How do you rehab someone who is VERY hypermobile and suffers from persistent low back pain- And their driver is NOT the lumbar spine?
This episode highlights the beauty of a specific exercise progression tailored to the patient’s meaningful movement as well as their driver. A very important principle of successful and long-lasting improvement is training new movement strategies and giving the body healthy choices to move.
We want our patients to have options to move and move well. Listen as we go through the clinical reasoning process to determine what types of movement patterns will work and what ones won’t. Doing the right thing at the right time is clinical expertise.
A glance at this episode:
- [2:53] Erica runs through the case history of a fitness instructor with low back pain
- [4:44] Susan and Erica discuss hypermobility and a lack of control in the system
- [7:26] Erica discusses the functional movement assessment
- [11:30] Susan and Erica discuss over-recruiting back extensors and lack of mobility in the lumbar spine
- [13:05] Susan discusses sensory input to the trunk and possible neural tension around these nerves
- [17:48] Erica explains that a muscle release will help with pain, but if you resort to the same movement strategy afterward, the release is useless
- [20:24] Erica discusses the importance of prior injuries in clinically reasoning through a case
- [21:51] Erica explains taping for posterior compression of the pelvis
- [23:27] Erica rechecks her assessment after not seeing this patient for a few weeks due to scheduling
- [24:25] Susan discusses an article by Kohler in JSOPT in 2012 about the recruitment pattern of the diaphragm in people with low back pain
- [29:28] Susan discusses patterning seen in people who are shorter and try to modify their posture to seem taller
- [32:33] Erica uses tape again to provide proprioceptive cuing
- [34:00] Erica covers the exercise program and progression to get this patient into a flexion pattern