Back Leg and Arm Exercises to Optimise BMD

This is a series of back, leg and arm exercises to load your skeleton in ways that should optimise your BMD. There are also balance exercises to help reduce your risk of falls. Between them these exercises will reduce your risk of fracture. Invest time at the beginning paying careful attention to these instructions so that you master the correct technique and become competent quickly. With each new exercise, allow two sessions to learn the movement pattern, using the easiest alternative, before you begin to train in earnest.

Some of the bone loading exercises form complete packages, which have been evaluated as such in research trials; they may be effective only if practised together. One package is the first six leg exercises and the other package is the Arm Press, All-fours, and the Wrist Press, Twist & Pull.

A WORK-OUT FOR YOUR BONES

For improvement in BMD with weight-training, you need to lift at least 70 per cent of your maximum. This level is best tested in a gym but you can judge it at home from the effort you apply. If the eighth lift is easy you’re below 70 per cent; if you can only just manage the last few lifts, you’re above 80. You should train three times a week.

For maintenance of bone strength, continue to train once a week at the level you achieved. This should at least prevent further bone loss, which is a benefit if you are postmenopausal because these years are associated with progressive bone loss. When you are ready to use weights: Begin with 500 g ~k Progress in 500 g stages k Use no more than 7 kg for arm lifts kr Use no more than 11.5 kg for leg lifts. Free weights are hard to control so the upper limits are set for safety not as a maximum for bone-loading. A larger woman will be able to lift more than a smaller one so we cannot prescribe a maximum. Few women will reach the safetjf limits, but if you do, then progress to a gymnasium and use the weight stacks, which allow you to use bigger weights with safety. Always move slowly, especially as you lower; j^ou are more powerful when you move slowly and this will load the bones better. Lift on the right and left sides in turn for all the leg exercises except the side leg lift and the leg press. If you are using weights, put one on each limb before you begin the exercise. Remember to follow the Essentials.

For each exercise aim to do 8 lifts, resting for a second between each lift.

Train up to 3 sets of 8 lifts, resting for a minute between each set.

Do not hold your breath; slowly count out loud to 3 as you lift and to 3 as you lower.

When the 8th lift is no longer a challenge, it is time to progress.

Aim to progress every 2 weeks.

If you have to stop due to illness, start again with less weight.

Stop if you feel any pain and reduce the weight.

Do not overtrain; up to an hour every other day is enough.

Flamingo swing

Good balance is important because if you lose your balance and fall, you might break any fragile bones. Taking steps to improve your balance is therefore a useful way of reducing the risk of osteoporotic fracture as you grow older.

We all have the potential to achieve excellent balance. Gymnasts, tightrope walkers and ice skaters are shining examples of what is possible with practice. You can train yourself to have better balance by practising Flamingo Swings. This balance exercise can enhance your control and flow of movement and sharpen the reflexes that help to prevent a trip from turning into a fall. Take the opportunity to practise them whenever possible, perhaps while you are waiting for the bus or talking on the telephone.

As their name suggests, these muscles enable you to stand erect by supporting the length of the spine.

A sedentary lifestyle does not provide sufficient action for back muscles. They are rarely exerted strongly or often enough to maintain optimum strength, so unexpected demands can cause trouble. When inadequate strength meets too large a force, damage occurs to ligaments and tendons and the consequence is back pain. This is such a common problem that almost everyone has suffered from it at some time. Lifting a lively child or moving a heavy object can damage your back if it is not strong enough. If you have a history of back pain consult your doctor before starting and begin with the arm supported alternative below.

Progression

Begin by lifting 5 cm, and progress to 10 cm. To go further, add a small flat weight across your shoulders. ¦

Caution

If your lower back hurts during this exercise, place a folded towel under your hips. Do only two lifts and see how your back feels during and after the exercise. If there is any discomfort try the adaptations below until your strength improves. If pain persists, stop and consult your doctor.

If you are unable to get down to the floor safely, you can do this exercise in bed.

