CSD: Low Back Pain with Right Hip/Glute med Weakness: Phase 4 (4-2-18)

    • Email Follow Up (My responses in bold)
      • Not able to do the exercises everyday with work related travel
      • Recap:
        • Self quad stretch with muscle fatigue
        • Quad stretch: stretch/no pain
        • Self MFR no groin pain but some discomfort lateral hip
        • Cross leg no pain using chair
        • bridge more muscle fatigue/sore
        • hip ext over bed: some discomfort and muscle fatigue
        • Ball bridge little soreness
        • R hip pops with ball roll
        • heelraise with fatigue
        • pain in the front of the hip with squat pulse
      • I will make some updates based on your feedback
        • Be careful with the squat, feeling some on the front of the hip is ok but I would rather you remain short of too much discomfort. Try bringing your feet really closed to what you are holding so the weight is more back on your heels
        • I am going to give you a movement to progress into lateral hip strength
        • Make sure with the strength related movements, some fatigue/soreness is ok as long as it goes away within a day or two. If you are sore or fatigue from doing the strength exercises, it is ok to take 2 days off before returning to them
        • As you are challenged more you may need 2 days to recover before trying the strength movements again
    • Phase 4
      • I will expand on the phase 3 movements with some new options as I discussed above
      • I have included the descriptions from last week in regards to the daily and strength sequences
        • Light movements that I call “Daily Sequence”
          • This is a sequence that is all about light movement and muscle activation
          • It is meant to improve mobility and possibly serve as a warm up, cool down, or a light sequence in the morning or at night to improve mobility
          • I will continue to give you some alternative options over the next few weeks to include in this sequence
          • The goal is to isolate 4-5 movements that you feel are most effective in moving parts of your body that are stiff/painful and feel that they improve mobility/stiffness
          • You will do one set of 10-20reps for each movement so this sequence should be very quick and user friendly
          • There is something called the “5 Tibetan Rites” that had a great impact on me
            • Basically, these monks for thousands of years did this sequence, some calling it “The Fountain of Youth”
            • I do not necessarily hand out the 5 rites, but I do believe that everyone should have their own personalized version of 5 movements that are not incredibly challenging, that move areas of their body that they do no move enough in their daily life
            • This sequence should be brief and take only 5-10 minutes at the most
            • I do my own 5 rite sequence before bed each night and I do it as a warm up pre workout/wrestling practice/jujitsu
        • Strength Circuits
          • These are meant to challenge you with the goal of creating fatigue or tension in muscle without overloading painful structures
          • Your goal with this is to feel muscle tension and hopefully fatigue
          • Each movement will have a time goal or a rep goal, once you achieve that goal with no negative side effects, you are ready for a new challenge
          • When your body fatigues, you may start to get pain and that is your cue to stop
          • Pay attention to what you feel later that day and the next day
            • Mild pain is alright as long as it goes back to baseline within 24 hours
            • If pain is more severe you have a couple options
              • 1) Ice right after to minimize inflammation
              • 2) Try to decrease the intensity of the exercise by not going through as much range of motion or not pushing so hard
                • In my mind, most exercises can be made painful or not painful by the way that you go about it
                • Example: If I give you a squat variation, there are many ways to decrease risk of pain
                  • Don’t go as deep into the motion, do it slower, keep weight more on the heels, hold an isometric position squat without moving in whatever range is least painful, do only 2-5 reps
                • Have the mind set of getting through new exercises making it super easy just to find a safe zone…you can always increase the challenge from there
      • Daily Sequence: Complete everyday
      • Strength Sequence