OPTIMUM PERFORMANCE
Best Foot
Forward
Designing single-leg training programs means more than targeting specific muscles.
It requires evaluating the athlete and using a whole-body approach.
BY JEREMY BOONE
& GRAY COOK
S
ingle-leg training has
received a great deal
of attention in injury
prevention, rehabilita-
tion, and performance-
enhancement programs over the last few
years, and for good reason. Since the ath-
letic movement skills of field and court
sports are dominated by the gait cycle—
taking off from one foot and landing on
the other—single-leg training is appro-
priate for return-to-play programs and
boosting athletic performance.
Unfortunately, the benefits of sin-
gle-leg training have led some people
to adopt it as a “one-size-fits-all” ap-
proach to lower-body development—
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without really thinking about the
purpose the exercise serves within a
training program. Too often this leads
to a goal of building a selected muscle
instead of improving overall athletic
performance.
However, there’s an alternative to
blindly integrating single-leg training
into workouts. And it starts with iden-
tifying the specific needs of the indi-
vidual athlete. If you want to improve
lower-body performance, you must first
think globally, then act locally. Rather
than counting on a standard set of exer-
cises, evaluate the athlete to determine
what he or she needs. Then, choose the
exercises that can best provide it.
©AP PHOTOS
ISOLATION FRENZY
A popular approach among those using
single-leg training is to target individu-
al muscles, and much recent attention
Jeremy Boone, CSCS, NMT, USAW,
is the owner of Athlete by Design in
Charlotte, N.C. He has worked with
several professional sports teams, includ-
ing the Carolina Panthers, and can be
reached at: www.athletebydesign.com.
Gray Cook, MSPT, OCS, CSCS, creator
of the Functional Movement Screen, is
Clinic Director at Orthopedic & Sports
Physical Therapy in Danville, Va. He can be
reached at: www.functionalmovement.com.
T&C OCTOBER 2006 37
 OPTIMUM PERFORMANCE
has been focused on the gluteus medius.
This muscle plays a key role in pelvic
stabilization and preventing low back
pain, and it can certainly be a trouble
spot when it’s too tight or not strong
enough. As a result, a number of iso-
lated exercises, such as bridge patterns
targeting this muscle, are being pre-
scribed to athletes whether they’re need-
ed or not. Without knowing the quality
of the movement patterns involving this
muscle, results are second rate at best.
In fact, we may find ourselves training
the gluteus medius to improve the lunge
pattern rather than improving the lunge
pattern to train the gluteus medius.
Another hot spot in single-leg train-
ing is the psoas muscle and its ability to
flex the hip joint, decelerate hip exten-
sion, and stabilize the lumbar spine. Yet
again, a common practice is to target
this muscle by providing a blanket pre-
scription of exercises for every athlete.
Often this prescription comes after just
a quick test or two. In one typical test
of the psoas muscle, the athlete sits in a
chair with feet flat on the floor and tries
to hold one knee at belly-button level
for set period of time. If he or she can-
38 T&C OCTOBER 2006
not do so, it’s assumed the psoas needs
to be strengthened. Another popular
test involves manually testing hip flex-
ion while the athlete lays on a table.
While these tests may have their place
in the evaluation process, it’s impor-
tant to remember they have little direct
transfer to athletic movement. First, the
body reacts differently when gravity is
involved. Second, during the gait cycle
flexion usually occurs at one hip while
extension occurs at the other. Thus, a
high level of core stability is required to
allow opposing hips to actually comple-
ment each other.
Here’s another aspect to consider: If
there’s no consensus about the relative
importance of the psoas and gluteus me-
dius, neither is likely the sole solution for
increasing lower-body performance. Fo-
cusing on either the psoas or the gluteus
medius ignores the relationship in move-
ment between the two and their relation-
ship to the rest of the kinetic chain.
Single-leg exercises are also common
in many popular injury-prevention pro-
grams. A common protocol is to stick
the landing from a vertical drop or hor-
izontal displacement exercise and hold
the position for 10 to 20 seconds. While
this improves joint stability, increas-
es muscle fiber recruitment, and raises
power, another important component
still needs to be addressed.
On the playing field, athletes land and
change direction in less than one second.
This means that the body must effective-
ly absorb force and be completely stable
for a brief moment in order to optimal-
ly transfer application of force. Adher-
ing to the principle of specificity, drills
that require athletes to execute and hold
movement patterns should have a time
restriction of one second or less in com-
ing to a complete stop.
Additional body parts may also be
used as drivers during single-leg land-
ing training. For example, if an ath-
lete keeps both hands on his or her hips
during a leap, you can evaluate the abil-
ity of the core to help decelerate motion
in a single leg without further compen-
sation from the arms.
EVALUATION
The primary goal of an athletic perfor-
mance evaluation is to identify strengths
and weaknesses in movement patterns.
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The following battery of tests can be
used to gain an inside look at move-
ment habits and how they positively or
negatively affect overall athletic perfor-
mance. The results can then be used to
help take the guesswork out of design-
ing effective training or rehabilitation
programs for the lower body.
Functional Movement Screen: Ath-
letes have long been evaluated through
speed, agility, and quickness tests as
well as sport-specific skill tests. All are
necessary to evaluate and understand
potential areas for improvement. How-
ever, another fundamental parameter
of athleticism is functional movement.
This is not performance-based and does
not depend on skill or strength, but
rather on the athlete’s ability to com-
plete basic movement patterns.
Five of the seven tests used in the
Functional Movement Screen relate
directly to the lower body: overhead
squat, lunge, hurdle step, active straight-
leg raise, and rotary stability. (To read
a full-length Training & Conditioning
article on the Functional Movement
Screen, go to: www.athleticsearch.com
and type “weak links” into the search
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OPTIMUM PERFORMANCE
window.) Limitations revealed by the force production and is measured by a
Functional Movement Screen can in- hop. Starting on one leg, the athlete plac-
terfere with athletic performance and es the toe of the leg being measured at a
strength and conditioning programs. start line. In a tall single-leg stance with
They should be addressed before pro- hands on hips, the athlete raises the knee
The hop and stop test takes only a few minutes
to administer and the results quantify single-leg force
production and absorption while also identifying
asymmetry between the right and left legs.
gressing to more sport-specific work. of the non-test leg to belly button height.
If these limitations are left uncorrect- The athlete then hops for maximal dis-
ed, athletes may adapt their movements tance, landing on the same leg. The dis-
to compensate, thus robbing them of tance from the start line to where the
movement efficiency, hurting their tech- toe of the landing foot hits the ground
nique, and increasing the risk of injury. is measured. Three attempts for each
Hop & Stop: The hop and stop test, leg are recorded.
originally created by Paul Juris, PhD, The second part of the test evaluates
is designed to evaluate force produc- force absorption as measured by a leap,
tion and force absorption of the lower which entails taking off from one leg
extremities. The test takes only a few and landing on the opposite leg. The
minutes to administer and the results starting position is the same as the hop
quantify single-leg force production and and distance is measured from the start
absorption while also identifying asym- line to the toe of the landing foot.
metry between the right and left legs. The athlete must perform three suc-
The first part of the test evaluates cessful leaps, which includes coming
T&C OCTOBER 2006 39
 OPTIMUM PERFORMANCE

