CD: Low Back Pain with Poor Glute Activation

12-11 Update
- Rocktape Application for Low Back Pain VIDEO
- L-31C Bent Over Box Row VIDEO
  - Tries to engage stomach while doing an upper body row
- L-28C Bear Hip Extension->Mountain Climber VIDEO
  - This can be challenging and you may want to just start with the bear position holding for 5 seconds and gradually progress to the movement on towels
  - If the floor is too challenging you can try with your hands on a higher surface like a chair
- Try to alternate the two movements above starting with 5-10 reps of each slow for 2 sets
- As I had movements to your program, theones from the old updates that I list in bold should be daily and the non-bold every other day. Also continue with the following movements
  - H-46 Upper Body Assisted Squat VIDEO
  - L-42 Double Leg Heel Raise VIDEO
  - L-4D Seated Flexion and Child’s Pose Breathing VIDEO
  - L-4C Hand Heel Rock Childs Pose to Plank or Up Dog VIDEO
    - progress to
      - L-27A Bear to Plank Push Off Loading DNS VIDEO NEW
  - L-20 Laying on Back Weight Pull Over and Band Pull Over VIDEO
  - L-9 Lying Hamstring Stretch VIDEO
    - I want to possibly subsititute a movement that is meant to improve the putting on the sock motion
    - H-12 Cross Leg Contract Relax Posterior Hip VIDEO OR H-13 Cross Leg Posterior Hip Stretch VIDEO
  - H-46 Upper Body Assisted Squat VIDEO
  - L-11A Self MFR Ball Glute/Piriformis VIDEO
  - L-4 Sidelying Thoracolumbar Rotation Stretch VIDEO
11-28 Update
- Given your success with the squat, lets attempt to move into some lateral trunk stability and some light mobilization of your back into rotation. Lets attempt this sequence cautiously and see if you are able to move into lateral trunk stability to improve function without increasing pain
  - L-4 Sidelying Thoracolumbar Rotation Stretch VIDEO
  - L-31 Scapular Control with Weight Shift Side Plank Progression VIDEO
11-21 Update
- Try these 2 movements and let me know how they feel
  - HOw does it feel when you do H-46 into the deep squat
  - L-42 Double Leg Heel Raise VIDEO
  - L-11A Self MFR Ball Glute/Piriformis VIDEO
11-8 Update
- As we go through this process I will continues to change the movements that you do based on the feedback you provide me with. I will continue to change your program based on that feedback as well as specific movement limitations you are having. Try the sequence below for this week and we we can discuss again next week
- L-4D Seated Flexion and Child’s Pose Breathing VIDEO
- L-4C Hand Heel Rock Childs Pose to Plank or Up Dog VIDEO
  - progress to
    - L-27A Bear to Plank Push Off Loading DNS VIDEO NEW
- L-20 Laying on Back Weight Pull Over and Band Pull Over VIDEO
- L-9 Lying Hamstring Stretch VIDEO
  - I want to possibly subsititute a movement that is meant to improve the putting on the sock motion
  - H-12 Cross Leg Contract Relax Posterior Hip VIDEO OR H-13 Cross Leg Posterior Hip Stretch VIDEO
- On Your Back Physio ball Stabilization with Rolling Progression VIDEO
  - Just do the pressing of your hands into the ball
- H-46 Upper Body Assisted Squat VIDEO
Email Feedback 10-31
- 1) I would say I’m maybe a 2-3 on the scale. I don’t feel there’s been much change/improvement on what I can do.
- 2) Movements that engage: on back with legs/feet in L position, tighten stomach, press heels into bench, raise one foot, etc; over ball, raise leg to flex glute and bend at knee (I haven’t noticed any that reduce the pain, other than the one on all fours and you rock seems to relieve some of the tension in the muscles, not much change in the pain in the spine itself)
- 3) Most difficult movements are any bending, stooping, squatting, putting socks/shoes on, shaving, and any movement like that. It is very painful in my low back with deep, stabbing and sharp pain that takes my breath away. The most challenging exercise is the ball; trying to engage the glutes and keep my back in position. It is not necessarily painful, just more challenging. The stretch where I put one foot on my knee and push against my hand on outer side of knee puts some pull on my lower back that gets tight afterwards.
- I feel the stabbing pain I would get just walking across the room, which would make me holler out loud and almost go down, have subsided and happen very infrequently. I don’t have as much discomfort when sleeping at night and don’t seem to toss and turn as much. I still wake up pretty stiff in the morning, which Dr. Engelen has me doing a arching back stretch to help loosen it up. I still have the constant dull discomfort in my low back throughout the day.
Update 10-27: 5-10 reps of each. Give me feedback on how it goes
- L-6 Seated Quad Stretch Foot Under Chair VIDEO
- H-12 Cross Leg Contract Relax Posterior Hip VIDEO
- Step Hip Extension with Push Off Progression (progress as able)
- Plank Knee to Chest and Hip Extension Progression (start at beginning)
- L-4D Seated Flexion and Child’s Pose Breathing VIDEO
- L-28C Bear Hip Extension->Mountain Climber VIDEO
- L-10 Seated Sciatic Nerve Floss VIDEO
Update 10-22
- Test Movement Preference
  - Use the following 2 videos to test your back’s reaction to a few positions. Give me feedback based on what you feel to further guide the direction of your program
  - Find the Movement Preference Supported VIDEO
  - Find the Movement Preference in Standing VIDEO
Phase 1: Light mobility and glute activation. All movements should be light and reproduce no pain. Emphasis is on abdominal control to protect the lower back as we progress into hip extension. If any of these movements are felt in the lower back stop and contact for me to adjust the program or specific movement
- 3 month position with feet elevated
- Hip Extension/Glute Max Progression (Pick one)
  - L-32 Quadruped with Physio Ball Hip Extension VIDEO
  - L-32A Hip Extension Over Table/Bed VIDEO
- L-6 Seated Quad Stretch Foot Under Chair VIDEO
Phase 2: These movements will be progressively more challenging. The benefit is that you have the potential to get more benefit in longer lasting relief. With the increase in challenge it is important that you apply the principles from phase 1 that focus on maintaining abdominal control as we increase the stretch/demand on your hips and arms. If any of these movements are painful, try to adjust the range or intensity
- Try ths sequence first and then we can grdually integrate the other movements
  - H-12 Cross Leg Contract Relax Posterior Hip VIDEO
    - Be careful with to just feel light tension in the back of hip
  - Step Hip Extension with Push Off Progression (progress as able)
  - Plank Knee to Chest and Hip Extension Progression (start at beginning)
Phase 3
- H-28C Bear Hip Extension->Mountain Climber VIDEO
  - For this one try just holding the bear position first. Isometric holds without the foot behind you
- Glute med progression: (Try each and go with the one that feels tiring but not painful)
  - H-48A Sidelying Leg Raise Progression to a Stretch VIDEO
  - H-48B Side Step Band Progression VIDEO