Patrick Gilbert PT, DPT, ATC, CSCS
You can make a workout as simple or as complex as you like. Undoubtedly, you have seen some wild things at your local commercial gym. A lot of people think that complex, new or unique is always better, but I do not believe that to be the case. By mastering the basics and making small tweaks to make them easier or more difficult, you have a fantastic outline for a workout. By incorporating these 6 movement patterns – the squat, hip hinge, lunge, upper body push and pull and loaded carries – you have a comprehensive series of exercises that hits nearly every part of the body. It is my belief that the core of every program should be based around these 6 fundamental movements. It is literally what my 12-week program Fundamentals of Training is centered on. Of course, in order to accomplish your specific goals, you need to make small tweaks to each of these movement patterns. But, at the end of the day, you should implement some form of these fundamental movements within each workout
The squat is thought by many to be the king of all lower body exercises. The squat movement incorporates ankle dorsiflexion, knee and hip flexion as well as some trunk flexion and core stability. It also requires activation of nearly every muscle in your lower body and core to perform it properly. With all this said, it’s a pretty solid “bang for your buck” movement, as you can work many different muscles at once. There is also room for endless tweaks, making this a very versatile exercise.
Squat – Barbell Back Squat
Two of the most important muscle groups for this exercise are the quadriceps and the glutes. The quads are largely responsible for the eccentric (lowering) portion of the movement, while both the quads and glutes are working while bringing yourself back up to standing. If you’ve ever attempted to lift something heavy from the floor and come away with a sore back, it could be due to a poor squat pattern where you did most of the lifting with your back and arms and did not utilize your leg muscles enough. When moving from the bottom of the squat back to the top, ensure that your weight is being pushed through your entire foot, with emphasis slightly behind the middle of your foot, towards your heel. In addition, imagine that you are “spreading the floor” with your feet. By pressing down and out you will engage your glutes better and create more power and stability on your ascent. Master the squat and you will be amazed when you unlock so many other health benefits in your life.
With this said, there are many factors that can interfere with your perfect squat form. These include restricted hip flexion or rotation, limited lumbar and thoracic spine range of motion and more. For more complex restrictions, a more detailed assessment and treatment plan is likely necessary. However, one of the biggest factors that can single-handedly derail the quality of your squat pattern is limited ankle dorsiflexion. Dorsiflexion is the ability of your shin to advance forward over your ankle as you drop down into your squat or perform other movements that require a similar action. There are many reasons that ankle dorsiflexion can be limited. The two primary culprits are soft tissue length restrictions and joint mobility limitations. If a soft tissue length restriction is present, you will likely feel a strong pulling sensation in the back of your heel and calf as you try to go into dorsiflexion. A limitation in joint mobility will feel more like your ankle is “stuck” as you try to move your shin forward. Both of these issues can be addressed with proper assessment and treatment techniques. Some can be fixed on your own with simple equipment such as a superband or mobilization wedge, but other more complex motion restrictions may require a rehab professional to tease out. If you are someone who struggles with having adequate ankle dorsiflexion, a simple trick you can use is to elevate your heels slightly when squatting. This can be as simple as placing some small weight plates under your heels. There are also small inclines that are made specifically for this. Additionally, powerlifting shoes typically have an extra heel lift built in for this exact issue. While it will not solve your motion issue, this quick fix will decrease the amount of dorsiflexion that is required to squat down, allowing you to complete this fundamental movement more effectively.
The hip hinge is an essential movement because of its massive dependence on what is known as the posterior chain. The posterior chain is a catch-all term for all the muscles on your back side that help to keep you upright against gravity. The biggest muscular players in the hip hinge are the hamstrings, glutes and erector spinae (muscles that stabilize and extend the spine), depending on which form of hip hinging you are performing.
Hip Hinge – Barbell Glute Bridge
One of the most basic hip hinge variations you can perform is a glute bridge. These can be done lying flat on the floor or with your back elevated. In both cases you are hinging at your hips in order to lift the load up and lower it back down. Compared with a standing hip hinge, this pattern is driven much more by your glutes than hamstrings, since your knee flexion angle does not change drastically and the knees never fully extend. Due to the lack of hamstring contribution, this hip hinge pattern can be great for developing hip extension strength and size for your backside.
