Dynamic Warm-ups in the Physical Therapy Setting - FITNESS PAIN FREE

Dynamic Warm-ups in the Physical Therapy Setting

arm bikeHey Sally, how are you doing today?  How about you spend 15 minutes warming up on the bike / elliptical / treadmill / arm bike and I’ll be right with you.

How many times do you hear this at a traditional physical therapy clinic?   In the strength and conditioning realm, using a warm-up like this is absolute heresy.  For some reason it still persists in the world of physical therapy though.

I’ve got to be honest, I’ll use the stationary bike and cardio equipment if I feel it’s really needed for my patients (cardio for chronic pain or nerve gliding effects – stationary bike for improving knee flexion in total knees).  However, I feel a pang on guilt giving this to other patients who could really benefit from a well done dynamic warm-up.  

It definitely takes more education, time and work on the therapist’s part to teach a warm-up like this but I also feel that the benefits are well worth it.  I base my warm-ups on the joint-by-joint approach popularized by Gray Cook and Mike Boyle.  It also fits well with my treatment which usually contains a heavy dose of SFMA guided exercise and manual therapy.   This is also a tremendous tool for post op lower extremity patients once they’re clear from a protocol perspective to get started on these movements.

Here is a video of a common lower extremity dynamic warm-up I use in the clinic for my patients.  Feel free to steal it and use the video as a refresher for patients who forget the movements (I usually send them home with a paper with the exercises written as well).  Sorry in advance for the horrendous audio quality.  Here’s me in action teaching the dynamic warm-up.

As you can see, besides warming the muscles and increasing heart rate we’re also getting:

  • Hip mobility
  • Ankle mobility
  • Foot, core and hip stability
  • Squat and deadlift correctives
  • Multi-segmental flexion (toe touch) mobility
  • Multi-directional lunge proficiency
  • Single leg balance
  • Hip and spine dissociation
  • Conditioning the lower leg in multiple planes
  • Preparing for more dynamic plyometric and change of direction drills

Now that’s a long list of benefits that I’d like my patients to have, all packaged in a 5-10 minute segment that can be performed prior to the start of our therapy session.  I’ll even modify this for my elderly population, performing most of these exercises to a much lower depth (usually with a chair for support).  Ultimately, one of my biggest goals with most of my patients is to return them to a sound recreational program and a sound warm-up is a big part of that.  Give this a shot the next time you have a patient you think would benefit from it.

Haven’t used an arm bike yet in my clinical practice,

Dan Pope DPT, CSCS

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