Lie face-down on the floor, your legs together, your arms by your side and your palms on the floor. Check your pelvic tilt.

Lengthen your spine and lift your shoulders, back and head off the floor. Moving slowly and with control, count to 5 to lift, hold, count to 5 to lower. Rest for 5 before repeating. Lift your palms just off the floor for an extra challenge.

Flying back lift

This exercise targets many muscles especially those running the length of the spine. It is a progression of the Back Lift and Leg Lift and you should do it only when you are comfortable with the Back Lift. It will improve your shoulder flexibility and strengthen the muscles that protect your shoulder joints. This helps to prevent ‘frozen shoulder’; a painful condition that is common in older women. It also creates a satisfying sense of top-to-toe body line and improves body awareness and postural control.

Progression

When you have mastered the Flying Back Lift, progress by lifting your arm and leg higher to a maximum of 10 cm.

Lie face-down with your forehead on your folded hands. Check your pelvic tilt and tighten your abdominals.

Slide one palm forwards along the ground. Lengthen your opposite leg along the floor away from your body. <se.,.:

Tighten your buttock muscles on this side, then lift your leg about 5 cm off the floor. Maintain this position as you lengthen and lift your outstretched arm about 3 cm. Count to 5 to lift, hold and count to 5 to lower.

Rest, then repeat on the other side. %S £’¦

Leg lift

Caution

If you feel pain in your lower back during this exercise, place a folded towel under your hips to stabilise the pelvis and reduce the arch in your lower back. If the pain persists, omit this exercise and seek advice from your doctor.

This exercise targets the lower back, buttocks and the back of the thighs. As you lift your leg, the muscles contract and pull on the bones of your spine and hip, which has a stimulating effect on BMD. It is also an excellent exercise for improving lower back strength, increasing the support for your lower spine and reducing the risk of lower back pain. It will also firm up the muscles of your bottom to give you a trimmer figure. These muscles are used in all weight-bearing activities but are only challenged to their full potential during vigorous activities such as uphill running or climbing up stairs quickly.

Progression

When you have mastered the Leg Lift exercise, increase the challenge by using ankle weights.

Lie face-down with your legs together and your forehead on your folded hands. Check your pelvic tilt and tighten your abdominals.

Lengthen one leg backwards along the floor, tighten your buttock muscles on this side and, keeping both hips pressed into the floor, lift your leg about 3 cm. Lengthen and lift another 3 cm upwards, then lower. Count to 3 to lift, hold, count to 3 to lower. Rest, then repeat on the other side.

Common mistake

Do not lift your leg so high that your hip lifts off the floor. This can place strain on your back.

Side leg lift

This exercise targets the large outer thigh muscles, which are attached across the top of the femur to the outer edges of the pelvic girdle. These muscles are used when you step sideways but are rarely used to their full potential. If you make them work against some resistance, the underlying bone is stimulated.

Progression

Start without weights and with bent knees. Add a light weight around your thigh to progress and then move the weight to your ankle to further increase the resistance.

Caution

If you have an artificial hip, start and finish with your knees bent and a cushion between your thighs.

Lie sideways with your knees and hips at right angles, with weights around your ankles. Rest your head on your lower arm or a cushion for comfort. Place your other hand on the mat, opposite your chest. Check your pelvic tilt and tighten your abdominals.

Taking care to keep your knee and foot facing forwards and slightly down, raise your top leg about 10 cm. Count to 3 to lift, hold, count to 3 to lower. Rest, then repeat. Roll over on to your other side and repeat with your other leg.

Thigh squeeze

Caution

If you experience any pain in your pubic area or lower back, check your pelvic tilt and move a little further away from your partner. If the pain persists, stop, and try doing the exercise on your own using a resistance ball.

This exercise targets the inner thigh muscles, which pull the legs together. You use these muscles when horse-riding or swimming breaststroke, but on the whole, hip adduction is an unusual activity in everyday life. Exercising these muscles provides unusual forces for the underlying skeleton to resist, which is why it helps to improve the density in the hip.

