EM: Anterior Hip Pain, 6 Week Program: Phase 2 Weeks 2-4 (12-18-17)

Phase 2: Progressive Abdominal Control With Activation of Glute and Hamstring
- This phase will focus on more challenging abdominal activation and ability to control position of lower back as we increase the challenge on your hip
- Emphasis on carefully progressing into weight bearing movements and muscle activation
- It is once again imperative that you feel no pain or pressure in the previously painful site
  - If you do feel any pain, try to move very slowly to that point in the range and then quickly move out of that position
  - Emphasis on reps being slow and controlled to maintain control and tension in the correct areas with each rep taking 3-5 seconds IN EACH DIRECTION…that is really slow
  - If you do feel any increase in pain, you may be able to decrease it by focusing on the position of the pelvis and abdominal control
- This phase will add a new movement each day to assess if a certain movement causes pain that night or the next day. You will see a phase 2 option that can replace the exercise above if you are able, but if you try phase 2 and it is painful, go back to doing the phase 1 version
  - Progress to the phase 2 option once you are able to complete 20 reps of the phase 1 option
  - If you reach the 20 reps, progress to phase 2 option and begin with 5-15 reps
- Ice is recommended after each session 10-20 minutes
- 5-20 reps for each movement
Goals:
- Minimize Irritation using ice as needed
- Avoid over stretching, this will likely cause significant pain
- Establish good abdominal control which will be needed as the movements become more challenging
- Progress activation of glute and hamstring
Day 1
- Quadruped with Physio Ball Hip Extension VIDEO
  - PHASE 2 PROGRESSION
    - Counter Push Phase 1 VIDEO
      - Do this slow, better to do 5-10 reps slow then a higher number fast
      - Have someone watch you if possible to make sure low back is not moving
- Supine Hooklying Self Myofascial Release Quad/Psoas VIDEO
  - Restriction in the front of the thigh and hip make it difficulty to activate the gluteus maximus or medius
  - Be careful not to push on areas that are too sensitive and avoid putting pressure directly on the lateral aspect of the hip. Pressure should be uncomfortable but not so much that you have soreness afterwards
- Supine Quad Stretch to Hamstring Stretch VIDEO
- Glute/Abdominal Isometric Supine Max Knee Flexion VIDEO
  - Goal is to lightly activate the glute without pain
  - You are attempting to maintain abdominal control
    - PHASE 2 PROGRESSION
      - Heels to Butt on Floor Phase 1 VIDEO
- Hip ER/IR With Knee Flexed Laying On Back VIDEO
  - Establish the motion needed to activate the lateral aspect of your hip beginning with active motion
- Lunge Knee Position Intro with Progression to Pre Single Leg Stance VIDEO
  - Begin in just a slightly staggered stance, if not painful, you may progress into a greater distance between the front and back foot like in the video
  - Begin with just light bend of the front knee for a short period, 5-10 reps each leg
Day 2
- Quadruped with Physio Ball Hip Extension VIDEO
  - PHASE 2 PROGRESSION
    - Counter Push Phase 1 VIDEO
      - Do this slow, better to do 5-10 reps slow then a higher number fast
      - Have someone watch you if possible to make sure low back is not moving
- Supine Hooklying Self Myofascial Release Quad/Psoas VIDEO
  - Restriction in the front of the thigh and hip make it difficulty to activate the gluteus maximus or medius
  - Be careful not to push on areas that are too sensitive and avoid putting pressure directly on the lateral aspect of the hip. Pressure should be uncomfortable but not so much that you have soreness afterwards
- Supine Quad Stretch to Hamstring Stretch VIDEO
- Glute/Abdominal Isometric Supine Max Knee Flexion VIDEO
  - Goal is to lightly activate the glute without pain
  - You are attempting to maintain abdominal control
    - PHASE 2 PROGRESSION
      - Heels to Butt on Floor Phase 1 VIDEO
- Hip ER/IR With Knee Flexed Laying On Back VIDEO
  - Establish the motion needed to activate the lateral aspect of your hip beginning with active motion
    - PHASE 2 PROGRESSION
      - Supine Clamshell VIDEO
- Lunge Knee Position Intro with Progression to Pre Single Leg Stance VIDEO
  - Begin in just a slightly staggered stance, if not painful, you may progress into a greater distance between the front and back foot like in the video
  - Begin with just light bend of the front knee for a short period, 5-10 reps each leg
Day 3
- Quadruped with Physio Ball Hip Extension VIDEO
  - PHASE 2 PROGRESSION
    - Counter Push Phase 1 VIDEO
      - Do this slow, better to do 5-10 reps slow then a higher number fast
      - Have someone watch you if possible to make sure low back is not moving
- Supine Hooklying Self Myofascial Release Quad/Psoas VIDEO
  - Restriction in the front of the thigh and hip make it difficulty to activate the gluteus maximus or medius
  - Be careful not to push on areas that are too sensitive and avoid putting pressure directly on the lateral aspect of the hip. Pressure should be uncomfortable but not so much that you have soreness afterwards
- Supine Quad Stretch to Hamstring Stretch VIDEO
- Glute/Abdominal Isometric Supine Max Knee Flexion VIDEO
  - Goal is to lightly activate the glute without pain
