Level 1

Get Your Lifestyle Back

GAIN Rehabilitation Level 1

Level 1 offers 30 videos of low impact exercises which are designed to help you begin your rehabilitation journey.

The explanation and instruction to each video are listed lower down on this page.

Please note: Users of this resource are advised to seek the guidance of their Doctor and/or physiotherapist before starting any of these exercises as GAIN or rehabathome.com cannot be held responsible for any injury or illness incurred while following these exercises. If you have had any joint replacement in the last 12 months, you should ask your GP or treating physio for guidance before carrying out any of the exercises.

Terms

 

Repetitions

Repeating an action or exercise, in the same way, one after another.

Sets

A group of consecutive repetitions.

Core strength/stability

The underlying muscles in the trunk which helps to maintain posture and help with movements of the body.

1. Lower tummy activation

The lower tummy muscles are very important for creating stability and support of your trunk and body during movements. During periods of inactivity or injury, these lower tummy muscles can become sluggish, have reduced strength and become tired quickly. This can then lead to poor movement and an increased risk of injury. This exercise can, therefore, be described as a fundamental and building block for all exercises.

Lying on your back, your knees bent and feet flat on the ground is the easiest way to recruit the correct muscle. As you become more familiar with how to activate and more importantly isolate the muscle you can start to carry out this exercise in sitting, standing and when moving about.

The muscle you are trying to activate is located in from the front of the pelvis and above your pubic bone. When trying to tighten the muscle you should feel the muscles draw in and up and not bulge outwards. Try not to hold your breath when activating the muscle. You are not trying to tighten this muscle as hard as you can either, it is more of a gentle squeeze of the muscles. Some people describe the activity as stopping yourself breaking wind or the sensation of stopping mid flow of having a wee. The key is that you feel a drawing up and not a bearing down movement.

Aiming for a 10 seconds continual contraction 10 times with a few seconds break between repetitions, all the time breathing normally. If you feel you have lost the contraction at any point stop and start again.

2. Shoulder glute bridge

This exercise is an excellent exercise for strengthening not only your lower limbs but also your core and pelvic stability. The shoulder or glute bridge is a versatile exercise which you will see develop and become hard as you progress through the exercise program.

When in the start position it is really important that you activate the lower tummy muscles. These act as your brace or more commonly know core stability. Try to maintain the tummy muscle activity throughout the exercise. It is really important that quality is the overall emphasis, not speed or quantity.

Tighten your buttock muscles by imagining you are holding a £10 note in between your buttock muscles. Keeping your heels and feet down, shoulders in contact with the ground raise your hips towards the ceiling. Keeping your buttocks tight lower yourself back down to the ground slowly. If you have maintained control try to repeat the exercise without relaxing in between each repetition. If you feel you have lost the control of the muscles then stop, reset and start again

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

3. Standing bicep curls

Upper limb strength is important for everyday tasks such as reaching into a cupboard or opening a door. This exercise has been added to help regain some of the upper limb strength which you may have lost during your time of inactivity or convalescing.

As with all of the strengthening exercises it is really important that you try to gentle recruit and engage your lower tummy muscle prior to undertaking the activity.

Hold a piece of exercise band (or similar) in both hands. Gently activate your lower tummy muscles. Carefully step on to the centre of the band trapping it between your feet and the ground. With your arms down by your side and still holding the band bend your elbows raising the lower arm towards your shoulders and then lower back to the start position. Always look forward in case the band fails.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

4. Seated hamstring stretch

Tightened muscles can cause a lot of issues with both pain and restriction to movement. During periods of inactivity or injury muscles can become tight and shortened. The following stretch is a way of increasing muscle length to the back of your thighs. It is carried out in sitting but can equally be carried out in standing which is a separate exercise.

During the stretch, if you experience burning, pins and needles or pain rather than just tightness you should either reduce the stretch by not reaching down the leg as far or stop and try again. If you continue to have the nerve symptoms then you should ask your local physiotherapist or GP for further advice.

Shuffle to the edge of the chair, straighten one leg and reaching down that leg towards your foot with both hands.

Hold the stretch for 30 seconds and repeat the stretch on both legs 3 times.

5. Sit to stand (no arms)

An activity which we all when fully-abled take for granted is standing up and sitting down on a chair. As a result of an injury or illness, this quite often becomes a large barrier and hurdle to peoples independence and ability to function. This following exercise is aimed at strengthening your lower limbs and core muscles in an effort to make that everyday task of standing from a chair automatic and less of a challenge.