Although swimming is a healthy activity, the forces are not high enough to stimulate bone. This is because the water yields as you kick. To load your bones, you need to work against a bigger resistance. A resistance ball is ideal, but it is fun and effective if you can work with a partner. It is important to choose a partner of similar size and strength to yourself. The added advantage is that while you are exercising your adductors, your partner is exercising her abductors, and vice versa when you change over.

Progression

Just squeeze as hard as you can.

Sit tall facing a partner, with your legs outside her legs. Both of you must position your knees directly over your toes, check your pelvic tilt and tighten your abdominals.

Slowly press your legs inwards, as your partner presses outwards. Count to 3 as you press, hold, count to 3 to release. Rest, then repeat.

Rest, then change positions and repeat.

Leg press

Caution iV If you have knee problems take care not to lock your knees.

If you have an artificial hip do not lift the thigh into the chest; begin with the knee at hip height.

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This exercise targets the muscles that straighten the hip, including the quadriceps, so it is good for increasing BMD in these areas. You use these muscles when you push off against the floor to rise from a chair or climb stairs. Activities like jogging and jumping also challenge these muscles and, in turn, promote BMD.

It is difficult to provide enough resistance in a home exercise for this group of muscles. You need to use both arms to provide resistance for one leg; if you still find it easy to stretch out the strongest band, use a weight-training machine in a gym to provide sufficient resistance. You will be surprised at how much you can push with your legs; these muscles can resist at least five times your body weight, for example, when you are jumping which straighten the hip and bend the knees.

The hamstrings are potentially powerful muscles but they are often weaker than they should be when compared to their opposite muscle group: the quadriceps. The hamstrings are used in everyday activities such as stair-climbing and for many sports, but they need extra resistance to improve strength and load the bones. The Leg Curl loads bones effectively only when you use ankle weights.

Progression

Master the exercise using a light ankle weight, then increase the weight and height of the lift to a limit of 8 cm.. /

Taking care not to overarch your back, lift your leg about 3 cm, hold, then lower with control for a count of 3. Rest, then repeat. Repeat with the other leg.

Kneel on all-fours with your legs hip-width apart. Your elbows should be bent under your shoulders, with your forearms and palms flat on the floor. Check your pelvic tilt, tighten your abdominals and slide one leg out behind you. Flex your foot and lift it about 3 cm. Lengthen your leg.

Caution : If you feel any discomfort in your joints, neck or head, or are unable to get to the floor safely, do the standing alternative.

If you are postmenopausal, do the standing alternative.

Continue to lift your straight leg until your knee is just above the level of your hip, then curl the lower leg inwards to a count of 3 until your ankle is directly above your knee.

Straight leg lift

This exercise targets the quadriceps muscles of the thigh that cross both the front of the hip and the front of the knees. They are powerful muscles that you use to some extent in all weight-bearing activities; it is the most important muscle for cycling or kicking. This exercise challenges the four quadriceps muscles to their full potential and loads the hip. It is also excellent for helping to reduce instability and discomfort arising from incorrect alignment of the knee joints. Keeping these muscles strong is important for independence as you grow older.

Performing this exercise in a controlled way and progressing step-by-step is very important if you are to get the maximum benefit.

Progression

Add a weight when you have mastered the Straight Leg Lift. Progress further by lifting the heel about 10 cm off the floor. Do not lift higher than your other thigh. Progress even further by increasing the weight. .

Sit towards the front of a chair, with your legs hip-width apart. Sit tall with your knees directly over your ankles. Hold the chair seat to support your back. Keeping your foot in contact with the floor, slowly slide one leg forward.

Lengthen your leg as much as possible by pushing your heel away, then check your pelvic tilt and tighten your abdominals and thigh muscles. Count to 3 as you lift your foot slowly, about 5 cm, hold, then lower it with control for 3. Rest, then repeat with the other leg.

Caution

If you feel any pain or discomfort in your back or knees during this exercise, check your pelvic tilt, abdominals and leg alignment. If the problem persists, discontinue this exercise and seek advice from your doctor.