CASE STUDY
The following is an example of test results from a professional athlete, along
with a suggested interpretation of the results.

Background
The athlete suffered a left hip fracture one year prior to testing. History also
includes repeated right ankle sprains and occasional low back pain. There is
no present pain, and the athlete is cleared to play.

Testing Results
FMS Overhead Squat: 2. Displayed lack of mobility in the right ankle/right
hip/thoracic spine.
FMS Hurdle Step: 1 for right, 2 for left. Displayed inability to balance on
left leg, thus could not complete the movement. External rotation of right leg
during left leg stance along with extreme lateral trunk flexion to the right side
further indicates instability and lack of mobility in the left hip and core.
FMS Lunge: 2 for both right and left leg. Displayed a mobility deficiency in
the right lower leg and a stability issue during left leg stance.
FMS Straight-Leg Raise: 2 for both right and left leg. Adequate hamstring
flexibility but further displayed hip mobility issues.
Hop & Step
Hop Leap
%Left %Right Symmetry %Onto left %Onto right Symmetry
87 81 8 120 106 14

The FMS score showed there is a lack of stability in the left hip and a lack of
mobility in the right ankle. In the Hop & Stop, there was a lack of adequate
force production in the right leg along with a symmetry score greater than
five. The leap score onto the right leg indicates a need for force absorption
work. The leap symmetry score was well above five and is therefore an area
of serious concern. Foot and arch evaluation was normal.

Training Suggestions
Week 1:
■ Implement mobility development strategies for the right ankle/hip/thoracic
spine, stability strategies for the left hip and core, and begin deep squat
progression routine.
■ Teach core stability exercises.
■ Include single-leg squat appropriate exercises for both legs with a higher
weekly volume on the right leg.
Week 2:
■ Add lunge and return series and alternate legs (force absorption), have right
leg step on mini-slant board to further help turn on calf muscle.
■ Add advanced core exercises as right leg mobility increases and left hip
stability increases.
■ Begin single-leg drop and stop progression on the right leg.

Week 3:
■ Include multi-directional lunge and reach at knee level with a higher weekly
volume on the right leg.
■ Advance to hop and stop progression on both legs.

Week 4:
■ Retest.

