The Most Common Weaknesses Physical Therapists See in Injured Patients

Dec 14, 2024

No one plans to get injured, but sometimes life happens! The good news? You can take simple steps to prevent some injuries before they occur. Basic physical therapy exercises—like core strengthening, glute activation, and balance work—can build resilience, enhance stability, and keep you moving without pain. Whether you’re an athlete, a weekend warrior, or simply navigating the demands of everyday life, understanding these common weaknesses can help you take proactive steps toward a more balanced movement and reduce the chance of injury.

With 16 years of experience as a physical therapist, I’ve seen a lot—specifically, common weaknesses and altered movement patterns. These are the exercises I most frequently prescribe to help address these prevalent impairments.

Hip Weakness - The gluteal muscles are critical for stability, balance, and power. Weak glutes can contribute to issues like knee pain, hip instability, and even lower back problems.

Hip Abduction and Glute Medius weakness
1. Monster walk: place a band around and your ankles and side step back and forth ensuring your toes stay pointed forward.
2. Side plank with a leg lift: Balancing on your forearm and the outside of your foot, lift your hips into a side plank then lift your top leg up.
Hip Adduction
1. Copenhagen plank: place your top foot on a work-out bench or a chair. As you balance on your forearm, pull your body up by pushing your top foot into the bench/chair.
2. Slider lateral lunges: 1 foot stays stationary with the other foot on a slider or towel. Push the slider out as far as possible allowing your stationary knee to bend. Then pull the slider back to the starting position as you stand up.
Hip Rotation
1. Prone hip internal rotation: lay on your stomach with a band placed around your ankles. Ensure you keep your knee bent at 90deg as you rotate 1 foot out.
2. Standing clamshell: Place a band around both knees; find your balance on 1 leg as your rotate the other knee out.
3. Curtsy lunge: As you balance on 1 foot, step the other foot diagonally behind you. Progress by holding onto a weight.

Core Weakness - The core serves as the foundation for almost every movement we make. A weak core can lead to poor posture, lower back pain, and inefficient movement patterns. For athletes, core weakness often manifests in decreased stability and power. Strengthening your core doesn’t just mean doing endless crunches—it involves engaging the entire core system, including the obliques, transverse abdominis, and lower back muscles.

Rotational Core
1. Paloff press: Hold the handle at chest level and push outwards without letting your trunk rotate under the tension.
2. Dying bug with ball: Push into the ball with your opposite hand and knee while you extend your other arm and leg towards to hover just off the ground.

Shoulder Weakness - Shoulder injuries are common, particularly among those who participate in activities requiring overhead movements, such as swimming or climbing. Weakness in the rotator cuff muscles and surrounding stabilizers can result in pain and reduced range of motion.

Shoulder External Rotation:
1. Bottoms up kettlebell: Hold a kettlebell in a bottoms up position with your elbow bent at 90deg and straight out in front of you. Then, rotate your elbow out to the side.
2. External Rotation at 90deg abduction: Hold a band in your hand with your arm out to your side and your elbow inline with your shoulder. Keeping your elbow bent at 90deg, rotate your hand up and down against the resistance of the band.
Scapular stability
1. Serratus punch: Laying on your back, hold onto a weight and "punch" it towards the ceiling. Then, squeeze your shoulder blade on the way down. Your elbow should stay straight the entire time.
2. Prone I, T, Y: Lay on a ball or off the edge of the table and hold onto light weights with your thumbs up toward the ceiling. Squeeze your shoulder blades as you lift the weights up in these 3 positions.

Putting it all together - Incorporating functional movements by engaging in exercises that mimic real-life movements to build strength and coordination. A well-rounded routine includes both strengthening and stretching to maintain muscle balance.

Single leg squats: Balance on 1 leg as you hinge your hips and bend your knee into a single leg squat.
Single leg RDL with knee drive and weight overhead on a BOSU: Standing on 1 foot with a weight in the opposite hand, hinge at your hips to lower the weight and kick your other leg behind you. Then, drive that leg towards the ceiling as you bring the weight over your head, maintaining your balance throughout the movement.
Bear crawls: From a hands and knees position, lift your knees 1-2 inches off the ground and crawl forward and backwards.
Kneeling diagonal chops: Hold onto a weight or a medicine ball in a half kneeling position, move the weight diagonally as you maintain your balance.

*all photos from https://www.hep2go.com/

Whether it’s recovering from an injury, addressing chronic pain, or improving strength and mobility, the key is finding the most effective and efficient exercises for you. Sometimes this requires a personalized approach tailored to your needs. Schedule an appointment today to get started!