How to rehab your PHT without a gym membership

: On today's episode, how to rehab your PHT without a gym membership. Welcome to the podcast helping you overcome your proximal hamstring tendinopathy. This podcast is designed to help you understand this condition, learn the most effective evidence-based treatments and bust the widespread misconceptions. My name is Brody Sharp. I'm an online physiotherapist, recreational athlete, creator of the Run Smarter series and a chronic proximal hamstring tendinopathy battler. Whether you are an athlete or not, this podcast will educate and empower you in taking the right steps to overcome this horrible condition. So let's give you the right knowledge along with practical takeaways in today's lesson. Can I just start off with saying thanks to everyone who has shared the podcast and has listened to the PhD podcast and is just trying to help other people out. Um, thanks for those who have reached out to me and said they're loving the podcast and what they've learned and the benefits it's having with your rehab. I love hearing it. And like I say, this is a resource. I've built this as a resource to help people and It won't reach everyone. It's a very niche podcast that, you know, a lot of people won't just accidentally stumble upon. So the best way that people can get out the podcast itself can get out there is if I try my best to, you know, post it and make sure people are aware of it. But if you love the podcast and you find someone who has PhD and is struggling, is asking questions on social media or is really struggling in their rehab, point them to this podcast and I'm seeing it here and there and I just, it just builds up the passion for this podcast. So thank you to everyone who is doing that already. If you do come across that opportunity in the future, please just have that on the forefront of your mind. And like I say, I just love helping people, especially with PHT, because I've seen a lot of it and I know how frustrating it can be. So just want to start by saying thank you. We have how to rehab your PHT without a gym membership today. I've got here five levels of, I guess. equipment that you have going from no equipment all the way through to having like adjustable dumbbells or something. So the more equipment that you have, we're going to work through each of those levels and see what you can do for exercise to help rehab your PhD. But I will start off by saying a gym membership is encouraged. This isn't about um, how to get away with rehab without a gym membership. It's encouraged that if you can, if it's, um, financially viable, if you have access to it, if it's close, if it's nearby, um, or if you have any sort of gym equipment available, that is more encouraged than not having that. I'll say this time and time again on this podcast, tendons love slow, heavy load. They adapt really quickly to slow, heavy load. They it's the optimal. environment they want to get stronger, to get to heal, to with less pain, those sorts of things. Slow heavy load has this analgesic effect for most. If you find the right dosage, find the right rhythm, find the right weight, it can actually decrease your symptoms and actually act as pain medication. So you can do something that's slow and heavy. minimize your pain for a couple of hours, you can get by through your day, maybe you can sit a bit longer, and then if pain comes back later in the day, you can repeat those and sort of treat it like a pain medication. Time under tension is what tendons love. A gym membership will give you access just to more resources, say like a prone hamstring curl machine or a seated hamstring curl machine. You won't find that anywhere else other than gyms and a prone hamstring curl is really good for rehab. And you have access to unlimited weight progressions and minute progressions. So I often have people at home who have an arranged system of like say dumbbells or kettlebells and they say, I have 15 pounds and then it goes up to 25 pounds. And some people really struggle with that progression to go from 15 to 25. Or, um, they go up to 25 pounds and they don't have a 30. Like that's the heaviest that they have. And they. they've limited themselves in how they can progress. Whereas in the gym, you have, you know, 16, 17, 18, 19 pounds, you've got as, as heavy as you want to go really with how, um, minute you want your progressions to be. So you just have those, the ability to progress, uh, with greater availability. Um, for the most part, limited equipment gives you limited ceiling of improvement. I've seen people try to rehab their, their PHT and they only have say therabands or they're only doing body weight exercises. They initially see improvement, but it quickly plateaus. And I say to them, this is why, because you've limited yourself with what you have available. You've limited the ceiling of improvement just because of the, the access that you have. But if you have a gym membership, all of those limitations go away. If you're travelling and you might not have access to a gym maybe for a couple of weeks. If you can't afford a gym membership, if it's too far away, if it's too, I know some people who live in say rural Australia and you know, they have to travel 45 