Heel Slides

5 options on your back!

Heel slides - to bend or not to bend! From total knee replacements to general debility... any veteran recipient of home care physical therapy has no doubt done a few heel-slides! They seem somewhat benign and useless but let's look deeper. This exercise can be done many different ways and in a couple different positions; standing and lying on your back. Heel slides strengthen your hip flexor muscles so you can pick your leg up over the bathtub wall. They also strengthen the hamstring so you can pull your foot a bit closer and tie your shoe!

Heel-slides as a strength training exercise can strengthen four muscle groups if they are taught correctly for the targeted muscle group. When you know what you are trying to strengthen, you can tweak heel slides in ways that improve your overall function!

• Ask your doctor if you should be doing this exercise.


• If you knee doesn't bend, this exercise may be difficult but will help in the long run with knee range of motion.


• If you have total hip replacement and need to follow the 90 degree rule, don't lift your foot off the bed with this exercise.


• Use your bathrobe belt or a gait belt looped around your foot to assist you if you are too weak to start with.


• Focus on QUALITY vs. QUANTITY when doing any exercise.


• Remember slow and controlled vs. fast and jerky.


• Follow any precautions your doctor may have given you.


• Be sure your weight bearing status matches what your doctor ordered.


• Sometimes you need to stretch more to enhance your heel slide exercise.


• Pain can inhibit progress, a tennis ball can give you great relief!

Lying on your back, slide your heel towards your bottom (glutes), bending your knee and your hip. Without thinking, you are strengthening everything we mentioned above. However with some conscious thought and slight repositioning, you can focus your efforts on various muscles therefore improving various daily abilities.

Here's how to tweak the heel slide to accomplish different goals. Remember that the key here is in how you are consciously doing the exercise and where you put movement emphasis.

• Hip Lifting Strengthening - (stepping over the bathtub edge or climbing steps) When lying on your back and sliding your heel towards your glutes, think, "knee to shoulder." The picture doesn't change, the focus does. This will help to target the hip flexor muscle. Remember that you are not fighting directly against gravity when you are on your back so it may be difficult to put an emphasis on knee to shoulder movement, whereas doing heel slides in standing (marching in place) allows you to work directly against gravity and strengthen the hip flexors more effectively. You may not be ready for this yet depending on your home exercise program and doctor's orders.


• Posterior thigh/knee Strengthening - (taking a step forwards in the walking pattern) When performing your heel-slide on your back, remember to think, "heel to butt" The picture doesn't change, the focus does. This will help to target the hamstring muscle group. Again, without working directly against gravity, this may be the best you can do to match you ability. As you get stronger, you can move on to standing heel slides.


• You can point your toes up towards your knees or down towards the bed when doing heel-slides. Toes up tend to focus more on the front part of the lower leg while pointing toes down focus on the calf muscle...both are necessary and beneficial with heel slides so mix and match!


• For those info guru's out there... to strengthen the external or lateral rotators in the ankle, leg and hip, simply rotate the ankle outward while doing the heel-slide.
  
  
  


• To strengthen the internal or medial rotators in the ankle, leg and hip, turn the ankle inwards while doing the heel-slide!
  
  
  

For some, heelslides can seem impossible due to the nature of your surgery, your pain tolerance and other factors. There is nothing wrong with helping your heel slides along by using your arms and a belt, gait belt, bathrobe belt or a pair of pants! Be gentle and don't cause your body to fight back against you. Help your heelslides for 10-20 reps, then drop the "help" and do 10 or so on your own. This helps you to strengthen into the range of motion you just gained! Works great! You can also pull gently with your arms on the belt and just hold it there for 3-5 minutes allowing the scar tissue and fascia to "melt" and give. Try the tennis ball trick to melting myofascial restrictions away - it has been incredibly effective!

Gait Belt	Leather Belt
Sheet, belt, rope	Pair of jeans

Start out doing what you can - never sacrificing quality for quantity. I would rather you do 6 perfect ones than 12 sloppy ones! Your body remembers what it does... do sloppy exercises and you'll reap sloppy results. Focus on 20 reps a couple times a day. Go at your own pace but do keep going. Some people need someone to push them, others need someone to slow them down - you know who you are. If you are seeing a home health physical therapist, be sure to ask how you can tweak this popular exercise to get the results you need!