SKM: Bilateral Lateral Hip Pain (Bursitis Responded Well to Injection) and Chronic Low Back Pain: Week 4 (5-14-18)

Phase 4:
- Try the organization I have listed below
- You will see some updates to your program below in CAPITAL LETTERS
- DAY 1 : STRENGTH CIRCUIT #1 (2 SETS) AND DAILY MOVEMENTS
- DAY 2: DAILY MOVEMENTS
- DAY 3: STRENGTH CIRCUIT #2 (2 SETS) AND DAILY MOVEMENTS
- DAY 4: DAILY MOVEMENTS
- DAY 5: STRENGTH CIRCUITS #1 AND #2 1 SET OF EACH + DAILY MOVEMENTS
- DAY 6: DAILY MOVEMENTS
- DAY 7: REST DAY/DAILY MOVEMENTS
This week will continue with the 2 categories established last week
Updates will be made to the strength and mobility sequence in BOLD to gradually increase the challenge
The explanations for strength and mobility sequences are below so you are clear as to what each sequence is meant to accomplish
VERY IMPORTANT:
- Make sure as you are doing more challenging movements, that you pay attention to the basics of controlling your low back/pelvic position. As the movements get more challenging, let me know if anything causes pain/soreness and I will talk you through it or make adjustments as necessary
Light movements that I call “Daily Sequence”
- This is a sequence that is all about light movement and muscle activation
- It is meant to improve mobility and possibly serve as a warm up, cool down, or a light sequence in the morning or at night to improve mobility
- I will continue to give you some alternative options over the next few weeks to include in this sequence
- The goal is to isolate 4-5 movements that you feel are most effective in moving parts of your body that are stiff/painful and feel that they improve mobility/stiffness
- You will do one set of 10-20reps for each movement so this sequence should be very quick and user friendly
- There is something called the “5 Tibetan Rites” that had a great impact on me
  - Basically, these monks for thousands of years did this sequence, some calling it “The Fountain of Youth”
  - I do not necessarily hand out the 5 rites, but I do believe that everyone should have their own personalized version of 5 movements that are not incredibly challenging, that move areas of their body that they do no move enough in their daily life
  - This sequence should be brief and take only 5-10 minutes at the most
  - I do my own 5 rite sequence before bed each night and I do it as a warm up pre workout/wrestling practice/jujitsu
Strength Circuits
- These are meant to challenge you with the goal of creating fatigue or tension in muscle without overloading painful structures
- Your goal with this is to feel muscle tension and hopefully fatigue
- Each movement will have a time goal or a rep goal, once you achieve that goal with no negative side effects, you are ready for a new challenge
- When your body fatigues, you may start to get pain and that is your cue to stop
- Pay attention to what you feel later that day and the next day
  - Mild pain is alright as long as it goes back to baseline within 24 hours
  - If pain is more severe you have a couple options
    - 1) Ice right after to minimize inflammation
    - 2) Try to decrease the intensity of the exercise by not going through as much range of motion or not pushing so hard
      - In my mind, most exercises can be made painful or not painful by the way that you go about it
      - Example: If I give you a squat variation, there are many ways to decrease risk of pain
        
        Don’t go as deep into the motion, do it slower, keep weight more on the heels, hold an isometric position squat without moving in whatever range is least painful, do only 2-5 reps
      - Have the mind set of getting through new exercises making it super easy just to find a safe zone…you can always increase the challenge from there
Daily Routine: Try this especially after activity or before bed
- Can be completed everyday
- 8-15 reps for each
- 109) Band Around Knees Progression VIDEO
  - Basic Bridge position
  - maintain flat low back
- 98.1) Quadruped Hip Extension progression VIDEO
  - Once again a mirror is a good idea
  - OR:
    - 98) Hip Extension Over Table/Bed VIDEO
- 26) Self MFR Quad/Hip Flexor VIDEO
  - Avoid doing this on any area that is really sensitive
  - It should be uncomfortable but not so much that you feel like you con’t relax
  - If this causes any back pain email me
- 38.1) Cross Leg Basic Rock to Cross leg Progression VIDEO
  - Basic movement progressing to a deeper stretch which progresses to contracting your glute in the stretch
  - Only progress as tolerable through the positions described
  - PROGRESSION
    - 42.1) Cross Leg Contract Relax VIDEO
Strength Circuit#1
- 124) Double Leg Heel Raise VIDEO
  - Ankle mobility can be part of the problem
  - Use this to activate and stretch your calf
  - Goal 8-20 reps
  - If able to do 20 reps progress to
    - 126) Single Leg Concentric/Eccentric VIDEO
      - Gradually progress 8-20 reps each leg
- HAMSTRING/GLUTE ACTIVATION: (CHOOSE ONE)
- 74) Bear Pelvic Control VIDEO
  - Highly recommend using a mirror
  - Getting this is important because your ability to maintain a flat back will be important for all movements moving forward
    - progress to
      - 71.1) Plank With Single Arm Holds High to Low VIDEO
      - Begin at a higher surface and progress to lower
      - Goal 5-10 sec holds each arm going back and forth with goal of total time
      - 30-90sec…If you get to 90sec go to a lower surface
- Hip Thrust Progression
  - 99) Double Leg VIDEO
    - 8-20 reps
    - Can do with back on couch or ball
Strength Circuit #2
- 185.1) Pre Run/Walk Single Leg Balance Drill VIDEO
  - Can do 8-20 reps
- 169) Supine Clamshell VIDEO
  - Try a light band around the knees, do this for time moving slowly in and out of the position. let me know if you have any pain and I will try an alternative
  - 30sec to 2 min
- 57.1) 1/2 Kneel Band Pull Down Thoracic Ext Prog VIDEO
  - Band attached up high over a door
  - 8-20 reps
- 149.1) Squat Pulses In Short Range VIDEO
  - Can be done with or without band around the knees
  - Once again for time 30sec to 2 minutes