The half-kneeling position is a great way to assess and treat your patients hip and core stability. While it seems like an easy exercise, it has many subtleties that can make or break the position. Having a greater understanding of the half-kneeling position will help ensure that your patient achieves the maximal benefit.
Half-Kneeling Position Important Details : Lateral View – ear, shoulder, hip, and knee in line; Frontal View – front foot and back leg are in the same line
What it Does
- Taps into the CNS hard-wired developmental stage
- Increases hip & core stability
- Is a self-limiting position – if they can’t do it they will lose posture
- Challenges lateral and rotary stability
- Creates a stable position to produce movement from (Reactive/Reflexive Stabilization)
- Kneeling eliminates the ability of the ankle and knee joints to provide stability. This means less degrees of freedom to compensate with. All efforts to maintain posture will achieved through the hip and core.
3 Keys to Performance
- Never let the trunk move. Remain in a tall stable spine posture.
- Keep the shoulder, hip, and knee in line – spine should be neutral
- Front foot should be in line with the back leg (narrow base of support)
Clinical Use
Examination
Any patient with a LE asymmetry or hip/core impairment should be tested. To test, simply place them in this position for 30 seconds and look for a loss of posture. By assessing bilaterally you will be able to determine any asymmetries. You can also look at their direction of loss of postural control to further determine where their specific impairment is located. After placing your patient in this position you will have a better assessment of their hip and core stability, as well as any asymmetries in the proximal kinetic chain.
Intervention
You’ll be surprised by how many people can not simply maintain this position without losing postural control. Before progressing with dynamic exercise it is of paramount importance that they are able to maintain stability for at least 1 min. If you don’t develop proximal stability before distal mobility then you will be setting yourself up for compensations later on in the plan of care.
Once the patient displays stability the flood gates open and you can start letting your creativity run wild. The greatest part about half-kneeling is that it is just a base of support. You could add an asymmetrical load to further challenge lateral and rotary stability or simply add a symmetrical load to increase the force. The possibilities are endless. It simply depends on your patients impairments and your clinical intentions.
By performing an UE movement through the static half-kneeling position you are training the correct muscle recruitment and timing pattern. Keep in mind that “when a extremity is used to challenge the position of the body, a reactive force is produced within the body that is equal in magnitude but opposite in direction to the forces producing the destabilizing movement.” (Hodges 1997)
Example Progressions:
Chop and Lift
PNF Patterns
Shoulder Rows
Pallof Press
1 Arm Landmine Press
”The act of not moving in the presence of movement is neuromuscular stabilization” – Gray Cook
References
Voight ML, Hoogenboom BJ, Cook G. The chop and lift reconsidered: Integrating neuromuscular principles into orthopedic and sports rehabilitation. N Am J Sports Phys Ther. 2008;3:151–159
Hodges PW, Richardson CA. Relationship between limb movement speed and associated contractions of the trunk muscles. Ergonomics. 1997;40:1220-1230.
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