Avoid the temptation to lift too high or use ankle weights too soon.

Thigh lift

Caution

If you feel any pain in your back, hip or knees, other than mild stiffness following this exercise, try it without weights. If the pain persists, seek advice from your doctor.

Do not lift your leg higher than shown.

This exercise targets several muscles that bend the hip joint, but the important one for bone loading is the psoas muscle which crosses from the femur to the lumbar spine. This exercise has been shown to be effective on its own, rather than as part of a package; it is usual to evaluate at least six weight-training exercises together. Performed at least three times a week using a 5 kg weight on the mid-thigh, this lift has been shown to maintain BMD in postmenopausal women.

You use these muscles a little when you lift your foot to step on to a bus and a lot when you lean backward if sitting without a support.

Progression

Master the exercise using just the weight of your leg, then add a light weight around your thigh as shown and lift just 3 cm. Progress by lifting another 3 cm without letting your chest or lower back sag. Progress further by moving the weight further down your thigh toward your knee, then increase the weight.

Sit toward the front of a chair with your feet hip-width apart and your knees directly over your ankles. Secure a weight across the top of one thigh. Sit tall and hold the chair to support your back. Check your pelvic tilt and tighten your abdominals.

Tense the muscles of your weighted thigh as if to lift the leg. Press down against the floor with your supporting foot. Re-tighten your abdominals and lift your weighted thigh about 5 cm. Count to 3 as you lift, hold, count to 3 lower. Rest, then repeat with your other leg.

Wrist curl

Caution

If you experience pain at the end of the upward or downward movement you have gone beyond your natural range.

Most women have weak arms compared to their legs, so it is well worth doing some upper body exercises. The wrist is particularly vulnerable to osteoporotic fracture, so the next few exercises concentrate on increasing wrist BMD. The Wrist Curl targets the muscles which cross the wrist. To identify these muscles, hold your forearm gently in one hand while you clench your other hand into a fist; you will feel your muscles contracting. The muscles provide your grip power for twisting the lids off jars.

The wrist is an extremely flexible joint which allows the hand to move in all three planes like an anglepoise lamp. The forearm muscles pull on the wrist bones as you lift the weight, and the force is greater while you lower the weight because the muscles control the pull of gravity.

Progression

Master the Wrist Curl exercise using a light weight, and progress further by increasing the weight. in each hand.

Alternative

Both exercises can be performed double-handed provided you can find a suitable surface, such as a waist-height narrow table or bench, where your back can be erect and your forearms supported.

Sit toward the front of a chair with your feet hip-width apart and your knees over your ankles. Hold a dumb-bell in an underhand grip, with your wrist horizontal and in line with your elbow. Support your forearm with your other hand, resting it on your thigh. Lean forward slightly. .

Count to 3 to curl the dumb-bell upwards, moving only your wrist. Hold.

Count to 3 to lower the weight until your wrist is fully extended downwards, and return it the start position. Rest, then repeat. Repeat with your other arm.

Turn your forearm over and repeat the exercise using an overhand grip.

Arm curl

Caution

The wrists should not move during this exercise. If you find it difficult to keep them fixed, use a lighter weight.

Do not lock the elbows at the end of the lowering movement and do not touch your shoulders on the lift.

T his exercise, often referred to as a biceps curl, targets the biceps muscle at the front of your upper arm – the muscle that everyone pinches to see if you are strong. It is attached to the radius and the humerus bones.

The exercise uses the biceps muscles to bend the elbow joints, and then allows them to straighten again resisting the force of gravity acting on the hand-held weights. These curls will make your biceps feel firm and give your arm a good line without becoming bulgy. You’ll find it easier to manage heavy shopping bags as your muscles increase in strength. This exercise will help to improve BMD in the wrists, because they are also involved in the lift.

