[quote]Otep wrote:
[quote]Im_New_Feed_Me wrote:
Sounds like a psoas (muscle) and a sacro-illiac (joint) problem. Both are closely related, and one usually causes the other eventually.
Go to a massage therapist and get them to manually work on the psoas, also, get them to give him some massages he can do on his own to relax the muscle a bit.
I’m just guessing that he has a job that makes him sit all day?
You are probably right about the stabilizers though, they will need some work. But he needs to address that muscle first.
Once it is relaxed a bit, he is going to need to do some activation, some strengthening, and some lengthening for it.
Get him to sit on a low box where his femurs are at 90 degrees with the floor. Then get him to sit upright and see if he can actively pull his knee up towards his chest and hold for 5 seconds. Then try the other side. Let me know the difference, either in strength or pain.
This is just my 2 cents.[/quote]
I’m actually fairly certain he stacks boxes for a living, and does other warehouse work. He wears his weightlifting belt to hold up his pants during his workout, and I wouldn’t put it past him to do that at his job too.
I can get him to do this test. Just for clarification, this isn’t a box set to parallel, but a little above, to where the femur is parallel, right? And then its okay for one foot to be on the ground keeping him stable, while he tries to pull the other toward his chest? And if he can’t do it, it has to do with psoas weakness? And the cure for that is… more psoas work? Sit ups?
To address the stabilizer issue, my guess would be bodyweight lunges in the extra-high rep range, like 50-100, so the muscle can get a lot of work without doing any spinal loading, which causes pain. Good idea?
He’ll probably dig the massage advice. Not only because massages are awesome, but because they’re cheaper than an MRI.
Assuming it is Psoas weakness (isn’t this usually the opposite problem for people with Low Back Pain? strong psoas and weak glutes + abs which leads to pelvic tilt?), where should I go for activation and flexibility exercises? I saw Robertson recommends some serious time spent on stretching in a recent article. Is that the way to go?
Thanks for the response.[/quote]
As for your first question about the test, yea to everything you said.
As for the stabilization exercises, I’d like to see him on one leg for a bit. (Anterior reach, upgrade to ant. reach on cable machine, one legged squats, x-band walks - for glute med, things like that)
Now, a few years ago, I assumed that tight hip flexors meant they were too active and strong. But after more reading and studying, I’ve come to the realization that just because a muscle is tight, does not make it strong. Same idea as a kyphotic person. Just because they have tight pecs and lats, doesn’t mean they can crack out push ups and pull ups like a motherfucker.
What we need to do is get in there and decrease the muscle density a little bit with some art, or massage. Then once, it’s relaxed, we can work on activating it and strengthening it.
In doing that, we3 should (somewhat) take care of the SI joint problem as well.
If anyone else has any ideas, feel free to chip in help me out. This is just what has worked with more than a few of my clients.
Let me know how he does on that test, and we can go from there.
Thanks!
Edit - Robertson is a genius, but save the stretching until he gets the soft tissue work done, we have no idea if the fibers are all stuck on one another (not so technically speaking) so it might not have much of a benefit until he gets it looked at.
