Today we'll discuss a progression following the Selective Functional Movement Assessment 4x4 Matrix Philosophy.
One of our patients has improved her lumbar and thoracic range of motion to near normal ranges as well as active prone hip extension on both sides. This is following resolution of radicular symptoms at the anterior left thigh from 4 week ago. She would now like to engage in bending, lifting and prolonged walking without being easily fatigued and achy at the upper lumbar spine. This suggests we should now progress the patient.
As soon are we progressed to hip extension in quadruped today she was unable to maintain a stable lumbar spine and looses balance all together. Once a Gray Cook band was added to a left directed force to her pelvis she is able to at least perform this exercise with fair form. This force helped to active the stabilizers required for this exercise. Right hip extension shows good form even without the assistance from the band, however. We performed this exercise for left hip extension for 3 sets of 10-15 which caused a desired level of fatigue at her core and lumbar paraspinal region.
Her home exercise is now to loop a large theraband secured in a doorway with the band pulling at her right pelvis in a left directed force. She was instructed to perform this exercise everyday for 3 sets of 10-15. After 2 more sessions the goal is to perform this exercise without the need of the Gray Cook band during left hip extension with a stable neutral spine in quadruped.
We commend our patient on the persistence of hard work she puts in and constantly progressing every session.
Dr. James Coomber, PT, DPT, COMT, CES, ART, SFMA
647 Route 18, East Brunswick, NJ, 08816