Progression

If you find this exercise hard, then try with one arm at a time. Master the technique with a light weight, then progress by increasing the weight. in each hand. 11 g

Stand tall with your feet hip-width apart and your knees bent slightly. Your arms should be a little more than shoulder-width apart. Hold the dumb-bells in an underhand grip with your palms facing forwards. Check your pelvic tilt, tighten your abdominals, press your shoulders back and down, and lengthen your arms.

Curl your arms upward toward your shoulders. Count to 3 as you lift, hold, and count to 3 to lower. Rest, then repeat.

Common mistake

Do not lean back as you lift your arms or swing the weight upward. Think of keeping the body firm and still as you lift and lower.

Arm press

Caution

If you have a shoulder injury, place your hands below shoulder height.

If you have arthritis in your fingers, shoulders or neck, do not perform the alternative opposite.

This exercise targets the muscles across the chest and upper arm and at the back of your upper arm ; it also involves your wrist muscles, particularly when the ‘spring’ is added to the press. It is a vertical press-up, which is much easier to perform than a horizontal one. As well as being good for your wrist BMD, it helps you to maintain your upper body muscles and a good bust line. The triceps area, in particular, can become ‘baggy’ as you get older, if neglected.

You need to hold your body firm in this exercise, which requires concentration. Think of your body as a rigid plank of wood, with your arms doing all the work.

Progression

You can add impact by performing the spring alternative. Push away a little more powerfully until your hands leave the wall and then land carefully, rolling your weight through your fingers, palm and heel of your hand.

Stand facing a wall with your feet hip-width apart. Place your palms, fingers upward, on the wall at shoulder height. Your arms should be shoulder-width apart, and your elbows extended but not locked. Check your pelvic tilt and tighten your abdominals.

Keeping you spine and neck long, bend your elbows and lower your body towards the wall. Press against the wall to return to your start position. Count to 3 as you lower, hold, count to 3 to return. Rest, then repeat.

Shoulder press

Caution

Protect your back and shoulders by pushing directly upwards. Do not lean forwards or back; keep your arms just in front of your ears.

Don’t worry if your shoulders click, as long as it is not painful.

This exercise targets the muscles across the top of the shoulder joint and the triceps at the back of the arm; it requires a good range of movement in the shoulder. You use these muscles when you lift something on to a high shelf. The exercise also involves your pectoral muscles and the muscles of the upper back and spine, so it should help improve BMD in the spine. The spine has to be like a firm pole to keep the weight of the arms and the dumb-bells in position. If you do not observe the caution box, the risk of shoulder injury is high.

Progression

Start cautiously with a light weight and increase gradually as you become more competent in each hand. For variety, turn your forearms and palms inwards to perform the press. The seated version helps to stabilise the lower back and is therefore safer when using heavier weights. Do not perform the standing alternative unless you are very competent.

Press the dumb-bells directly up until your arms are as straight as possible but not locked. Count to 3 as you lift, hold, count to 3 as you lower to the start position. Rest, then repeat.

Sit with your feet and legs hip-width apart. Hold the dumbbells in a ‘thumb under’ grip with your elbows bent and your hands a little wider than shoulder-width apart. Your palms should face forward with your knuckles up toward the ceiling. Check your pelvic tilt and tighten your abdominals.

Common mistake

Don’t push your arms forwards: this places strain on your back.

Don’t allow your arms to swing as you lift or lower.

Chest press

This exercise targets the muscles that straighten the forearm and many supporting muscles in the back and chest, including the pectorals. You use these muscles to push heavy objects around, for example, when you rearrange the furniture or give children a push on the swing. This exercise will firm up your bust line, as well as helping to improve BMD in the spine.

The arm action is similar to that in the Shoulder Press but the forces are acting in a different direction so the loading on the spine will be different. It is less demanding of the supporting muscles and is feasible even if you have a poor range of movement in the shoulder.

Progression

Increase the weights to work your muscles harder. in each hand. This floor chest press effectively loads the wrists and spine. Benefits to the spine are greater if you go to a gym and use a chest press machine.

Caution

Attention to the position of the weight is particularly important for safety in this exercise.