40 T&C OCTOBER 2006 ATHLETICBID.COM


to a stop in less than a second upon
ground contact, within five attempts. If
more than five attempts are needed, the
athlete should take a three-minute rest
before trying again.
To pass the hop test, the athlete must
hop 89 percent or more of his or her
height. A score of less than 89 percent
indicates that the athlete needs to work
on force production for that leg. A nor-
mative value for the leap score is 109
percent of height, and scores lower than
this indicate a need to develop force ab-
sorption for the landing leg.
Symmetry scores are determined in
each category by comparing the results
for the right and left legs. Asymmetry
reflects possible skill and motor control
differences between the legs and is sep-
arate from mobility or stability differ-
ences.
Ideally, there would be no asymme-
try, but sport skills with higher levels
of technical difficulty on one side than
the other often make asymmetry inevi-
table. Recent studies show that asym-
metry greater than 10 percent increases
the risk of injury two and a half times.
We take it a step further and aim for a
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OPTIMUM PERFORMANCE
variance of five percent or less. this manner and the arch does not col-
Foot and Arch: Since the way the lapse, then they have moderate prob-
foot makes contact with the ground can lems with pronation, which can limit
reduce force by up to 20 percent, we their athletic effectiveness. This can be
Evaluating lower-body movement patterns while the
athlete is barefoot allows the coach or athletic trainer
to visually understand how the foot feeds the rest
of the leg during ground contact and propulsion.
also have to look closely at the foot and corrected through targeted work or an
arch. Shoes are used to improve trac- off-the-shelf orthotic.
tion and protect feet from stress, but If they cannot complete a deep squat
can also hide pronation problems that or hold their knee on the outside of their
hinder lower-body performance. foot through a deep squat, they proba-
Fortunately, overpronation, which bly need to see a physical therapist for a
indicates a lack of full dorsiflexion, more thorough evaluation and, perhaps,
can be easily seen in a deep squat when customized orthotics. However, orthot-
an athlete is viewed barefoot from the ics alone rarely improve the squat be-
front and side. At the bottom of a deep cause they do not address hip mobility
squat, you will see the foot spin out- and core stability. Developing a proper
ward, the knee drop inside the foot, squat pattern should be a primary focus
and the arch flatten completely. so that the orthotics can work.
Cue athletes to hold their knees out- Evaluating lower-body movement
side their feet and watch them squat patterns while the athlete is barefoot
again. If they can perform the squat in allows you to visually understand how
T&C OCTOBER 2006 41
 OPTIMUM PERFORMANCE
the foot feeds the rest of the leg during
ground contact and propulsion. As long
as there are no abnormal foot issues,
performing lower-body exercises while
barefoot will aid in producing proper
ground contact and heighten proprio-
ceptive awareness of the lower extremi-
ties and trunk.
A barefoot warmup progression
might include the following:
• 2-3 minutes of jogging
• Dynamic calf stretch
• Balance work
• Three-position calf stretch
(toe in, toe neutral, and toe out)
• Single-leg jump rope (with and
without pausing)
• Multi-directional skip
• Light agility work
DESIGNING A PROGRAM
Once evaluation is complete you can
design a program that will address the
athlete’s needs. You can choose ex-
ercises to increase force production,
force absorption, or core stability. (See
“Training Menu,” at right.) These ex-
ercises will also help develop joint sta-
bility, balance, and coordination of the
42 T&C OCTOBER 2006
neuromuscular system in preparation
for higher levels of training intensity.
Adjustments can be made to amplitude,
speed, load, time, body part restriction,
and planes of movement.
A good rule to follow when incorpo-
rating evaluation feedback is to always
address the negative before adding a
positive. If stiffness is present, the body
has to deal with a limited range of mo-
tion. The brain starts to write new
motor programs to accommodate the
many restrictions that have developed
over time. When significant limitations
are found, design a workout program
based around gaining mobility before
implementing stabilizing strategies.
For example, let’s say an athlete has
the following results:
• Meets force production criteria on
both legs (hop and stop test).
• Cannot decelerate well on the
right leg compared to the left (hop
and stop test).
• Scores a two in the FMS over-
head squat test and displays a lim-
ited amount of dorsiflexion due to a
sprained right ankle two years ago,
but is presently healthy.
TRAINING
MENU
The following is a list of commonly
deficient areas and exercises that
can be used to correct them.
Force Absorption
• Drop Squat/Lunge
• Fall & Stop Lunge
• Hop & Stop
Force Production
• Single-Leg Squat
• Walking Lunge
• Step Up
Core Stability
• Chop & Lift Patterns
• RNT Single-Leg Step Up
Before going into single-leg landing
exercises to improve deceleration, we
need to address the mobility issues in
the right ankle. Even if the athlete im-
proves eccentric strength in the right
leg, high-intensity cutting maneuvers
to the left could still present a problem.
Lack of optimal dorsiflexion may also
result in potential injury in the lower-
extremity kinetic chain.
The “think globally, act locally” phi-
losophy extends all the way to the core.
The energy-storing ability of any plyo-
metric action is dependent on the mus-
cle having one stable attachment point
and one mobile attachment point. In
the lower body, the stable attachment
point is the pelvis and lumbar segment,
which work together to stabilize the
core. Since the mobility of one segment
is always dependent on the stability of
another segment, many athletes can im-
prove their plyometric reactions, con-
sistency, and endurance by becoming
more stable through the core and pro-
viding a more consistent and efficient
attachment point.
The targeting of specific muscles
certainly has a place in lower-body de-
velopment, but any gains can be ham-
pered by deficiencies elsewhere that
go unaddressed. Once any deficiencies
revealed by the global view have been
corrected, more concentrated and lo-
calized lower-body work can realize its
full potential and produce the greatest
gains possible. ■
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