LM: Lateral Hip/Thigh Pain with Prolonged Walking: Week 10 (11-3-17)

  • LOUIS CK: OF COURSE…..BUT MAYBE VIDEO
  • Highlights from our last session
    • Look into new orthotics that are more firm plastic versus foam
      • Firm orthotics can be initially uncomfortable on your feet
      • Make sure you increase the amount of time you wear them gradually if they are uncomfortable to get your feet used to them as needed
    • Take longer steps
      • Try to focus on pressing through the big toe
  • Some updates in BOLD below in regards to program changes
  • Everyday Movements
    • Abdominal Control With Hamstring Curl Phase 2 VIDEO
      • Just keep toes straight up towards the ceiling and feet apart
      • Begin by rolling ball into as deep of a knee band as comfortable and then all the way out straight letting heels raise off ball
      • If that feels fine, press into the heels as you move in and out of the knee band
      • 10x-15x
    • Bridge Band Around Knees Progression VIDEO
      • 10-20reps slow
      • Stop if you begin to feel knee discomfort
      • This felt better after doing the ball roll above
      • Make sure you keep outside of foot lined up with the outside of your hips
    • The above 2 exercises can be done multiple times a day
    • Hand Heel Rock Childs Pose to Plank or Up Dog VIDEO
      • In the video I rock further forward then we discussed which is fine for you to do but the important part is rocking slowly back towards your heels
      • 5-10x
      • This is supposed to be easy
    • Myofascial Release: We discussed this as a good option pre and post walking
      • You don’t need to spend 10 minutes hitting every point
      • Focus on the areas that feel most sore, like the lateral thigh
      • Try to compare what it feels like on the left and the right
      • The goal is for the 2 sides to feel similar. If you do not notice a drastic difference then it probably does not need to be pressed on
      • How do the spots feel before and after walking?…Do they hurt more after walking…does walking go better if you do the tennis ball right before?
      • Focus on areas that are most sensitive
      • Self MFR Ball Glute/Piriformis VIDEO
      • 2-3 spots into the back of your hip each for 10-15 reps
      • Side Lying IT Band VIDEO 
        • I also discussed with you rolling on top of the tennis ball on your side to hit points along the lateral aspect of your thigh. Lay on each point for 30sec up to 1-2 min
      • Self MFR Hamstring VIDEO
        • lateral hamstring start by the hip and work towards the knee
        • 10-20reps multiple spots along hamstring
    • Feet Apart Hip Abduction Raise Small Range VIDEO
      • This is the feet apart position at the counter
      • Remain short of any hip pain but keep feet as far apart as comfortable
      • try for 30-60sec
  • Every Other Day: Do the sequence below which includes the daily movements above: Follow the order listed below
    • Myofascial Release: Once again…hit the spots that feel most sensitive, especially lateral thigh
      • Focus on areas that are most sensitive
      • Self MFR Ball Glute/Piriformis VIDEO
      • 2-3 spots into the back of your hip each for 10-15 reps
      • Side Lying IT Band VIDEO 
        • I also discussed with you rolling on top of the tennis ball on your side to hit points along the lateral aspect of your thigh. Lay on each point for 30sec up to 1-2 min
      • Self MFR Hamstring VIDEO
        • lateral hamstring start by the hip and work towards the knee
        • 10-20reps multiple spots along hamstring
    • Bridge Band Around Knees Progression VIDEO
      • 10-20reps slow
      • Stop if you begin to feel knee discomfort
      • This felt better after doing the ball roll above
      • Make sure you keep outside of foot lined up with outside of hip
    • Squat Pulses In Short Range VIDEO
      • Do this with the blue band around knees for 1-2 minutes
      • Keep the band just above your knees
      • Feet slightly wider with outside of feet around the outside of hips
      • Keep the weight on your heels…try to go deeper into the squat
      • GOAL: Feel tired in your thighs with the least amount of knee pain which seemed to work well in a deeper position
      • Phase 2:  Squat with Forward Reach Band Around Knees VIDEO
        • Progress to this for 8-20 reps
        • If you have any knee pain either don’t go down as far or go back to the door
        • If it get easy for 20 reps you can progress to a light weight in your hands…video below
    • Tall Kneel Lean Back VIDEO
      • If you feel this in the knee, don’t do it that day
      • Goal is to feel tension in the quad
      • May be a good idea after this one to stand and walk or try to squat to make sure it does not increase pain in the knee
        • NO BAND WITH THIS ONE
        • 30-90sec
    • Double Leg Bridge Phase 3 VIDEO
      • Make sure knees stay bent around 90deg
      • Tense stomach first
      • Try for 10-20reps slow with a brief pause at the top
      • make sure your knees stay bent
      • GOAL: feel this in back of calf or thigh
    • Double Leg Heel Raise VIDEO
      • 5-20 reps
      • Change to doing this on the edge of the step probably with shoes unless step is carpet
      • Make sure you go straight up and straight down
      • at the bottom of the motion, try to think about lift toes toward shin to feel calf stretch
    • Supine Clamshell VIDEO
      • THIS IS OPTIONAL NOW
      • If you really like it and makes you happy….by all means keep it but it is not absolutely necessary
    • Quadruped with Physio Ball Hip Extension VIDEO 
      • You have now graduated to no ball
      • On your hands and knee, slide one foot slightly back…straighten your knee of the back leg and squeeze your butt
      • Tense lower abdomen to make sure your low back is not sagging/dropping down…then slowly lift straight leg off ground and hold 5 seconds
      • Make sure you focus on the lower abdominal tension each time before you lift you leg
        • Phase 2: Progress to raising opposite hand off the ground, hold for 5 seconds
          • Gradually increase the time with each rep by 5seconds to 10sec…15sec…until you feel tired
    • 185.1) Pre Run/Walk Single Leg Balance Drill VIDEO
      • This was the balance drill we did facing the mirror
      • Start with one foot back and that hand forward
      • Slow transition from front to back
      • you will see in the video I start someone holding a post but you can skip past that
      • start with 5-10 slow reps each leg
      • Make sure you don’t lock out the knee you are standing on
      • DON’T LET MOVING FOOT TOUCH GROUND AND TRY FOR MINIMUM OF 30SEC MAX OF 2 MINUTES