If you experience dizziness when you get up from the floor, make sure you come up slowly.

Lie on a mat with your knees bent, your feet and legs hip-width apart and your feet on the floor. Hold the dumbbells in an overhand grip, your palms facing forwards, and your knuckles facing the ceiling. Your arms should be bent and slightly wider than shoulder-width apart. Check your pelvic tilt and tighten your abdominals. Press the dumb-bells upwards, without locking the elbows, to reach the start position. maintain the arm and wrist position. Press the dumb-bells up again to a count of 3. Hold in the start position, then repeat.

Slowly lower the dumb-bells to a count of 3 by bending your elbows, allowing your arms to move out to the sides until they touch the floor. Rest, but

Alternative

You can do an effective chest press while seated by using a band instead of dumb-bells if you are unable to get to the floor safely.

All-fours

This exercise is a weight-bearing exercise for your arms rather than your legs. It targets many of the same muscles as the Arm Press, particularly the pectorals, triceps and wrist flexors. The loading on your wrist, however, is greater than in an arm press. When you are on all-fours, your forearms are carrying nearly half of your body weight. By moving the position of your hands on the floor you can vary the direction of loading and the way that your wrist muscles are pulling to support your weight.

This exercise, along with the Arm Press and the Wrist Press, Twist & Pull, forms a set of bone-loading exercises, which load the wrist in different directions. Research has shown that, when all these exercises were done three times a week by postmenopausal women, they improved BMD in the wrists by almost six per cent.

You load your wrist in a similar way when you polish a table, clean the windows or push a child along in a pushchair. Pushing a pushchair probably achieves just as much as this set of exercises, provided the child weighs over 9 kg. Going uphill with a pushchair provides a wrist press, downhill a wrist pull, and awkward kerbs provide a similar experience to the next exercise.

Caution

If you experience any pain during this exercise, omit the forward movement, but spend time on all-fours. If the pain persists, stop.

If your wrists are painful as a result of this exercise, keep your body weight evenly distributed between your knees and hands. If the pain persists, stop and do more Wrist Curls.

B Kneel on all-fours with your wrists directly under your shoulders, your fingers facing forward, your knees and feet slightly apart and your knees above your hips. Check your pelvic tilt and tighten your abdominals. Move your body and hips slightly forward, so that most of your body weight is over your wrists.

Making small, controlled movements, walk your hands forward as far as you can without overarching your back or moving your knees or feet. Hold, then walk your hands back to the start position.

Rest, then repeat.

Walk your hands out to either side, as far as you can, keeping your body rigid. Hold, then walk your hands back to the start position. Rest, then repeat.

Wrist press, twist & pull

Caution

Avoid being competitive, keep the pole equidistant between both partners.

Tr If you have arthritis in your hands, do not do this exercise.

These exercises target the muscles controlling the movement of your hands: the wrist flexors and extensors. These are the muscles you use to grip and twist bottle tops, wring wet towels and push a shopping trolley. They load your wrist bone in many directions. You’ll need a partner, preferably of a similar size to yourself. If you have to rely on someone bigger, make sure they adjust their strength to meet yours. Use a smooth pole, at least 60 cm long, such as a body-bar or broom handle. If you cannot find a pole, you could do some arm wrestling at the kitchen table.

There are three exercises here: the press, the twist and the pull. In each exercise, your partner will be working against you, thus generating high resistant forces. You should feel these forces all the way down your body, proving how many muscle groups are being challenged.

Progression

Generate as much force as you can, counting to three as you press, twist or pull. Hold for a second before you release.

Start Stand opposite your partner with your feet slightly wider than hip-width apart and your knees bent. Hold the bar with both hands shoulder-width apart, one hand using an underhand grip, the other overhand. Check your pelvic tilt and tighten your abdominals.

Press Push upwards with your underhand palm and downwards with the other as if trying to rotate the ends of the pole. Your partner should press in the opposite direction. Change your grips around and repeat in the opposite direction. Rest, then repeat.