minutes to get to a gym, sometimes more, sometimes they don't have access to a gym. So this is why I decided to put this episode together with the premise. Yes, it is encouraged that a gym membership is enforced, but if you're traveling or other circumstances come through that mean that you won't have access to that equipment, these are some options for you. Or based on your schedule, if you have say access to a gym once or twice a week, these are some levels of activities, levels of exercise that you can do on those other days, maybe just at home with some limited equipment. So let's dive in. Like I said, I have five levels based on what equipment you might have access to at home. So level one is just no equipment whatsoever. You don't have anything, don't have any bands, um, Swiss balls, weights, anything like that. There are some exercises you can do and you're probably well familiar with. Cause when I jump on injury chats and talk to a lot of people with PhD, this is where they often start. And it is bridges of different variations. So you can do a bridge, you can do a double leg bridge from the floor. You can do long lever bridges, which are just bringing your heels further away from your body. So long increasing the length of that lever. You can do, um, double leg, single leg. You can do bridges on a step. So if you have a bench or if you just have a chair, just putting your feet up on that and doing some bridges. Those, um, the most popular. people progress those, they see initial success. But like I said initially, that rate of progression plateaus out because the tendon does get stronger and it does get better, but you've just then maxed out all your availability. And so people, because they see initial success, they persist with the bridges and they do it for several months without any sort of progression. And that's why the rate of improvement plateaus out. If you don't have any other equipment as well, you can do some Nordic drops. This does require something at home, like a couch or a chair, not necessarily a chair, a couch or like a bed, something heavy that you can hook your heels under. You sort of dig your heels under that furniture and you're on your knees and the Nordic is keeping everything from your knees to your shoulders nice and straight. And then you lower yourself down as slow as you can control. you'll get to a point where you're unable to control it any further. Then you just let go, fall to the ground, have your hands catch you. All of these exercises, you can just YouTube afterwards because, um, I know sometimes it could be hard to grasp just through an audio format, but Nordic drops you can do, you'll, you will have to find something in the house or even just find someone in the house who can hold your ankles for you. But as well as the Nordic drops, you have what I call Nordic hip hinges. I don't know what the actual term for it. This is probably the most important. If you can, if you don't have any equipment, but you have a setup where you can hook your heels onto something doing these are sort of like doing dead lifts. Uh, which is one of the most important exercises for PhD rehab. So. Hook your heels onto something. And instead of keeping everything straight from your knees to your shoulders, you're actually dipping or hinging at the hips. and kind of doing like a deadlift action, but you're just dipping forward like a drinking bird. And this is putting the tendon under load, but also under compression. And you can progress this by increasing the range of movement. So you might start only going to a 45 degree angle and then coming back up. But then eventually you might wanna progress to something that dips forward so that your hips are bending close to 90 degrees. Once that's done, you can increase the repetitions. for end stage rehab, often prescribed these sort of exercises, but increasing the speed. So you slowly go down, but then increase the speed on the way back up. They can be quite nice. So you can challenge your hamstring quite a lot with no equipment. Like I say, you might need someone to hold your ankles, or you might need a piece of furniture to hook your ankles under, but that could be really effective. That's all I had for level one. So no equipment required. The next one I have here are just thera-bands, resistance bands, because they're inexpensive, relatively inexpensive, and if you're traveling, really easy to pack. Lightweight, just scrunch them up, fold them up, doesn't take up a lot of space. So if that scenario is you, you can do all the exercises I've just listed above that require no equipment, but then you can add in prone hamstring curls. So prone just means facing the floor. and hamstring curls so you'll have the band wrapped around like a couch leg or something and then you're just having that wrap around your ankle and you're curling your foot or your ankle towards your hips so curling doing hamstring curls you can progress that by adding resistance so either a stronger band or moving further away from the fixation point so there's more tension or just getting two bands and wrapping them both around the couch leg in your ankle. So progress that by increasing the resistance. You can increase the reps, you can increase the