LP: Low back on the L with glute max inhibition

8-29-17
- We discussed the importance of low back/pelvic position during daily activities and strengthening activities. We focused on the 3 sequences below
- #1
  - Bear Pelvic Control VIDEO
  - Quadruped with Physio Ball Hip Extension VIDEO
    - I gave you this on your hands and knees instead of a ball the ball is also helpful. The ball under you makes the exercise easier
    - Bear Hip Extension->Mountain Climber VIDEO
      - This video shows without the ball similar to how we did it, but keep the bent knee on the ground instead of coming off the ground in the video
- #2
  - Pelvic Awareness Drill VIDEO
    - We did this at the counter
  - Single Leg Balance Progression: demonstrates the progression we initiated at the counter with a progression back into single leg stance
- #3
  - Pelvic awareness drill on your back, shown above in standing and on hands and knees
  - Laying on Back Weight Pull Over and Band Pull Over VIDEO
    - Light weight 2-4lbs to start
6-6-17 Updates
- Patient reports lateral knee and medial ankle pain that occurred with walking
- Pain localized to lateral knee at lateral hamstring and medial ankle subtalar joint
- Reproduction of tightness in the area of pain with lateral hamstring stretch
- Updated program as follows
  - H-5C Self MFR Hamstring VIDEO
    - tennis ball more so along the lateral back of the thigh to hit lateral hamstring
    - can be done daily 2x/day
  - Lateral hamstring stretch VIDEO
    - can also be done with R foot across to the L on the second step leaning forward
  - K-42A Step Knee Flexion Intro VIDEO
    - go into knee bend and back out to straighten knee
  - Everyother day
    - K-45E Lunge with Band Around Knee Glute Med Activation VIDEO
      - very small knee bend using red band, work on less need for support from post
5-10 Updates
- Mobility Sequence to be complated daily
  - H-5C Self MFR Hamstring VIDEO
    - Can alos be done for the calf with active movement of the ankle
  - H-8D 1/2 Kneel Anterior Lunge Single Arm Overhead Reach VIDEO
    - no overhead reach
  - H-13 Cross Leg Posterior Hip Stretch VIDEO
  - H-15B Standing Adductor and QL/Lat Stretch VIDEO
- strength circuits
  - circuit #1
  - circuit #2
  - circuit#3
    - H-45A Row Band in Lunge/Half Kneel VIDEO
      - we did this seateded on a machine instead of in a staggered stance
    - H-36 Double Leg Bridge Phase 3 VIDEO
    - H-46F Band Extension Deadlift VIDEO
1-28 Update
- Following our discussion concerning pain in the 1st MTP joint with standing and walking, below are a few key pints from our last conversation
- Taping for the 1st MTP VIDEO
- Exercises to continue to maintain hip strength and mobility without stressing the toe
- Daily Movements
  - L-3A Shoulder Flexion Seated->Standing VIDEO
  - L-16 Cross Leg Pigeon Pose Regression VIDEO
    - L-14 Cross Leg Contract Relax Posterior Hip VIDEO
      - Do in sitting
  - L-10 Seated Sciatic Nerve Floss VIDEO
    - Replace with the following 2 movements
      - L-5BSelf MFR Quad/Hip Flexor VIDEO
      - L-11A Self MFR Ball Glute/Piriformis VIDEO
  - L-5A Kneeling Hip Flexor and Hamstring Stretch VIDEO
- Strength Circuits
  - Circuit #1
    - L-55A Sidelying Leg Raise Progression to a Stretch VIDEO
    - L-20 Laying on Back Weight Pull Over and Band Pull Over VIDEO
      - added a crunch at the end with a reach to the ceiling
      - Laying on back on ball 5lbs
    - L-33 Heels to Butt on Floor Phase 1 VIDEO
  - Circuit #2
    - Palloff Press
      - L-30C 1/2 Kneeling Variation VIDEO
        
        Light resistance band
    - L-48 Row Band in Lunge/Half Kneel VIDEO
      - stay on one knee with back foot flat or row machine at gym
    - L-48A Press band in Lunge/Half Kneel VIDEO
      - stay on one knee or press machine at the gym
