This week's exercise focus is on core stability in a functional position.  In sports and everyday life we constantly have to work on balance and stability in unstable positions.  Whether you are a basketball player getting hit while running or just bumped into while walking to work, core stability must kick in to keep you on your feet.  Using an exercise like split stance lunge w/ rhythmic stabilization can help progress a good core program.  
Have the patient/athlete assume a lunge position with their back leg on the bosu ball.  After they assume the proper upright position instruct them to extend their arms straight out with hands together.  Begin slowly applying rhythmic stabilization in all directions.  Increase speed as needed.  
To progress this exercise, simply have the patient/athlete move their back leg forward so that only their back toe is on the bosu ball, further creating an unstable surface to challenge their core.

Dynamic shoulder stability is extremely important in both rehabilitation and prevention.  Unfortunately, all too often we get comfortable prescribing low level rotator cuff exercises that the patient gets bored with.  For those patients that are ready to advance or need more dynamic stability of the shoulder, this exercise will most definitely challenge them.  There are multiple ways to progress this difficult exercise which is why it is so valuable to have in your toolbox.  It is especially useful for your high level athletes, such as baseball players, who often are in need of dynamic stability of the shoulder.     

Have the patient seated on a stability ball with their feet close together to challenge the core immediately.  Using a cable or theraband, have the patient assume the starting position for shoulder external rotation with a towel roll in between their arm and body.  Next, have them perform external rotation to adjust to the stability ball.  When ready, begin each repetition with manual resistance throughout the concentric portion of ER.  It is important to begin the resistance at the beginning of the exercise where often the theraband is more slack or the cable is providing less resistance.  
There are multiple ways you can challenge and progress this exercise:
   - Have the patient perform external rotation and hold at a certain degree (45, 60, 90) against manual resistance (good for when a certain range of the motion is weaker)
   - Have the patient extend their opposite knee to increase core activation and further challenge the shoulder stabilizers
   - Have the patient hold a dumbbell with their opposite arm in an abducted position while performing the exercise to increase co-contraction of the shoulder musculature, increase endurance of the shoulder stabilizers, and promote physiologic overflow.  

This week's exercise is a unique stretch for the hip adductors.  This stretch comes from Eric Cressey and works on tissue extensibility of the hip adductors in both a hip flexed position as well as a hips extended position.  I have found this exercise to be very beneficial and what is important about this particular stretch is it hits all fibers of the adductors.  As we know from anatomy, the anterior fibers of the adductor magnus may assist in flexion of the hip while the posterior fibers may assist in extension.  By performing this stretch in both the hip flexed and hips extended position we are covering all fibers of the hip adductor musculature. 

Forearm strength is an underestimated variable in sports and everyday life.  A strong grip is important for performance in sports, improvements in weight lifting, and can even help stabilize the shoulder.  Sports like judo and wrestling have research behind them showing that grip strength is a strong determinant for performance.  Furthermore, studies have shown that isometric hand strength and isometric shoulder stabilizers have a positive correlation.  

Weight lifting exercises are a prime example of the importance of forearm strength.  Any weight lifter knows that the stronger you grip the bar or dumbbell, the easier the exercise becomes.  Have you ever tried to perform a heavy press or row with an open palm? 

Towel Pullups can challenge an individual to activate more muscle to complete the pullup.  A person who can perform body weight pullups will often find themselves struggling to complete reps with towel pullups.  Grip strength is commonly the culprit.  

Wrap two towels around each of the inside bars of the pullup station.  Grip the towels toward the top to make the exercise easier to begin.  If you find you cannot pull yourself up to complete a full rep, one way to begin building strength is placing a bench or chair underneath so you can perform negatives.  If that is still too difficult, start by simply holding yourself up to work the forearms, back, and shoulders isometrically.  Remember that the thicker the towels or the further away you grip the towels, the harder the exercise becomes.