Week 16: Tibial Controlled Articular Rotations (CARs)

Purpose: To increase tibial internal and external rotation range of motion through active control of the entire motion

What It Targets: Stretching of the Posterior Hip Joint Capsule, the Deep Hip Rotators: Inferior Gemellus, Superior Gemellus, Piriformis, Obturator Internus, Obturator Externus, Quadratus Femoris, Hamstrings

Procedure:

1. Lay on a table or floor with the working leg bent up and heel flat on the floor

2. Place both palms on either side of the top of your knee (femoral condyles)

3. Dig your heel into the floor

4. Rotate your shin (tibia) inward as far as you can without pain

5. Pause at end range for 3-5 seconds

6. Return to neutral, and rotate your shin (tibia) outward as far as you can without pain

7. Repeat as prescribed

Main Cues:

• Movement should be isolated to the shin bone (tibia)

• The direction that is most difficult is the one you should be working on the most (typically internal rotation)

• Maximize the pain-free range of motion with use of strong effort

Common Compensations/Adverse Effects:

• Cramp is elicited in foot or calf

Correction: This is okay! This is your brain’s reaction to a new stimulus. Shake it off and repeat again. Once you gain more motor control of this task, cramping will lessen. Practice makes better!

• Excessive motion in foot/ankle

Correction: Focus on keeping foot in line with heel and heel in line with knee

• Pain in knee or ankle

Correction: Reduce the range of motion and repeat with 50-75% effort until motion becomes more comfortable

Why We Love It:

• Restores motor control to an area that is very rarely isolated or worked

• Improves function of both the knee and the ankle

• Is relatively easy to do and does not require any equipment

*Disclaimer: Not all exercises are suitable for everyone, and participation in novel activities may increase the risk of adverse effects such as pain, soreness, or injury. Please consult with your Physician or a local Physical Therapist prior to attempting any exercise you feel uncomfortable performing. If adverse reactions occur, discontinue performance of the exercise and consult your physician or trusted clinician for evaluation.

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