Standing Hip Hinge (Straight Leg) – Romanian Deadlift
Contrary to the glute bridge, the standing version of a hip hinge will require much more hamstring and spinal extensor activation. This is much truer for the stiff-legged deadlift, otherwise known as a Romanian deadlift, since your knees remain relatively straight throughout. The important thing to realize here is that your hamstrings do not only create knee flexion; they also create hip extension. The hamstrings originate at the ischial tuberosity of your pelvis and insert below your knee. Though your hamstrings are not directly lengthened due to the relative stability of knee angle during this movement, by hinging at your hips, you bring their origin further from the insertion and lengthen the hamstrings that way.
Standing Hip Hinge (Bent Leg) – Traditional Deadlift
On the other hand, the traditional deadlift will utilize both the hamstrings and glutes, as well as the erector spinae due to the change in combined knee and hip flexion. Both exercises are fantastic for building a strong backside and should both be programmed with regularity. They target different parts of your posterior chain, so you can feel free to take a break from one and hit the other in a given week of training.
Whatever variation of this pattern you are using, many people underutilize this fundamental movement. This is mainly because a majority of people tend to be knee-dominant in the way that they move, they forget how to use their hips effectively. The massive propensity for prolonged sitting is also a large reason why so many people have inefficient glute function and weakened spinal extensors. With all this said, when performed properly, the hip hinge can help to develop strength and endurance in the posterior chain and spinal stabilizers to take huge amounts of stress off the lumbar spine and create resiliency against low back pain.
The lunge is probably the best exercise pattern to gauge true single leg strength. The nice part about the lunge is that you can perform all sorts of variations of this exercise to target the specific portions of the leg that you want. At its core, a lunge pattern has you bend at both knees while in a split stance, with one foot behind the other by about a stride length. You can also elevate the rear foot depending on the variation. Doing this places much of the load on the leg that is in front at the time of descent and eventual ascent.
The lunge is probably the best exercise pattern to gauge true single leg strengthTweet
Lunge – Stationary Lunge
This load is shared primarily between the quadriceps and the glutes during both eccentric and concentric movements, but many other muscle groups also play a role in performing a lunge. The hamstrings assist eccentrically during lowering, as well as concentrically with hip extension. The calf musculature also assists throughout the movement in order to maintain single leg balance. The lateral glutes will play a large role in keeping your hips level during both the descent and ascent. The core must also remain strong in order to maintain stability throughout your upper body and trunk while your lower body moves the load during this movement. Last but not least, your heart will be left pumping after completing lunges! This is mainly because you essentially have to do double the amount of reps for most other bilateral exercises. But I never said this was easy!
Having good single leg strength and endurance makes you much more resilient to injury. As humans, we complete many tasks that have one foot down at a time. Activities like jogging and running, climbing stairs, stepping on and off of a curb and many more require good single leg strength and stability in order for them to be performed safely and effectively. While performing a movement primarily with one leg at a time, the other cannot compensate to make up for weakness in the working leg. Performing single leg exercises forces each leg to “show what it’s got”, so to speak. Through this, you can tease out potential side to side imbalances and work to bring them closer together. The same principles of single vs double limb work also apply for all three fundamental upper body movements.
Upper Body Push
The upper body push involves any motion where you are pushing a load away from your body with your hands. This movement pattern can be broken down into two types of pushing – horizontal and vertical. Both are important for strength and function, but they work very different parts of your upper body.
Horizontal Push – Bench Press
Horizontal pushing will mainly emphasize your chest and anterior shoulders. Though it will also work your triceps and scapular protractors including serratus anterior which helps maintain good shoulder blade position and movement. Some horizontal push variations, such as push ups or cable flys allow your shoulder blades to move, which adds an additional layer of shoulder motion and therefore, another motion you need to control. On the other hand, movements such as a dumbbell chest press and bench press will generally have your shoulder blades stabilized. This limits the amount of shoulder blade movement that occurs, and generally focuses on the larger movers, including chest, anterior shoulders and triceps. Mixing in both patterns are essential to good, quality horizontal pressing and shoulder health.