  - Circuit #3
    - L-50B Reverse Lunge VIDEO
    - Laying on back abdominal stabilization with leg lift VIDEO
      - End of the video with hands up to ceiling and slowly dropping each leg towards the floor
    - L-38 Double Leg Bridge Phase 3 VIDEO
12-20 Update
- Toe Pain
  - Ice, may tape to the adjacent toe in the morning and remove when able to sit and rest
  - A-6C Great Toe Extension Stretch VIDEO
    - May just want to do some light traction on the toe rather then the full ext stretch in the video
10-25 Updated Strengthening Program
- Circuit #1
  - L-61 Sagittal Plane Stability VIDEO (Goal is 90sec)
  - L-20 Laying on Back Weight Pull Over and Band Pull Over VIDEO
    - added a crunch at the end with a reach to the ceiling
    - Laying on back on ball 5lbs
  - L-28A Bear to Downward Dog Floor VIDEO
- Circuit #2
  - L-55B Side Step Band Progression VIDEO
    - Band around ankle with lateral step
  - L-48 Row Band in Lunge/Half Kneel VIDEO
    - 10lbs
    - Change to
      - S-22A Bent Over Box Row VIDEO
  - L-48A Press band in Lunge/Half Kneel VIDEO
    - change to double blue
- Circuit #3
  - L-51 Single Leg Deadlift VIDEO
    - hold onto wall with hand that the leg is off the ground
  - L-28C Bear Hip Extension->Mountain Climber VIDEO
  - L-38 Double Leg Bridge Phase 3 VIDEO
- Circuit#4
  - L-42 Double Leg Heel Raise VIDEO
    - Progress to: the following
    - L-44 Single Leg Concentric/Eccentric VIDEO
  - L-31A Side Plank with Rotation Progression VIDEO
  - L-48D Lunge with Band Around Knee Glute Med Activation VIDEO OR L-48C Step Up Lunge VIDEO OR Lunge in standing with weight in one hand as you tip over towards the weighted side, currently using 6lbs
- Cycling Progression
  - This is to be incorporated in with walking progression. initially you will bike 5-10 minutes and then walk after
  - Level 2 will bike 15 minutes
  - level 3 20 minutes
  - Each level progress by 5 minutes beginning with a fairly level path and progressing to incorporating some hills once able to bike 30 minutes without increase in symptoms
  - Follow soreness rules at this link for guidance as to when to increase or decrease the level
Warm up Sequence updated 10-25
- L-3A Shoulder Flexion Seated->Standing VIDEO
- L-16 Cross Leg Pigeon Pose Regression VIDEO
  - L-14 Cross Leg Contract Relax Posterior Hip VIDEO
    - Do in sitting
- L-10 Seated Sciatic Nerve Floss VIDEO
  - Replace with the following 2 movements
    - L-5BSelf MFR Quad/Hip Flexor VIDEO
    - L-11A Self MFR Ball Glute/Piriformis VIDEO
- L-5A Kneeling Hip Flexor and Hamstring Stretch VIDEO
Circuit # 1
- Deep Squat Holding Post
  - Upper Body Assisted Squat VIDEO
    - Pelvic Awareness Drill In between Squats
  - 15x each
- L-42 Double Leg Heel Raise VIDEO
  - (12/6)
- Bear to Down Dog
  - (7/4)
Circuit #2
- L-50 Band Extension Deadlift VIDEO: You complete with bent elbows into a row instead of down to side in video
  - red 20/green 12reps
  - WE CHANGED TO A NORMAL DEADLIFT WITH A 10LB KETTLEBELL 8 REPS TO START
- L-57 Frontal Plane Stability VIDEO
  - No hands (20reps) progress to on towels or uneven surface
  - CURRENTLY ON TOWELS
- L-48C Lunge with Band Around Knee Glute Med Activation VIDEO
  - red band
Circuit #3
- L-60 Phase 1 Static Balance VIDEO
  - foam pad 30sec harder on the R/ single leg bosu 25sec with hand held assist harder on the L
  - ABLE TO DO BOSU BALL 1:20SEC
- L-20 Laying on Back Weight Pull Over and Band Pull Over VIDEO
  - Blue (18/9)
- Double Step Up
  - 18
Circuit #4
- L-30A Press band in Lunge/Half Kneel VIDEO
  - Double Red (16/8)
- L-48 Row Band in Lunge/Half Kneel VIDEO
  - Double Green (16/8)
- L-54 Side Lying Clamshell Wall VIDEO REPLACED BY THE FOLLOWING MOVEMENT
  - 18rep
- L-55 Side Lying Straight Leg Raise with Wall VIDEO NEW