speed later in the progressions if you'd like to. But prone hamstring curls are definitely what you can add if you do have access to a resistance band. You can also do standing hip extension. So again, attaching it to a couch leg, facing the couch, having the band wrap around your ankle. So you're standing now facing the couch and you're extending your leg, keeping your leg straight and moving backwards, keeping the, just moving the leg backwards, kind of like you're doing a backwards kick, but just with a straight leg, uh, can definitely help with hamstring rehab. If you want to progress that you just, again, increase the amount of tension, move further away from the couch, add extra bands, those sorts of things. Another one I like to add, if you do have resistance bands available is just crab walks. It's not all monster walks or resisted side stepping, whatever you want to call it. So just having the band around your knees, getting into a half squat, and then doing side steps side to side. Now, while that doesn't directly rehab or impact the proximal hamstring, it does work your glutes quite well. And we know that in PhD rehab, while you are working the hamstring tendon directly, It is also nice to focus on building up the strength of your hips. It's like the secondary thing that you would, you should do in your rehab. So if you have access to bands, that's another thing that you could do. So level one, you've got no equipment, bridges, Nordic drops, hip hinges. Level two, if you've got a band, do some prone hamstring curls, do some standing hip extensions, do some crab walks. The third. level here is if you have access to a Swiss ball. Swiss balls are relatively inexpensive, so you can have them in the house. They are quite common that people have in their house, but not ideal if you're going traveling because they take up a lot of space, unless you want to go through the effort of deflating it and then inflating it when you get to your destination. But if you do have a Swiss ball, so it's one of those big inflatable balls that you sit on, it's not the smaller, heavier medicine ball. It's the big one that you sit on. You can do bridges. So lying on the floor with your feet up on the ball and doing a bridge. You can progress that by adding some hamstring curls or roll outs. So your bridge, you go up, you roll the ball out, and then you use your hamstrings to dig in through your heels and curl the ball back towards you. Again, might need some YouTube videos for this, but you could do a double leg. You can do it single leg. You can also do eccentric hamstring curls. So feet on the ball, you come up into a bridge, you move onto one leg, and then you slowly roll the ball out. So the hamstring is working hard to eccentrically lengthen while it's controlling that slow roll out. Another one which isn't that popular, but if you have been doing Nordic drops in the past, you can use a Swiss ball to assist those rollouts. I have shown this on social media in the past, but if you can look at your traditional Nordic drop and you have a Swiss ball in front of you, you can use that Swiss ball just to assist that descent. So your hands are on the ball and you're kind of just rolling the ball with your hands as you roll out and descend into that Nordic drop. and then you can roll the ball back towards you to come back up. Again, might need to YouTube that one, but that could be quite helpful. This podcast episode is sponsored by the Run Smarter Physiotherapy Clinic, which is my own physio clinic where I help treat a wide range of PhD sufferers, both locally in person and all over the world with online physiotherapy packages. In the years I've been self-employed as a physio, close to 70% of my entire caseload has been helping people with proximal hamstring tendinopathy, which is why I decided to launch this podcast. So if you're building upon your own rehab knowledge through the podcast, but still require tailored assistance, I'd love to be on your rehab team. Whether you are a runner or not, head to runsmarter.online to see your available options for working together. If you're still unsure if physiotherapy is right for you, or if you need a rehab second opinion, you can always schedule a free 20 minute injury chat with me. Find the free injury chat button on my website or in the podcast show notes to be taken to my online calendar to book in a time. Let's move on to level four, which most people, uh, they don't really have the idea, this idea in their head. And this is if you have a heavy backpack, if you have a backpack that has like decent enough kind of stitching that it can. contain a lot of heavy stuff, then you have some weights that you have access to. And there will be some exercises that don't really fit or don't, aren't really that effective with a heavy backpack, but there are some that are really effective. So if you have the backpack, you can, um, not wear it, but hold it at your, on your hips and you can do bridges. So then you have some weighted bridges that you can, that you can do. If you have the straps, if you strap it on, but wrap it around to your front, so you're kind of wearing it on your chest, you can add weight to your Nordic hip dips. So, you know, tucking your hips under, put on that backpack. It probably needs to be quite secure to your chest. So you might want to wear the straps, but have it back the front. So it's on your chest, but then cross your arms over your chest. So it stays really close to you. And then you do your hip dips. That can be really, really effective. If you wear your traditional backpack like you normally would, weighted up, then you can do some weighted step ups. Now you might need access to stairs or a bench or a chair. Something that's around anywhere between mid shin and knee height can be really effective for step ups. And I use weighted step ups a lot with my PhD clients. So if you can get a backpack to weigh... 