The Bosu has been one of my favourite tools for objectively measuring functional instabilities in the lower extremity. These can often be the root cause of several issues of the lower body especially in the hip, knee and lower back. These are three key tests you can perform on the BOSU to see if you have an imbalance. They are also the introductory exercises used to learn how to use the BOSU before moving on to more advanced exercises. It often takes 1-2 sessions to master these exercises.
Assessment 1
Step on flat side
What we are looking at here is how long does it take for the bosu to stop shaking. It is normal for the bosu to shake if you have never been on one before. We can often see a difference between the two sides if their is an underlying imbalance. It usually takes a few attempts to get this and often several more attempts on a weaker side. You should be able to get this in 3 attempts or less. Continue to practice this until you are able to confidently balance on the flat side then move on to the next exercise.
Assessment 2
Step on Round side
This will be a bit harder for most people. On average it takes a few attempts to be able to step on without any compensatory movements. You want to be able to slowly step up without any movement of the head or shoulder. Count how many times it takes you to get it on the L and R side. A difference of more than 3 attempts would be indicative of an imbalance. You want to practice this until you are able get 8/10 attempts slowly stepping up with no compensatory movements.
Exercise One - The Foundational exercise of the Bosu
Single leg stand hold time
Next up is practicing how long you can maintain your hold on the BOSU. If needed we can use an upper body support to allow us to stay up long enough to fatigue out some of our stabilizing muscles. The muscles that fagiue first during this test are your most active stabilizers. Often we well see people with overactive hip flexors fatigue this region and be unable to shift the load onto the glutes. This is our first rehabilitation target. We will also often seen people with chronic ankle instability fatigue quickly in the peroneals or medial ankle stabilizers. We can also use the time to first perceived fatigue as a baseline for tracking progress through rehabilitation interventions. This is often what a do when tracking progress for my clients for tendon injuries of the foot and hip as the results are very consistent and reliable.
Once you can hold the BOSU for 1 min being able to shift the control to your glutes you are ready to progress to the next stage of rehabilitation.