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Hip lift question

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This topic contains 2 replies, has 2 voices, and was last updated by   Scott Glidden August 20, 2018 at 2:34 pm.

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  • August 17, 2018 at 1:35 pm #5436

    Scott Glidden
    Participant

      Background

      53 year old female
      Lumbar pain that radiates to R posterior hip for 6 years.
      5-6/10 tension on average. Up to 8-9/10 at worst and 1-2/10 at best
      Provocative: walking, standing
      Palliative: sitting
      MRI confirmed herniated disc at L5/S1.

      SLR L: 82/8 (pull in butt) +D R: 80/8 (pull in hamstring) +D
      SHF: L 3F/4-5 (pinch at ant hip) R 3F/7-8 (post hip pull)
      QLF: initially 10001, 4 visits in it is 11122.
      KHE: L: 10″/5 pull in butt R: 11″/ 5 in front of hip
      SLPF: 100% with calf tension at bottom

      Adhesion is present all over in lumbar spine, but has very nicely improved to
      QLF: 11122 in 4 visits. She is very happy with care and feels so good that she ended up doing too much and flared up her back lifting things at home (she knows she did it to herself, she is one of those ‘must be active’ type folks) Considering her hamstrings are fairly healthy and anticipating the need for good mornings down the road, on the 4th visit I had her perform a lunge test which she failed miserably. Upon showing her the hip lift she said she hand tingling into her hip when performing it.

      How do I progress from here? Clean up SLR to 100% then load? There is clearly shearing at her injured disc causing the tingling, but she needs the hamstring strength. Do I modify the hip lift?

      August 17, 2018 at 3:08 pm #5437

      Matthew Ellerbrock

        The beauty of the hip lift is that is shouldn’t put any shear on the disc if done properly. That being said if it hurts her back I would discontinue until she can do the hip lift correctly without back/leg symptoms.

        Remember it’s mobility then strength and you may just be progressing her too quickly. Great progress like this sometimes let’s us get greedy as a provider .

        Was her form good (no abdominal contracture)?

        August 20, 2018 at 2:34 pm #5438

        Scott Glidden
        Participant

          A bit of greed indeed. Backing off of exercise until her QLF is 100%. She wasn’t engaging her abs, so hopefully the extra pay off of less load on the discs will get her to where she needs to be.

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