Vertical Push – Half-Kneeling Unilateral Landmine Overhead Press
On the other side, vertical pushing places much more emphasis on your shoulders as a whole, as well as scapular upward rotators. As you press the load up overhead, your shoulder blades naturally follow your ribcage up to assist the upper arm in elevating. Typically for every 2° your upper arm elevates, the scapula rotates upward by 1°. This is known as scapula-humeral rhythm. Maintaining this ratio is critical for safe and healthy overhead pressing. Vertical pushing will test shoulder stability more so than horizontal pushing due to its end position of near-full shoulder flexion/elevation. Horizontal pressing, on the other hand, typically ends around mid-range of shoulder flexion. Exercising at these ranges of motion are critical for building long-term shoulder health and resiliency. After all, you are only as strong as your weakest joint position or movement. Both horizontal and vertical forms of upper body pushing are crucial to upper body strength and function, in addition to looking and feeling good!
Upper Body Pull
As a society, we are certainly push-dominant. By this I don’t just mean that all the bench presses are overrun on National Chest Day (otherwise known as Mondays). But on a serious note, we typically sit much more than we stand, and generally perform tasks in front of us, usually while leaning forward. What this means for most of us is that we tend to slump forward and adopt what is known as a rounded shoulder posture. The structures in the front of our upper body become shortened, pulling our neck and shoulders forward. Meanwhile, the posterior musculature gets stretched out and unable to do its job of stabilizing and maintaining your posture effectively. All this demonstrates the need for pulling to be programmed into training routines. While having a strong back is useful for looking good, it is is absolutely essential in order to combat the normal positional preferences adopted in everyday life, which I would argue is much more important.
Just like pushing, upper body pulls can also be broken down into horizontal and vertical pulling. An example of a horizontal pull is any variation of a row, where you bring the load from in front of you toward you while retracting your shoulder blades. Any type of pull up or lat pulldown where the weight is coming from overhead down toward your head or chest are examples of vertical pulls. As an aside, I am NOT a fan of behind neck pulldowns. Along the same lines as pushing, the vertical and horizontal pull variations will work slightly different parts of your upper body. Both are important and neither can be neglected in a good training program.
Horizontal Pull – Seated Row
In my opinion, horizontal pulling is even more important for long-term shoulder health than vertical pulling, since it not only emphasizes upper arm extension, but shoulder blade retraction too. Horizontal pulls also tend to extend the spine as you bring the load in toward you. This helps to combat the muscle lengthening that occurs over time in response to poor posture. So in addition to helping to strengthen your back, horizontal pulls can also help your posture! For this reason, I tend to program slightly more horizontal pulling than its vertical counterpart.
Vertical Pull – Pull Up
Vertical pulling does an excellent job of working the lats, as their primary job is to bring the upper arm into extension, adduction and internal rotation. These are the exact motions that your arms undergo while performing a pull-up. The scapula also performs downward rotation during vertical pulling, which is largely performed by the rhomboids and middle trapezius. Finally, the scapulae retract, or come closer to the midline of your spine which is accomplished via action of the rhomboids and levator scapulae muscles. While these last two scapular motions are extremely important, the lats are far and away the most active during vertical pulling.
As an added bonus, becoming stronger with the pulling pattern will also help to improve your deadlift. But how, you ask? By building strength through your back and shoulders, you create a more stable base to hold onto a loaded barbell in order to pull it from the floor during the deadlift. If you can master these fundamental pulling movements, you will have a much better chance at avoiding nagging shoulder, back and neck issues.
The ability and capacity to carry may be one of the most functional aspects of these 6 fundamental movements. Simply put, how long can you hold on to something heavy? The duration and amount of weight you can carry is otherwise known as grip strength, which has an extremely close relationship to overall upper body functional strength. In a 2003 study, poor grip strength was shown to be a more useful marker of weakness and frailty in older men than chronological age alone.1 This is important because there are so many activities that we perform on a daily basis that require us to carry things. Tasks such as carrying groceries, infants or a heavy box will test our grip strength and overall strength.
Bilateral Loaded Carry – Dumbbell Farmer’s Carry
Because carrying heavy weights around can get a bit boring, I tend to program a variety of carry variations in workouts. This includes anything from double arm carries to single arm (unilateral) isometric holds and everything in between. It is important to be strong in a range of ways, so you are prepared to handle anything. The main difference between single and double arm carries are the amount of force that your lateral core must provide in order to keep you upright while carrying something with one arm. When you have an equal load being distributed between each hand, you are balanced. Carrying heavy loads will place neutral stress on your spine, which can help maintain spinal health through core activation and spine stabilization. While this means you still must keep maximal core tension, the side to side load is even, so in theory, there should be no side to side difference in what you are asking the core to do.