10 kilos or like 20 pounds, you're getting yourself a pretty decent workout. Make sure you can tolerate it to start with, but that's a really, really nice exercise. If you can kind of hold the backpack so that it doesn't, so on it's like short strap or so it's not like dangling too far down, you can do some single leg deadlifts. Why I say you kind of need a short strap is if it's dangling quite far, then you dip forward into your single leg deadlift and it's not long before it touches the floor. Like you're not going through a large range of movement before hitting the floor. So if you can maybe hold onto it by maybe just grab the both straps together as well as the top kind of hand hold that it has and so it kind of fits neatly in your hand doesn't dangle too far then you can do some single leg deadlifts. That could be really, really effective. Um, as long as all, as, as well as all these other things, like if you have just a heavy backpack, you can do that. Then you can do your Nordic hip dips. You can do your single leg bridges. You can do your Nordics without anything to see a traditional Nordics. Um, you can do your hamstring curls. If you have some Thera bands, we're pretty much at the point now where we're doing most things well. And if you can just find heavier and heavier things that you can carry or that you can hold on to. You might want to hold on to two backpacks. Get two backpacks that you just hold one in each hand and you can then do step ups. You might want to get two really heavy backpacks, wear one at the back, wear one at the front of your chest and do step ups. Like these sort of things you have access to. Most people own heavy things and if those heavy things can fit into a backpack then you're working things quite nicely. The last one, the last level, which I highly recommend for people. Sometimes when I jump on these injury chats with people and they wanna start working together, wanna start working with me, I ask what do they have available? And they say, okay, I have these TheraBands, that's about it, but I'm happy to buy anything. This is what I say, adjustable dumbbells. So those sort of dumbbells like handheld dumbbells that have multiple... weighted plates that you can arrange on different, you can screw them on and off and just have an assortment of different weights is really, really effective. And for some of my clients, I say, go buy those adjustable dumbbells. Let's not start working together until you have them in your house. Then we've got a lot to work with. And so why I say that, as opposed to just buying those fixed dumbbells. So like some people might go out and buy a pair of 10 pound dumbbells and that's all that's all it is. You'll quickly progress. Weights are expensive. I get that. Um, so when you go out and buy a set of 10 pound dumbbells and then you use them initially, it's quite a nice exercise, but then within two weeks they are too easy for you and you need to progress. You have to go out and buy some more and that's more expensive in itself and you want to be able to adjust them as you get stronger because being progressive with your exercises is what most people fall short on when it comes to their rehab. So really be careful. Like I said, buy some adjustable dumbbells. It can range like some go from in terms of the set, can go from a kilo and a half all the way up to maybe 20 kilos, sometimes more. In pounds, sometimes it can be like five pounds and go all the way up to 30 pounds on each side. So that's 60 pounds of weight that you can utilize. You won't be lifting 60 pounds straight away, but you know the eventual goal to get there with some of those exercises is achievable. So adjustable dumbbells. If you don't have a gym membership, if you don't have weights and you're looking you say, you know, I'm fed up with this PhD. I'm willing to pay whatever. Then get some adjustable dumbbells. because then we can do a lot of these exercises that I've just described, weighted step ups, single leg deadlifts. But what you probably can't do with everything else that I've described is deadlifts. You can't really do deadlifts with a backpack. It's really, unless you want to hold onto it with your hands and dip forward, you can't really wear it on your back because the distribution of the weights just doesn't really work. But you can do it once you have your dumbbells. So very important. And the other thing is like end stage sort of kettlebell swings. You can do kettlebell swings, obviously, with kettlebells. I have seen people do it with dumbbells, though. They