Step ups are a standard exercise that we’ve all done. Find an elevated surface, choose your desired weight, and step onto that surface. The simplicity is what makes it so effective. It’s a great exercise, and one that we all should be doing to improve our hip strength, cardiorespiratory endurance, and balance.
Typically this exercise is done quickly, and with very little concerned for form. We often want to get the exercise done with as much weight as possible and as quickly as possible. (I’m looking at you crossfitters!!)
While doing the exercise this way is completely fine, at NorCal Physio we modify this slightly to gain even more benefit from this.
How we use high step ups at NorCal Physiotherapy.
We use this for both athletes with pain or injury and also with athletes looking to improve their performance.
The injured athlete that we use this with is one who will have limited hip stability, hip extension, strength, or poor movement, quality at the hip and spine. Very often this athlete will present with low back pain, anterior hip pain, knee pain. The movements that typically cause pain will be east centric movements at the hip and knee, such as squatting, lunging, running.
The performance focused athlete will likely have noticed a shift in the hips with squatting, poor control while lunging, or even difficulty with pistol squats.
What we like to focus on is not the injured vs healthly athlete; because they are the same person - they both have the limitation - one just has pain and the other does not yet have pain. So here are the categories of athlete that we use this exercise for:
The athlete with an inability to disassociate the low back and hip.
Very often in this case, we see compensatory lumbar flexion (leaning forward) when the hip moves into flexion (Knee to chest). While this is not a bad movement and is in fact a complementary movement, doing this too often and without control can lead to pain or performance limitations. Very commonly we get hip flexor Type symptoms with this.
The athlete with limited or asymmetrical hip extension strength.
Another scenario that we would implement this exercise is when we note that one side is stronger than the other side. Typically we’re talking about hip control and engagement during a squat. You can see this with some shifting in the bottom of the squat. This exercise is very nice for this scenario because it isolates one hip instead of relying on the other. Here's the kicker - this exercise is very diagnostic because of its difficulty. Even if you don’t think you have an asymmetrical movement pattern, give this a shot. It’s a great way to diagnose any limitations side to side.
The athlete with poor single leg balance.
Even though we consider step ups a strength exercise, this is very much a balance exercise also. When we’re going through this exercise for speed and load, we pay very little attention to his position and control. When we slow the exercise down, we can now start to see abnormal movements in the pelvis and hip. Most notably, we will see hip limitations at the very top of this movement when we’re trying to stabilize on top of the box.
Tips to doing this exercise well.
Yes, it’s very basic exercise however, we want to be very specific with movement so that we get as much benefit out of it as possible. As this video shows, we want to be as robotic in nature as possible. Before initiating the movement, make sure that the stance leg is engaged. Go through the mental checklist - press the big toe into the ground (intrinsic foot muscles), straighten the knee (quad muscles), stand as tall as you can (glute muscles), tuck the ribs (trunk braceing). When this is set up, then bring the foot to the top of the box. Once the foot is on the box, try not to weight shift too far forward. You want to be able to drive the foot into the box to lift your body off the ground. Be very careful that you do not push off of the bottom leg. We want this to be a hip extension-based exercise not a calf exercise. That being said, if this is very difficult, go ahead and push off with the calf until you get enough strength so that you don’t have to. At the very top of the movement make sure the stance leg is nice and strong (go through that mental checklist again). On the way back down, move through this exercise slowly and with purpose. As best as you can, stabilize the hips through the full range of motion.
Reps and Sets
This is going to be based on your performance of this exercise. Start with 3 reps on each side, with the goal of increasing to 3 sets of 6-8 reps. Remember - this is about control! so if your form is breaking down, STOP, REST, RESTART.
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