Unilateral Loaded Carry – Suitcase Carry
However, being loaded only on one side means that your lateral core and obliques need to act as a counterbalance in order for you to stay upright while standing or walking. This will also force your lateral hips to stabilize the pelvis, especially if you are walking while carrying a unilateral load. Every time you are in single leg stance, your stance leg hip needs to work to keep the pelvis level so the non-weight bearing side does not drop. This is magnified when there is load introduced. While this is also true for a bilateral loaded carry, it is even more important with a unilateral load.
Performing carries will help to augment your other upper body lifts, as well as your lower body lifts that require you to hold significant weight. On the flip side, continuing to get stronger through your other upper body movements will also feed your grip strength. It is one of those rare positive cycles. So grab onto some serious weight and build that grip and upper body strength!
Bonus – “Accessory Work”
Of course, by now you are asking, “What about my rotator cuff? What about my glute activation exercises? What about my calves?!” Fear not, there is always room for “accessory” exercises!
I like to mix these in as supersets with the 6 fundamental movement patterns. For example, if I am programming an upper body push, I frequently pair that with some form of direct shoulder or scapular exercises to ensure the shoulder stabilizers are turned on and functioning properly. Similarly, I love to program lateral hip work with a squat or lunge pattern, so I am not only working in the sagittal plane during the squat or lunge, but also utilizing the frontal and transverse planes with the hips. Having minibands and superbands on hand is a must for accessory exercises like this, since they are are so versatile. These can also be used to augment the 6 fundamental movement patterns by adding extra resistance.
Accessory Exercises – Elevated Calf Raise
Exercises targeting the calves are also easy to add in on the back end of a lower body day. Don’t think of these as an afterthought; since heavier fundamental lifts for the day likely tax the quads, hamstrings and glutes, the calves should have something left in the tank for some direct work towards the end of a workout.
Since heavier fundamental lifts for the day likely tax the quads, hamstrings and glutes, the calves should have something left in the tank for some direct work towards the end of a workoutTweet
Lastly, while each of these fundamental movements should involve your core through maintaining a strong and stable base, you may still want more. The loaded carry, especially when only loaded on one side are a fantastic way to build a resilient core. Though, if you still feel like you need more direct work to get that six-pack, accessory core work is always great to supplement in during supersets or as a “finisher” to a workout. Isometric core exercises like planks, anti-extension exercises like deadbugs and anti-rotation exercises such as the pallof press are all great ways to create tension through the core and maintain a healthy spine.
Quick side note: please do me a favor and stay away from sit ups. I prefer movements that move away from repeated lumbar flexion. Consistently flexing your lumbar spine over time can result in a flattening of your lumbar curve, which can lead to potential back issues if not managed properly. I highlight some of the issues with a flattened lumbar spine in this post about the Posterior Pelvic Tilt.
When programming all these movements to create a workout, it helps to make sure you know what you are emphasizing. There are many ways to implement these fundamental movements. You may go with a lower body workout utilizing the squat, hip hinge and lunge patterns, then an upper body workout with the push, pull and carry patterns. Conversely, you may want to program a “pull-heavy” day with deadlifts, upper body pulls and carrys, then a “push-heavy” day with squats, lunges and upper body pushes. Or you may decide to split them up or combine them in all sorts of other ways. The possibilities are endless!
- Syddall H, Cooper C, Martin F, Briggs R, Sayer AA. Is grip strength a useful single marker of frailty? Age and Ageing. 2003 November; 32(6):650-656.
About the Author – Patrick Gilbert PT, DPT, ATC, CSCS
Patrick is a physical therapist, athletic trainer and personal trainer. He runs Summit Performance and Therapy in Indianapolis, Indiana. He has been training clients of all backgrounds for years and has been a practicing physical therapist since 2016. His training philosophy combines his knowledge of rehabilitation as well as strength and conditioning in order to train clients to achieve great results and avoid injuries in the process. His physical therapy practice focuses on a three-dimensional view and treatment of the body and its many parts. Treatment emphasizes manual techniques and rehabilitative exercises to get patients back to previous activity levels without pain or dysfunction.
For more information about training or rehabilitating with Patrick, contact him at SummitPerformancePT@gmail.com or visit SummitPerformancePT.com