just hold onto a plate that's attached and just wrap their fingers around the plate rather than the hand hold. And as long as everything's nice and secure, they can do kettlebell swings with that. Kettlebell swings are just end stage exercise. You know, once we've built up, you know, a steady amount of say cardio, like running, once we've built up some really heavy, slow deadlifts, then we can start looking at doing some kettlebell swings. But you won't be able to do with anything else. I guess maybe with a backpack. I haven't ever seen someone do kettlebell swings with a weighted backpack, but I guess that's an option. But again, the rate of progression, the minute. options that you have available with an adjustable dumbbell, you can go from five kilos to then five and a half kilos to then six and a half kilos to eight kilos and you can slowly build these up as you get stronger. That's a key. So to summary, as a summary, level one, if you've got no exercise, no exercise equipment, do your bridges, do your Nordic drops, do your Nordic hip hinges, progress those through range of movement, increasing the reps. maybe some speed if you start getting to kind of end stage. Level two, if you've got therabands, do some prone hamstring curls, hip extensions, crab walks, just get the glutes activating, gets a bit of resistance and start progressing that with greater tension, more bands. Then if you do have access to a Swiss ball, it's probably not crucial that you have a Swiss ball, you can definitely get away with a lot of exercise without it, but a lot of people have it, it's quite common. some bridges, do some bridges with hamstring curls, use the Swiss ball to assist your Nordic dips. Then we're going heavy. We've got level four. If you can get a heavy backpack, start applying it to your bridges, start applying it to your Nordic hip dips, weighted step-ups, add those in, single leg deadlifts, that can be done. And then level five, the kind of most optimal if you don't have a gym membership. Adjustable dumbbells start doing your deadlifts progress the weight progress the range of movement as symptoms allow I Do have an episode a prior episode on deadlift progressions. So once you do have adjustable dumbbells if you're not too sure or a lot of people are very apprehensive just To start deadlifts because they've done it in the past and it's flared them up, but I do have an earlier episode Let me just look now because I can find the episode number for you. Episode 46 was titled insights into deadlift progressions. So you can go check that out. But yes, I do have four final tips, which I've kind of mentioned in this podcast already, but thought I'd just laid out there. Number one, heavyweight is encouraged. If you're able, do it. If you do have a gym membership, or if you can have access to a gym membership, do it. It's going to assist further assist you it's going to be the best advantage that you have. Number two, tendons love slow heavy load. Keep that in mind, it can be used as an algesic effect, it needs to be used with your rehab. Number three, be progressive, be progressive. It's a lot of people are see success and then they get really complacent. They just want to get back into running. And they get to the bare minimum of strength that is required for them to get back to running. And then they stop there, or they just like go into steady state kind of mode. Be progressive. Once deadlifts are too easy, step ups are too easy, increase the weight. Number four, you've kind of gathered this for now. Just be creative. There are so many people who just limit themselves, talk themselves out of. progressing because they just say, yep, I just don't have anything available. This is what I have. But there are ways you can be creative. Open your minds to being resourceful and finding out all these different options. So hopefully you can start applying something different after listening to this episode. If you do, and you see success, please reach out, let me know. I love hearing this sort of stuff. Um, my aim is to help people who. don't necessarily or who just aim to learn more about PhD, just want to start being as resourceful as I can because I do see the importance of the individual learning about PhD and trying things on their own. If you try all these things and you're still struggling to overcome it, jump onto a free injury chat. I have them in every show note displayed. The link is there. Book in a time, we can have a chat and see if there's any missing links or something you might want to include. But hopefully you found this one effective. Hopefully you found this one relatable and something that you can change to better enhance your chances of recovering. And we'll catch you next episode. Thanks once again for listening and taking control of your rehab. If you are a runner and love learning through the podcast format, then go ahead and check out the Run Smarter podcast. Hosted by me, I'll include the link along with all the other links mentioned today in the show notes. So open up your device. Click on the show description and all the links will be there waiting for you. Congratulations on paving your way forward towards an empowering, pain-free future. And remember, knowledge is power.