Twist Return to your start position. Twist the pole, as if wringing a towel. Your partner should twist in the opposite direction. Change your grips and repeat the exercise in the opposite direction. Rest, then repeat.

Pull Return to your start position. Hold the pole with an underhand grip, while your partner uses an overhand grip. Pull in toward your waist as your partner pulls in the opposite direction. Reverse your grip and repeat. Rest, then repeat.

Abdominal lift

This exercise targets the muscles that form the front wall of your lower abdomen. These are important muscles as they support your trunk and indirectly, your back and spine. They need to be strong to perform your bone-loading exercises effectively; all the forces generated by your arms and legs are supported by the centre of your body. These muscles are important for maintaining good posture and correct pelvic tilt. Strong abdominals also give you a trim figure and reduce your risk of falls. Slack abdominal muscles allow your middle to bulge outward and can lead to back pain. Focus on tightening the triangle of muscles spreading from your waistline to your pubic bone.

Out-dated sit-ups should be avoided because they increase the risk of vertebral fracture.

Lie face-down with your forehead on your folded hands. Position your legs about 5 cm apart. Check your pelvic tilt.

Breathe in, then breathe out as you contract your abdominals and lift your navel in toward your spine. Hold, then release back to the start. Rest, then repeat.

Progress by positioning your arms, elbows, and shoulders as shown. Lift your navel, abdominals and hips off the floor. Try not to over-tilt your pelvis. Breathe out as you contract, lift and pull in. Hold, and breathe in as you release. Rest, then repeat.

Flexibility stretches

Caution

Never bounce in a stretch. This can tighten the muscle you are trying to stretch, and may cause injury. »V Remain seated a few moments after the lying stretch. Get up slowly to avoid dizziness.

A cool-down using flexibility stretches, gentle relaxation and brief revitalising circulation exercises is an essential finish to every exercise programme. The exercises have left your muscles warm and pliant, so this is a good time to develop your joint flexibility. Begin by repeating the warm-up stretches ; the emphasis now should be on developing each stretch as far as you can, comfortably.

Add the two stretches shown here to provide more supported positions for your hamstring and inner thigh muscles. These muscles are especially important to stretch and they respond particularly well to longer, developmental stretches. Extend the duration of the stretches gradually from ten seconds each to one minute.

Do not touch your toes with straight legs to stretch the back and hamstrings. This outdated stretch carries increased risk of back and eye injuries.

Effective stretching

Put on an extra top to retain body heat and to feel more comfortable.

It is important to do these longer stretches gradually.

Move slowly with control to take your muscles into the fully stretched positions shown.

Hold until you feel the tightness subside.

Then, on an out-breath, move gently further into the stretch. Try to relax into the stretch.

Release any tension in the rest of the body, especially the shoulders.

To finish, move slowly out of the stretch again.

Relax and revitalise

Spend a few minutes relaxing.

Lie on your back on the floor, with knees raised slightly.

Tense and relax your muscles to feel the difference in your face, shoulders, hands, all the way down.

Do a full body stretch to wake you up again.

Hamstring stretch Lie on your back with both knees bent and your feet flat on the floor. Check your pelvic tilt, tighten your abdominals and, keeping the knee bent, lift one leg in towards your chest. Take hold of the back of your thigh with both hands. Relax for a count of 10.

Slowly straighten your leg until you feel a stretch in the back of your raised thigh. Slide your outside hand up on to the lower leg so your whole leg is supported. If you feel the stretch subside, bring the leg gently a little further toward your chest. Hold for a count of 10 or more. Relax, then return to the start and repeat on the other leg.

Sit on a folded mat with the soles of your feet together, your back long and your chest lifted. Place your arms on your legs as shown, and allow your knees to open naturally. Check your pelvic tilt and tighten your abdominals.

Use your forearms and then your hands to press your legs down gently, until you feel a stretch along your inner thighs. If you feel the stretch subside, lean forward slightly for a deeper stretch. Hold for a count of 10 or more.

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