This Months Staff Exercise Tip

By Nick Adkins, Exercise Physiologist

Like everyone who comes to MD Health, I love my exercise. What I love best is the variety of exercise that can be done. Throughout my daily life, I complete a mix of pilates, heavy resistance training, cardiovascular training and plyometrics.

Out of all the exercises I do, there are two which are my absolute favourite and I prescribe these to almost every single client I see at MD Health because they are so effective.

1. Four Point Kneel – Single Leg Hip Extension on the Reformer:

My favorite pilates exercise, it is a great exercise to stimulate activation of the Gluteus Maximus muscle as you start from the hips in a flexed position and push to a neutral position (the Gluteus Maximus is the main buttocks muscle, Beth wrote a great article explaining the importance of this muscle (
Many electromyography (EMG) studies have shown that Gluteus Maximus muscle is most active when going from Hip Flexion to Neutral. It is also a level 3 core exercise, so it is perfect for beginners.
How to complete this exercise:

– Start by selecting the appropriate resistance, either two red springs or one red and one blue for beginners.

– Put yourself in what we call the 4 point kneeling position on the reformer.

– Your hands should be directly under your shoulders for best upper body support, the heel of one foot should be resting against the foot bar, with the opposite knee resting on the carriage.

– Push through the heel resting on the bar, until the leg is COMPLETELY straight, keeping the hips level. The carriage will move forwards with you on it.

– Hold the contraction of the gluteus maximus for about two seconds, and then return to the starting position.

– You may also feel this in the shoulders, as they have to stabilize the upper body during the movement.

If this is too easy, try these progressions!

– When you have pushed out, raise the opposite (contralateral) side arm. This causes one of the Lattisimus Dorsi muscles to be stretched, placing more stress on the thoracolumbar fascia, making the ‘core’ work harder. This makes it a level 7 exercise.

– While completely pushed out, raise the other leg that is resting on the carriage. This forces you to stabilize through your hips and shoulders a lot more as you no longer have the support of the resting leg. This is an advanced level 9 exercise.

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2. The Squat:

My favorite exercise to do at the gym! I love the squat exercise for many reasons. Firstly, it is a natural movement. If you watch a toddler, they have the best squatting technique, unfortunately, as we get older, many of us become lazy and forget how to squat. This can be easily corrected.
Secondly, it is a full body compound movement; many major muscle groups to work together throughout the squat, in particular the Gluteus Maximus, the Quadriceps group and the ‘Core’ (Transversus Abdominus,  Multifidus etc.).

Depending on your exercise goals, the squat has many purposes. Working the largest muscles yields greater kilojoule consumption (ideal for weight loss), improved compound strength will lead to better function and stability (within your daily life or a specific sport). Squatting also stimulates the Central Nervous System (CNS) to allow greater work capacity and if you are lifting heavy, it also stimulates the Anterior Pituitary Gland to release more Human Growth Hormone (HGH) (ideal for putting on muscle bulk).

How to complete this exercise (perfect technique is vital with the squat!):

– Stand with your feet shoulder width apart, chest up, shoulders back and tummy in.

– Lower your hips back and down, while also bending at the knees. Keeping your chest up and looking straight ahead (you can also raise your arms out in front to aid balance if you haven’t squatted before).

– A great cue is to think about sitting in a chair, your bum goes back and down.

– Lower your hips until your upper legs are parallel with the ground, keeping your back straight.

– Throughout the movement, your knees should move out to the side just a little bit (this causes an external rotation bias of the hips, which puts more load through the glutes and also creates better foot posture as the arches are raised).

– Push through the heels of both feet and push your hips forward to raise yourself back up to the starting position.

IMPORTANT!! Your knees should NEVER roll in when squatting; this creates a valgus force through the knees, placing increased and unnecessary load on the MCL (Medial Collateral Ligament) and the Medial and Lateral Menisci (knee cartilage). If your knees roll in, there are a number of ways to correct your technique, you can reduce your range of motion until you have built more strength to control the knees (this is called a half squat – only lower half way down i.e. to a 45° angle at the knees). You can also tie a theraband around your knees, so when you lower, you have to place your knees out so the band doesn’t fall.

When you’re able to squat perfectly with just your body weight, you can progress to the more advanced versions of the squat, the most common is the Barbell Squat, where you have a loaded Barbell resting on the fleshy part of your upper back (upper trapezius fibers) to increase the load on the working muscles. The increased load is also great for working your core, as you have to stabilize your hips under the increased load.

There are great instructional videos for squat technique on the MD Health YouTube channel.

Beginners –


Author: Michael Dermansky

Michael has now been working in physiotherapy for over 20 years, since graduating from Melbourne University in 1998 and is even more passionate about getting the best outcomes for clients than he was then. Michael is always studying and looking for new and innovative ways to improve the service at MD Health, including and not limited to the ideas from the fitness industry and great customer service companies. In his spare moments, he loves spending time with his two children, Sebastian and Alexander and hopefully taking them skiing more and more often.

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