  - You are attempting to maintain abdominal control
    - PHASE 2 PROGRESSION
      - Heels to Butt on Floor Phase 1 VIDEO
- Hip ER/IR With Knee Flexed Laying On Back VIDEO
  - Establish the motion needed to activate the lateral aspect of your hip beginning with active motion
    - PHASE 2 PROGRESSION
      - Supine Clamshell VIDEO
- Lunge Knee Position Intro with Progression to Pre Single Leg Stance VIDEO
  - Begin in just a slightly staggered stance, if not painful, you may progress into a greater distance between the front and back foot like in the video
  - Begin with just light bend of the front knee for a short period, 5-10 reps each leg
    - PHASE 2 PROGRESSION (Complete 1 of the movements below)
      - High Lunge at Table VIDEO
      - Counter to Wall Single Leg VIDEO
Day 4
- Quadruped with Physio Ball Hip Extension VIDEO
  - PHASE 2 PROGRESSION
    - Counter Push Phase 1 VIDEO
      - Do this slow, better to do 5-10 reps slow then a higher number fast
      - Have someone watch you if possible to make sure low back is not moving
- Supine Hooklying Self Myofascial Release Quad/Psoas VIDEO
  - Restriction in the front of the thigh and hip make it difficulty to activate the gluteus maximus or medius
  - Be careful not to push on areas that are too sensitive and avoid putting pressure directly on the lateral aspect of the hip. Pressure should be uncomfortable but not so much that you have soreness afterwards
- Supine Quad Stretch to Hamstring Stretch VIDEO
- Glute/Abdominal Isometric Supine Max Knee Flexion VIDEO
  - Goal is to lightly activate the glute without pain
  - You are attempting to maintain abdominal control
    - PHASE 2 PROGRESSION
      - Heels to Butt on Floor Phase 1 VIDEO
- Hip ER/IR With Knee Flexed Laying On Back VIDEO
  - Establish the motion needed to activate the lateral aspect of your hip beginning with active motion
- Lunge Knee Position Intro with Progression to Pre Single Leg Stance VIDEO
  - Begin in just a slightly staggered stance, if not painful, you may progress into a greater distance between the front and back foot like in the video
  - Begin with just light bend of the front knee for a short period, 5-10 reps each leg
Day 5
- Quadruped with Physio Ball Hip Extension VIDEO
  - PHASE 2 PROGRESSION
    - Counter Push Phase 1 VIDEO
      - Do this slow, better to do 5-10 reps slow then a higher number fast
      - Have someone watch you if possible to make sure low back is not moving
- Supine Hooklying Self Myofascial Release Quad/Psoas VIDEO
  - Restriction in the front of the thigh and hip make it difficulty to activate the gluteus maximus or medius
  - Be careful not to push on areas that are too sensitive and avoid putting pressure directly on the lateral aspect of the hip. Pressure should be uncomfortable but not so much that you have soreness afterwards
- Supine Quad Stretch to Hamstring Stretch VIDEO
- Glute/Abdominal Isometric Supine Max Knee Flexion VIDEO
  - Goal is to lightly activate the glute without pain
  - You are attempting to maintain abdominal control
    - PHASE 2 PROGRESSION
      - Heels to Butt on Floor Phase 1 VIDEO
- Hip ER/IR With Knee Flexed Laying On Back VIDEO
  - Establish the motion needed to activate the lateral aspect of your hip beginning with active motion
    - PHASE 2 PROGRESSION
      - Supine Clamshell VIDEO
- Lunge Knee Position Intro with Progression to Pre Single Leg Stance VIDEO
  - Begin in just a slightly staggered stance, if not painful, you may progress into a greater distance between the front and back foot like in the video
  - Begin with just light bend of the front knee for a short period, 5-10 reps each leg
Day 6
- Quadruped with Physio Ball Hip Extension VIDEO
  - PHASE 2 PROGRESSION
    - Counter Push Phase 1 VIDEO
      - Do this slow, better to do 5-10 reps slow then a higher number fast
      - Have someone watch you if possible to make sure low back is not moving
- Supine Hooklying Self Myofascial Release Quad/Psoas VIDEO
  - Restriction in the front of the thigh and hip make it difficulty to activate the gluteus maximus or medius
  - Be careful not to push on areas that are too sensitive and avoid putting pressure directly on the lateral aspect of the hip. Pressure should be uncomfortable but not so much that you have soreness afterwards
- Supine Quad Stretch to Hamstring Stretch VIDEO
- Glute/Abdominal Isometric Supine Max Knee Flexion VIDEO
  - Goal is to lightly activate the glute without pain
  - You are attempting to maintain abdominal control
    - PHASE 2 PROGRESSION
      - Heels to Butt on Floor Phase 1 VIDEO
- Hip ER/IR With Knee Flexed Laying On Back VIDEO
  - Establish the motion needed to activate the lateral aspect of your hip beginning with active motion
    - PHASE 2 PROGRESSION
      - Supine Clamshell VIDEO
- Lunge Knee Position Intro with Progression to Pre Single Leg Stance VIDEO
  - Begin in just a slightly staggered stance, if not painful, you may progress into a greater distance between the front and back foot like in the video
  - Begin with just light bend of the front knee for a short period, 5-10 reps each leg
    - PHASE 2 PROGRESSION (Complete 1 of the movements below)
      - High Lunge at Table VIDEO
      - Counter to Wall Single Leg VIDEO
Day 7
- Rest Day to complete light movements throughout the day
Repeat above for at least 2 weeks