MR: Lateral Hip Pain/Glute Weakness and Bursitis: Week Eight

Week Eight
- Email feedback from week 7
  - Slower pace walk reduced ankle pain while walking at macy’s
  - Using ankle brace as needed
  - Double leg bridge on bed, ball to unstable
  - Plank at table 10x
  - sidelying clamshell 45deg angle with greater ROM
  - 2 posts balance 12x, but had pain when lifted one cane
  - double leg heelraise 15reps
  - band hroizontal abduction with heel spasm
  - Made progress but difficulty climbing steps
- Week 6 feedback
  - Continuing to have significant ankle pain, after walking up steep hill had pain later that day and the following day
  - Standing Adductor slides 12x
  - Double leg bridge 12x
  - Kneeling butt to heel 20x
  - Sidelying clamshell: right 8x left 10x very small range
  - Band horizontal abduction 10 reps
  - 2 post balance is good, unable to lift a post without pain
- I want to work more towards a lunge/step up position in a small range
- I will give you a lunge option to do in place of the squat
- I would like an update on what happens when you go through the heelraise progression in circuit#3
- Circuit #3 can be done along with circuit #2
- In BOLD below you will see updates that I have made to your current movements
Goal continues to be 10-20reps or 30-90sec
As usual, make sure that none of these movements are causing significant pain
- As soon as you feel pain or fatigue, stop
You will alternate the two days below, Sunday is an off day or repeat Circuit#1
Email me on Sunday with your assessment of how the week went. I will send you a few specific questions I would like to know before completing your program for the following week
Circuit 1: Complete Monday, Wednesday, Friday: Light Day
- Bridge Band Around Knees Progression VIDEO
  - I believe I gave you a few bands, start with green around your knees
  - The bridge has never given you any issue so let’s keep this one
  - When able to complete 20 reps progress to
    - Heels to Butt on Floor Marching Phase 2 VIDEO
      - Continue with this movement until you are able to reach 20 reps
- Upper Body Assisted Squat VIDEO
  - Let’s try this movement holding door handle or sink
  - Once you are able to do 20 reps without any problems, progress to the movement below
    - Squat with Forward Reach Band Around Knees VIDEO
      - Use the same color band that you use for clamshell and bridge
      - If you still feel better holding the sink, stick with that but add band around knees
    - NEW: Either movement below should be tried in place of the squat
      - Step Up Lunge VIDEO
        
        Make sure you press through the heel
        
        Start off just stepping up on phone book height and thn gradually work higher as shown in video
      - OR: Reverse Lunge Towel Slide VIDEO
- Standing Quad isometric in a Stretch VIDEO
  - I want to make sure you are able to activate your quad without pain in the hip
  - If this causes any pain, stop and email me
- Hip Extension Over Table/Bed VIDEO
  - Progress to plank position at edge of table height below
  - 10-20 reps on each leg
  - Table Height Phase 2 VIDEO
Circuit 2: Tuesday, Thursday, Saturday: Light Sequence plus some more challenging movements
- Bridge Band Around Knees Progression VIDEO
  - I believe I gave you a few bands, start with green around your knees
  - The bridge has never given you any issue so let’s keep this one
  - When able to complete 20 reps progress to
    - Heels to Butt on Floor Marching Phase 2 VIDEO
- Standing Adductor Isometric VIDEO
  - Hold each 5 sec, make sure you feel tension in inner thigh without pain
    - May progress to:
      - Standing Adductor Slide VIDEO
        
        Be careful not to progress too quickly out to the side, start in a short range
      - MAKE SURE YOU AVOID YOUR KNEE CAVING INWARD AND TRY TO ENGAGE THE BIG TOE GRIPPING THE TOWEL TO EBGAGE THE ARCH OF THE FOOT AS YOU PULL INWARD
- Bridge Progression Physio Ball (In order for easiest to hardest, pick one that is challenging but not painful)
- Standing Quad isometric in a Stretch VIDEO
  - I want to make sure you are able to activate your quad without pain in the hip
  - If this causes any pain, stop and email me
  - PHASE 2:
    - Kneeling Quadricep Activation Butt to Heels VIDEO
      - DO THIS SLOW AND CONTROLLED
- Hip Extension Over Table/Bed VIDEO
  - Progress to plank position at edge of table height below
  - 10-20 reps on each leg
  - Table Height Phase 2 VIDEO
- Side Lying Clamshell Wall VIDEO
  - If this causes pain, go back to the supine clamshell listed below
  - You discussed progressing to this…Try to do it in a very small range at first to minimize the risk of pinching or sharp hip pain
  - If the sidelying clamshell isn’t working try the movement below as an alternative
    - Side Sit with Rotation and Glute Isometric VIDEO
  - Supine Clamshell VIDEO
- Single Leg Balance Progression (Pick one)
  - Your goal with each is to be able to do it for a minimum of 30sec and up to 2 minutes
  - If you get to 2 minutes without significant difficulty, you are ready to progress to the nest one on the list
  - H-48G Counter to Wall Single Leg VIDEO
  - H-48H Two Posts Four Point to Single Leg VIDEO
  - H-48I Stride Lunge to Single Leg Stance Door Way VIDEO
  - H-49 Sagittal Plane Stability VIDEO
  - H-50 Frontal Plane Stability VIDEO
  - H-51 Transverse Plane Stability VIDEO
  - H-52 Multiplanar Stability VIDEO
Circuit #3
- A-40A Tibialis Posterior Seated Sweep VIDEO
  - make sure your knee doesn’t move and keep pressure on big toe not letting it come up off the ground
  - 10-20reps
- Heelraise Progression :NEW
  - Focus on moving initially through 50% of your available motion
  - If that feels fine, then progress to moving through the full motion working your way towards 20 reps
  - Phase 1: Seated Heelraise VIDEO
  - Phase 2:Double Leg Heel Raise VIDEO
    - It is fine if you barely raise heels off the floor. I want to see if you are able to move in a very short amount of motion and eventually feel your calf tiring before your ankle hurts
    - If you can’t achieve this in standing, you can focus on phase 1 for a longer period of time
- A-46F Band Horizontal Abduction VIDEO
  - Band in the hand of the foot that is back
  - Don’t go into a deep lunge but try to make sure your stance is narrow enough that you feel slightly unstable
  - 10-20reps each arm