LM: Lateral Hip/Thigh Pain with Prolonged Walking: Week 6 (7-21-17)

  • Week 6 important points
    • We talked about paying attention to how your knee feels as you approach an exercise
    • Use walking or squatting/getting in and out of a chair as a test position to tell you if an exercise increased or decreased the pain you are having
      • Do this in between each exercise to assess your body’s reaction to the exercise you just did
    • Three levels/phases of difficulty
      • Phase 1 Lying on your back
      • Phase 2 In between lying and standing
      • Phase 3 Standing
    • Below I will list the phase 1 sequecne which you can do everyday potentially 2-3x/day and it should make you feel better if your knee hurts
    • Phase 1: Do this sequence for the first 2-3 days
      • 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
      • 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
      • The above 2 exercises can be done multiple times a day
    • Phase 2
      • Hand Heel Rock Childs Pose to Plank or Up Dog VIDEO
        • In the video I rock further forwad then we discussed which is fne for you to do but the improtant part is rocking slowly back towards your heels
        • 5-10x
      • Tall Kneel Lean Back VIDEO
        • This is the most challenging/threatening of the phase 2 positions
          • 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
        • ONLY DO THIS MOVEMENT 1X/DAY, THE OTHER 3 ABOVE ARE FINE TO DO 2-3X/DAY AS NEEDED TO PROVIDE RELIEF
    • Phase 1: Additional Options
      • These movement are also likely fine to do everyday and are very low risk but I don’t beleive they are as improtant as the movements above in regards to decreasing your pain when your knee hurts
      • Beyond the tennis ball activities, you may want to add a new movement below each day to gradually add to your once a day list. This will help you to recognize if a particular movement is causing an issue
      • Myofascial Release
        • 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
      • Supine Clamshell VIDEO
        • Progress to blue band if you are able
        • 30-90sec
      •  Lateral Hamstring Stretch Strap and Seated VIDEO
        • step or the strap
        • 10-20x in and out of light tension
    • Phase 2
      • Quadruped with Physio Ball Hip Extension VIDEO 
        • This is to replace the over the bed position
        • Start by tensing your abdomen and straightening one knee
        • If that feels fine and you have no pain in the back, you can lift the straight knee off the ground
    • Phase 3: These movements are in standing and involve an increase in load on the leg because you are standing
      • THESE MOVEMENTS SHOULD BE DONE EVERY OTHER DAY, ADDING ONE MOVEMENT TO THE ROUTINE EACH TIME
        • Organization should be
          • Day2-3 you do the four movements above that we found to reduce pain
          • Day 3, start to add a new phase 1 and 2 movement each day until you have all the phase 1 and 2 movements and you have no significant issues
          • Then start to add a new phase 3 movement everyother day
            • Standing movements are safer to add everyother day in the following order
        • Double Leg Heel Raise VIDEO
          • 5-20 reps
        • Standing Paloff Press in Lunge and Terminal Stance VIDEO
          • Start with feet side by side
          • If that feels fine, try a staggered stance, the more you step the back foot behind you, the more tension on your lower back
          • Only increase step length if you have no back pain
        • Upper Body Assisted Squat VIDEO
          • band around knees
          • weight on heels
          • feet pretty close (2-3 inches) from what you are holding onto
          • Just short of 90deg, Maybe even less knee bend if there is any pain
          • 10-20reps