Lets keep with the movements below for your strengthening and walking progression
Lets start to phase in some jogging with the current treadmill progression. I want you to do the treadmill uphill walk 5 minutes, jog 5 minutes, walk treadmill 5 minutes on incline again. This will be level one
Levels will increase by attempting to recreate the above cycle a second time but 1/2 as long for each taking you from 15 minutes above to approximately 22:30, level 3: 2 full cycles taking you to 30 minutes
This should be less painful then the bear. It may be even better to do it with a band around the knees which will engage more of your hip and decrease pressure on ITB
ADD a Band just above the knees if you have one, tie knees together with band, maintain outward tension on band as you sit down into the squat
Doing all 3 circuits on the same day might be a little bit much. Lets start off with 1-2 strength circuits every other day alternating which strength circuits you do. If this all goes well this week we will start to imcorporate some agility stuff next week
Keep Stride long but short or reproducing pain if possible
Increase incline on treadmill as able and keep a slower walking pace
work up towards 4-6% incline and then work time up gradually to 10-20 minutes
Everyother day at the most, take 2 days off if sore from previous episode
11-13 Update
It sounds like the bosu ball exposed some legitimate weakness in your hip given the soreness you had following it. I think you need more time to continue to improve hip strength and stability prior to returning to plyometrics. After I hear about your current reps and weights I will update your program below accordingly.
11-8 Update
It sounds like things are moving in the right direction. We are going to keep the mobility movements the same because it sounds like you are doing well with those.
Strength:
Circuit #1
Heel Raise Progression at Wall
Goal: get to the third one down and try to get fairly symmetrical strength, 10-20reps
This should be less painful then the bear. It may be even better to do it with a band around the knees which will engage more of your hip and decrease pressure on ITB
ADD a Band just above the knees if you have one, tie knees together with band, mainatain outward tension on band as you sit down into the squat
Doing all 3 circuits on the same day might be a little bit much. Lets start off with 1-2 strength circuits every other day alternating which strength circuits you do. If this all goes well this week we will start to imcorporate some agility stuff next week
Lying on back on physioball/exercise ball with upper torso and head supported
10-30 Update:
Your Response to My Email:
I was going to reach out to you this weekend. I had a follow up doc appt last Thursday and we decided that doing this run next weekend wasn’t a good idea. Anytime I run, the day after I am in major pain. We decided that I needed to “reset” and not worry about the race, but instead, get me ready for my next one which is in January. That being said, I know you have given me a lot of different exercises to do in prep for this race, but since I’m not doing it, what exercises should I be doing on a regular basis? Also, to answer your questions:
1. On average, I would say I’m probably a 5, unless I run then I feel like its a 0.
That is a pretty normal repsonse and I am not surprised that you are not quite redy for running. With strengthening the initial improvement you feel is neurological and the result of you engaging different areas of your body. To actually build strength, I usually look for that to occur over a 6-8 week time frame. I usually like to see that your involved side is at least about 80% as strong as the non-painful side in all single leg oriented movements before I usually progress the agility stuff. I will give you some specific self tests
2. I really like the mobility exercises you give me, I feel like the Quad/Hip Flexor and the Ball Glute videos really engage my glutes. Same goes for the cross leg contract relax posterior hip video, and the counter push exercise. I have to say I also really like the side sit to side plank exercise. You mentioned its one of the hardest glute movements but I really like it and it actually feels good when I’m doing it.
There are alot of options for mobility and everyone is a little different as to which ones feel like they generate the most positive impact. You want to pick 4-6 movements that you feel have the most impact from a pain relief and mobility aspect. That side sit position may be one of those if you feel like it gives you alot of relief.
3. I tried doing the single leg deadliest with rotation exercise and I felt some pain so I can only do a few of those. I was having issues with the bridge exercises but I did phase 1 enough that I’ve been able to progress up to phase 2 and 3 so it doesn’t feel to bad, but I can only do about 5 of them. The one thing that I do continue to have issues with are the bear crawls. I feel uncomfortable pain anytime I try to do those.