The process of sit to stand has multiple stages and requires a degree of coordination, sequencing and strength. First, you need to shuffle to the edge of the chair. Place your feet square and on a stable surface. Tighten your lower tummy muscles. Lean forward so that your chest is over your thighs, this should encourage your pelvis to tilt forwards. From this point push down through your heels into the ground, squeeze your bum cheeks together and try to stand up leading with your chest. Look slightly upwards to encourage an upward movement. Once at the top of the movement return back into the chair slowly, don’t just drop into the chair!!

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

6. Sit to stand (with arms)

An activity which we all when fully-abled take for granted is standing up and sitting down on a chair. As a result of an injury or illness, this quite often becomes a large barrier and hurdle to peoples independence and ability to function. This following exercise is aimed at strengthening your lower limbs and core muscles in an effort to make that everyday task of standing from a chair automatic and less of a challenge.

The process of sit to stand has multiple stages and requires a degree of coordination, sequencing and strength. First, you need to shuffle to the edge of the chair. Place your feet square and on a stable surface. Tighten your lower tummy muscles. Place your hands on the arms rests of the chair and lean forward so that your chest is over your thighs, this should encourage your pelvis to tilt forwards. From this point push down through your heels into the ground, your arms and hands onto the chair armrests, squeeze your bum cheeks together and try to stand up leading with your chest. Look slightly upwards to encourage an upward movement. Once at the top of the movement return back into the chair slowly by reaching back with your hands, placing them on the armrests, don’t just drop into the chair!!

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

7. Seated calf stretch using a Theraband

The lower leg muscles known as the calf often become problematic after long periods of inactivity, bed rest or injury. When they shorten then restriction a persons ability to move about, reduced a person’s ability to balance and can become painful. Lengthening them or maintaining their length is a crucial part to facilitate recovery.

Sitting in a chair shuffle towards the edge, straighten one of your legs and place an exercise band, towel or something similar over your forefoot. Keeping your knee straight gently take up the slack of the band until some discomfort/pulling can be felt up the back of the calf muscle. If pins and needles, tingling or burning is felt, reduce the stretch or start again.

Hold the stretch for 30 seconds and alternate the stretch on both legs 3 times.

8. Seated postural set

Most of us will not even think about sitting up or even think that sitting in a chair can be challenging and an effort to some people. Correct sitting and sitting for prolonged periods are both vital for peoples health. It is therefore vitally important that after a period of injury, hospitalisation or convalescing you are able to sit well.

Sitting in a chair upright and central. Gently pull in your tummy muscles and activate your core. Without losing the control of your trunk/body lean forward slightly to take the pressure off your back away from the chair back. Maintain this position while breathing normally and keeping those lower tummy muscles gently active. Once the exercise has finished return back into the chair and release your tummy muscles.

Hold the position for 30 seconds. You are aiming to increase the duration of sitting free from the back support for upto 2 minutes.

9. Standing calf stretch

The back lower leg muscles known as the calf muscles often become problematic after long periods of inactivity, bed rest or injury. When they shorten then restriction a persons ability to move about, reduced a person’s ability to balance and can become painful. Lengthening them or maintaining their length is a crucial part to facilitate recovery.

Standing in front of a stable surface, a kitchen worktop is ideal for this. Holding onto the work surface take a step back with one of your legs. Keeping your heels in contact with the ground transfer your weight onto the front leg. Maintain a straight leg at the back. As with any of the stretches, discomfort is normal. Pain, pins and needles or burning is not normal and should be avoided. If you experience these then stop and try again.

Hold the stretch for 30 seconds and alternate the stretch on both legs 3 times.

10. Seated hip flexion

Your hip flexors are a group of muscles which are found at the top of your thigh and into the front of your pelvis. Their main role is to help with walking and standing. They have another important role in pelvic and trunk stability. It is therefore vital for good movement and injury prevention that these muscles are not forgotten about during rehabilitation.

It is important that if you have recently had hip surgery that you check with your treating physiotherapist and/or GP to gain guidance on this exercise.

Sitting on a chair with your knees flexed and feet flat on the floor, lengthen your back and sit up tall. Gently tighten your lower tummy muscles and raise one of your thighs up off the chair, lower down slowly.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

11. Clam

The gluteal muscles are vital for both moment and pelvic / trunk stability. Increasing the strength and endurance of these muscles is very important after a period of inactivity following illness or injury.

