leg RDL-Baby Steps, Training Wheels and Driver’s License

Filed under: Balance/proprioception,Exercise Instruction,Exercise Technique — Shon @ 3:44 pm January 25, 2012

The single leg RDL (also known as the one leg single leg deadlift) is an extremely useful and functional exercise for many training and patient populations.  In one movement, you get: 

1) Fantastic triphasic (eccentric-isometric-concentric) activity of the hamstrings through a functional range of movement.

2) Great gluteal (maximus and medius) activity and stabilization throughout the movement.

3) Appropriate involvement of Janda's "deep longitudinal subsystem" and Myers'  "lateral line" (including the peroneals and anterior tibialis in concert with the lateral hamstrings, sacrotuberous ligament and gluteus maximus/ medius).  In simpler terms:  Awesome co-contraction and integration from the foot/ ankle through the hip and pelvis. 

4) An excellent stimulus for torso muscular stability training.  Appropriate dynamically stiffness of the torso is much easier and efficient to "drive" though the SLRDL movement pattern then one that is limp wristed. 

The problem that I have with the exercise is inherent in the fact that most people I see in the clinic generally have multiple impairments, not limited to strength/ contractility, mobility /stability, and balance, all of which will generally disqualify them from going full bore into the single leg RDL.  In particular, most, if not all post operative anterior cruciate ligament (ACL) patients are significantly deficient in all of the above, especially early in the rehabilitative process.  This study in the Journal of Sport Rehabilitation shed light on significant motor control deficits 12 months after ACL reconstruction, while Howells and colleagues in a systematic review of the literature noted impaired postural control as an issue in post operative ACL patients. 

So what does this have to do with the single leg RDL?  Really in the way it is taught most of the time.  Most texts and or instructional videos teach the SLRDL in a "hands free" mode, which while acceptable for many healthy trainees as well  as proprioceptively gifted patients (an outlier group for sure).  It is the way I taught it for a long time as well, with the expectation that sooner or later most people would catch on to the "correct" technique.  Recently, however, I decided that I was wasting both my patient's  and my own time by not streamlining the process better by incorporating additional external stabilization, tactile cueing and environmental constraint to facilitate capture of the technique.  

Below, I give you three simple but effective steps to teach just about  anyone how to subliminally slip into the single leg RDL. 

Phase 1- "Baby Steps"

Below is video of one of my patients, six weeks post ACL reconstruction, demonstrating the first progression of the SLRDL.  We are assuming the person has major issues with unilateral balance, let alone moving through space on one leg.  Here we are using maximal support of both arms for balance as well as to keep the pelvis and shoulders level, allowing a proper hinge at the hip (as well as a hurdle to allow tactile cueing of the back leg): 

 

Keeping the trunk and pelvis level without using the arms for support would have made this much more of a difficult proposition so soon after reconstruction.  Here, the pattern gets grooved quite nicely, with the ability to steer posture through the upper body, while the foot learns to make tactile adjustments without having to control the whole chain by itself.

Phase 2- "Training Wheels"

The next phase involves utilizing a dowel (or similar prop) for support, decreasing the upper extremity involvement as well as adding a bit more proprioceptive challenge:

As you can see here, we are using a kettlebell in the opposite hand to add load.  Weight can be utilized as soon as the athlete/ patient/client demonstrates appropriate trunk/ pelvic control; adding weight too soon can lead to trunk rotation-something desirable for Stuart McGill's excellent "Hip Airplane" exercise, but not the response we are looking for in this particular progression. 

Phase 3- "Driver's License"

After we have grounded and sealed technique using the first two progressions, we then take off the "training wheels" and allow performance to roll without props/ support: 

At this point, we have the outcome we want- appropriate head to toe alignment, good pelvic/ trunk stability and the hinging mechanics we are looking for.  More importantly, the patient is now independent in the performance of the exercise-it's his for life.  Of course, it will be useful not only in his clinical care, but as a performance enhancement tool after discharge.

In Summary

The single leg RDL is a fantastic exercise, but can be a challenge for certain clients and patient populations to master, namely due to impaired proprioception/ balance and whole system stability.  Fortunately, the remedy for this is pretty simple: use your available environment to externally stabilize and groove the movement pattern you are looking for.  Rely on upper body support, tactile cues, or whatever other tools you have available to get your patient/ client to understand the basic pattern, then take support away as technique allows.  Before you know it, they will perform the way you want independently, with great technique that they now own.