Based on what you have told me we are going to adjust your strengthening program. Each one will have a goal attached to it, and each week I want to know where you are at in regards to that goal. These should be completed everyother day.
Circuit #1
Heel Raise Progression at Wall
Goal: get to the third one down and try to get fairly symmetrical strength, 10-20reps
This should be less painful then the bear. It may be even better to do it with a band around the knees which will engage more of your hip and decrease pressure on ITB
Goal: Stay in a painfree range but gradually move deeper into squat keeping weight on heels. Get to 20 reps gradually
Hold on agility until we ensure you have more symmetrical strength and endurance
Let me know how this is going in a week
Any of the other strength movements that you like can be included in the strength days but I am particularly interested in the movements above and how much weaker you feel on one side or if there is pain
10-23 Update
Weekly Schedule
Monday: Mobility Only: I added a few new options. You want to choose 4-6 of the movements below that you feel give you the most benefit. Now with that said I woould make that decision based on a few things:
Which ones feel the most different when you compare the painful to the non-painful side
Try not to confuse good pain and bad pain
The goal with any of these is to feel that something is tight or restricted. As you do it you should feel that any discomfort remains the same or gets less as you do it. If it feels like it is getting worse or you feel worse after, you pushed too hard or that movement is not for you. It is possible to over stretch. Some people do a movement that feels good so they push it way too hard thinking more is better and then they wake up the next day in a ton of pain. Let me know which work best, and which were most different when comparing side to side. This will give me a better idead where you are at
Tuesday: Agility or Run of you are not sore from sunday, If you are sore do mobility again and any of the strength stuff that does not irritate the soreness
Wednesday mobility
Thursday Strength
Friday mobility
Saturday agility run
sunday mobility
Strength Update
How is the glute med progression and single leg balance progression going
Try each and let me know if you have any pain with either
If any of the strength causes any pain don’t do it. We want to go lighter with the strength stuff at this point to optimize how you feel on the run days. Only go to a light/moderate fatigue but specifically let me know where you are on the glute med stuff
Single leg balance stuff can be done on bosu if you have one which is listed below
This can be done everyday and may serve as a good warm up/cool down sequence for running in the future. This is meant to address mobility limitations that could limit your ability to run in the most efficient manner. It also attempts to lightly engage the glute while progressing into hip extension. Attempt 10-20reps of each
When this is part of a warm up you will not hold the position for 5 seconds, just move slowly in and out of it
Phase 2: Foundational Strength
Circuit #1: 10-20 reps of each first set, 2nd set do 1/2 as many reps of first set (If you get 16 bridges first set, second time around 8 reps). Get through this without pain and we will then progress into lateral hip and trunk stability. Complete the strengthening every other day preferably on days where you are not running or at least after running. Continue to do phase 1 everyday.
Focus on lateral hip and trunk stability with progression of standing balance. These movements will begin to develop the hip stability required to reduce the tension that builds up in the IT Band as a secondary lateral hip and thigh stabilizer. Complete both phase 2 and phase 3 every other day with the same rep and set parameters as above. We will drop to one set of each movement initially including both phase 1 and phase 2 circuits. Any exercise that recreates pain should be avoided and try one of the other options in that specific section or contact me and we will to discuss how we will alter the movement Next step will be plyometric pre running if able to complete the movements below without increase in pain
Circuit #2
Gluteus Medius Activation (Pick One, they get progressively harder)
Begin with 30 sec at each station and progress towards 60 seconds as able. Begin with a total of 3-4 min and progress to 8-10 minutes. repeating the sequence 3-5x. Ice after 10-15minutes. Once you get to 10 minutes can start to progress to walk jog progression. Start off on level at a track. Begin with 1-2 miles. alternate walking and jogging each lap. Once again follow soreness rules and ice after. Follow up with me as needed for more guidance. Kinesiotape may be useful for running/agility sessions if you have a plateau limited by pain. Keep me posted