It is important that if you have recently had hip surgery that you check with your treating physiotherapist and/or GP to gain guidance on this exercise.

Lying on your side, keeping your knees and legs together, flex your knees and hips until you are in a foetal position. Gentle tighten your lower tummy muscles. Keeping your heels together raise your uppermost leg from your knee. Try to keep your pelvis and trunk as still as possible. Lower down slowly. Throughout the whole movement, you are looking for control and smoothness of the movement.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

12. Bent knee fall out

Hip stability and control is vital for standing and walking. After a period of immobility, this group of muscles can become weakened and fatigue quickly leading to a poor movement and a risk of further injury. It is therefore critical that strengthening in both terms of strength and endurance is addressed.

It is important that if you have recently had hip surgery that you check with your treating physiotherapist and / or GP to gain guidance on this exercise.
Lying on your back with your knees bent and feet flat on the floor. Gently engage and tighten your lower tummy muscles. Keeping one leg as still as possible. Slowly and with control drop your opposite leg out to the side. Return the hip and leg back to the start point. During the whole movement try to keep your lower tummy active and stable. Imagine you have a glass of water on your tummy during the exercise.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

13. Double heel calf raise

The muscles at the back of your lower legs are known as your calves. Their main function is to help with walking but also have a vital role in standing and act as a stabilising muscle. After a period of inactivity through illness or injury, these muscles will weaken. It is therefore important that these muscles are stimulated and activated to help them recover.

Standing in front of a stable surface, (kitchen work to is an ideal place for this) place your hands on the surface to provide you with some support. Standing tall with your head up looking forward, tighten your lower tummy muscles, try to lift your heels off of the floor by pushing down through both feet. At the top of the movement hold for 1 second and then lower yourself back down slowly and with control.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

14. Bicep curls

Having strength in your upper body is important to be able to carry out everyday activities and tasks. Simple activities which we all take for granted can become hard and challenging after a period of inactivity. Increasing strength within the upper body is therefore critical to help return someone independence.

In standing hold onto either a drinks bottle or some small weights. Stand up tall and tighten your lower tummy muscles. With your arms by your side, bend your elbows until your hands are near your shoulders, return the weights back to the start point.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

15. Shoulder front raise

You would not normally associate building up shoulder muscles as an important element of rehabilitation after a hospital stay or a period of immobility. However, they are crucial for movements such as reaching into cupboards, getting dressed and opening/closing doors.

The only equipment needed for this exercise is a little weight. This could be, to begin with, as much as the weight of your own arms. Additional weight can be added by either holding a food can or a bottle of water. The good thing about a bottle of water is that you can add more water as you develop more strength.

In either standing or sitting with your arms down by your side, with or without additional weight, check your posture by looking forward and raising your chest. Tighten your lower tummy and with our palms facing down raise your arms forwards aiming for shoulder height. Lower your arms down slowly back to the start point.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

16. seated heel raise

The muscles at the back of your lower legs are known as your calves. Their main function is to help with walking but also have a vital role in standing and act as a stabilising muscle. After a period of inactivity through illness or injury, these muscles will weaken. It is therefore important that these muscles are stimulated and activated to help them recover. Even if you are unable to stand unaided this exercise can be carried out in sitting.

Sitting in a chair correct your posture by sitting tall and raising your chest. Gently tighten your lower tummy muscles. With your knees bent and feet flat on the floor push the front of your feet down into the ground and raise your heels up off the ground, lower down slowly and repeat.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

17. Sit to stand (feet offset)

Standing from a chair is an important element of a person’s independence. It required a combination of strength from several muscle groups, coordination of the muscles and a degree of balance.

First, you need to shuffle to the edge of the chair. Correct your posture by sitting tall and raising your chest. Gently tighten your lower tummy muscles. With your knees bent, feet flat on the floor and an offset your feet position push down through your heels. Place your hands on the arms rests of the chair or out to the side / across your chest and lean forward so that your chest is over your thighs, this should encourage your pelvis to tilt forwards. From this point push down through your heels into the ground, squeeze your bum cheeks together and try to stand up leading with your chest. Look slightly upwards to encourage an upward movement. Once at the top of the movement return back into the chair slowly by either with no arms or reaching back with your hands, placing them on the armrests, don’t just drop into the chair!!

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets.

18. Active straight leg raise

During periods of inactivity lower limb strength can become reduced and can lead to difficulties in walking and moving around, limiting a person’s independence. Increasing the strength of the lower limb is therefore very important and critical for a person’s recovery.

Laying on your back with your legs straight. Gently tighten your lower tummy muscles, tighten and squeeze your thigh muscle and then left that leg 2-3 inches off of the bed or floor. Hold for 1-2 seconds and lower down under control. Throughout the whole exercise imagine you have a glass of water or tennis ball on your tummy, the aim is not to allow it to fall off.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets on each leg

19. Laid down hip flexion

Weakness in the pelvis and lower limb is well known to occur during periods of immobility and or periods of hospitalisation. It is therefore vital to increase the strength of these muscles to enable you to regain your independence.

Lying on your back with your head supported. Gently tighten your lower tummy muscles, bend your knee and flex your hip towards your chest. Lower back to the start position by straightening your leg and un-flexing your hip. During the movement, there are a few key elements which you need to think of, slow and smooth moment, keep your lower leg parallel with the ground and imagine you have a glass of water or tennis ball on your tummy. The aim is not to allow the pelvis to rock.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets on each side. You can either complete one leg at a time or alternate legs.

20. Side-lying hip abduction

The muscles around your hips and pelvis are crucial for helping with mobility, stability and a persons ability to be independent. Weakness in these muscle groups can lead to injury to your lower back, hip or lower limbs. It is therefore very important if they are weak and have reduced power this is addressed.

Lying on your side with your head supported. Bend your bottom leg to provide stability to your pelvis, tighten your lower tummy muscles to increased pelvic stability. Keeping your top leg straight try to lift it away from the other leg. Throughout the whole movement think about keeping your pelvis still by imagining a glass of water or ball on the top part of your hip. Lower the leg down with control.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets on each side.

21. Standing hip abduction

Hip muscles and the muscles around the gluteals are very important for providing stability and control around the pelvis. During periods of inactivity and periods of convalescing these are susceptible to becoming weakened. It is therefore important that this is addressed with strengthening exercises.

Standing in front of a stable surface, a kitchen work surface is a good place to carry out this exercise. Place your hands on the works surface, stand up tall and looking straight ahead. Gently tighten your lower tummy. Transfer your weight over to one side and then raise your opposite leg out to the side. You are not looking to get the hip as far as possible, you are trying to lift it with control. Do not waddle your pelvis.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets on each side.

22. Standing hamstring stretch

The hamstring muscles are the muscles behind your thighs and are very important for walking and standing. During a period of inactivity, injury or convalescing these commonly become tight / shortened. When they are shortened it will impede on a persons ability to walk normally and work effectively. It is therefore important that the length of the hamstring is adequate.

Standing side on next to a stable surface. Take a small stride forwards with one leg, keeping the front leg straight, slowly sit backwards on to the back most leg, lean forward until a pulling feeling can be felt along the back of the straightened leg. Hold this position. Pins and needles, acute pain or tingling is not what we are wanting you to feel during this activity. If you do, stand up and try again.

Hold the stretch for 30 seconds and alternate the stretch on both legs 3 times.

23. Tandem stance narrow position

A persons ability to stand safely is normally taken for granted. But due to injury, periods of inactivity or convalescing this can become not only challenging but also a demanding activity. It is therefore important that a persons balance ability is challenged in a safe way to help with recovery.

Standing in the corner of a room, corner of kitchen worktops or next to a stable surface place the toes of one foot behind the heel of the other foot. Stand up tall and look ahead. Gently tighten your lower tummy muscles and if safe to do so remove your hands from the worktops. At any point, if you wobble or feel that you are going to fall over, place your hands down or move feet to regain your balance.

You are aiming to hold the position for 30 seconds and repeat with each leg at the front. Repeat 2-3 times each side.

24. Tandem stance (wide position)

A persons ability to stand safely is normally taken for granted. But due to injury, periods of inactivity or convalescing this can become not only challenging but also a demanding activity. It is therefore important that a persons balance ability is challenged in a safe way to help with recovery.

Standing in the corner of a room, corner of kitchen worktops or next to a stable surface take a step with one of your legs to create a gap between our legs. Stand up tall and look ahead. Gently tighten your lower tummy muscles and if safe to do so remove your hands from the worktops. At any point, if you wobble or feel that you are going to fall over, place your hands down or move feet to regain your balance.

You are aiming to hold the position for 30 seconds and repeat with each leg at the front. Repeat 2-3 times each side.

25. Step ups

Walking up and down the stairs or a step is an important part of providing a person with independence. During periods of incapacity either through injury, illness or convalescing this simple task can become a very difficult challenge. Therefore it is important and vital strengthening is undertaken.

If you are lucky enough to have a step box or access to a step box place this in front of a stable surface. The kitchen worktop is a good place. An alternative is the bottom step of your stairs. Standing next to the step box tighten your lower tummy gently. If you need to study yourself place your hands on the work surface infant of you or the stair banister rails either side of the stairs. Place one foot onto the centre of the box looking straight ahead step up onto the box placing your other foot onto the centre of the box. Slowly take a step backwards with one leg and place on the floor. Return your opposite leg to the floor.

10 repetitions with each leg leading and repeat 2-3 sets.

26. Seated knee extension with Theraband

During periods of inactivity lower limb strength can become reduced and can lead to difficulties in walking and moving around, limiting a person’s independence. Increasing the strength of the lower limb is therefore very important and critical for a person’s recovery.

Sitting in a chair, tie an exercise band into a loop, place the loop around the chair leg and place your leg inside the loop, with the loop around your ankle. Sitting up tall and with a gentle tightening of your lower tummy muscles, straighten your leg up and against the resistance of the band, lower down slowly and repeat.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets on each side.

27. Seated quad stretch

Your quadriceps (quads) muscles are located on the front of your thigh. During periods of immobility, injury or convalescing these muscles can become weakened and shortened. This shortening can lead to pain and restrict normal movements. In an effort to regain better quality movements, reduce pain and discomfort and to improve a persons independence it is important these muscles groups are lengthened.

Sitting on a chair without armrests. Shuffle your bum to the edge of the chair. Sitting up tall gently tighten your lower tummy muscles. Reach down to the side which you have shuffled and clasp the ankle of the same side leg. Bend your knee and using your arms draw your lower leg towards your bum. Once finished lower down slowly. During the stretch, a small degree of discomfort is ok along the front of the thigh. If you feel pins and needles, numbness or acute sharp pain then stop and try again.

Hold the stretch for 30 seconds and alternate the stretch on both legs 3 times.

28. Finger opposition slide

Hand and finger dexterity would not be a person’s initial thoughts when it comes to rehabilitation. However, they are vital for a person’s independence for simple tasks such as getting dressed or brushing your teeth. After a period of immobility or illness, the ability to move your hands and fingers in a controlled and precise way is commonly compromised. It is therefore critical to start to challenge the hands and challenge your control to simulate the healing process.

Using the tip of your thumb, place it on the tip of the index finger, separate the hands and then repeat on each of the finger creases along the finger. Once completed carry out the same task on the middle finger, then the ring finger and finally the little finger. Once completed take the thumb and touch the tip of the index finger, keeping contact slide it down to the base of the finger, lift off and complete with the rest of the fingers.

This is an exercise that can be carried out regularly during the day.

29. Hand putty grip

Hand strength and dexterity would not be a person’s initial thoughts when it comes to rehabilitation after an illness or period of convalescing. However, they are vital for a person’s independence for simple tasks such as getting dressed or unscrewing a jar lid off. After a period of immobility or illness, the ability to move your hands and fingers in a controlled and precise way is commonly compromised. It is therefore critical to start to challenge the hands and challenge your control to simulate the healing process and increase your grip strength.

There is no hard or fast rule with this exercise but some ideas are squeezing the putty in one hand, rolling into a ball with both hands, rolling into a sausage with both hands, tearing the putty apart with both hands.

This is an exercise that can be carried out regularly during the day.

30. Seated leg extension

During periods of inactivity lower limb strength can become reduced and can lead to difficulties in walking and moving around, limiting a person’s independence. Increasing the strength of the lower limb is therefore very important and critical for a person’s recovery.

Sitting in a chair, sit tall, gently tighten your lower tummy muscles. Start with your knees bent and your feet flat on the floor. Tight and contract one of your thigh muscles and straighten your lower leg so that it lifts up off of the floor. You are aiming to achieve the lower leg lift to be parallel with the ground. Hold at the highest point you are able to reach for 1 second and then with control lower back to the start position.

Aiming for 15 repetitions with a 5-10 seconds rest between sets and looking to achieve 3 sets on each side.