Hips, Knees and Ankles! 

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Hips, Knees and Ankles

These three have to be dealt with together as they are very dependent on one another for so many reasons. 

First, remember that most ankle and knee problems will manifest themselves in the hip. So just because you have pain on the inside of your knee, or in the ankle joint DOES NOT MEAN they are broken. Often times, baring a trauma, it is a cumulative micro-trauma that has broken down tissue (think of a car tire with wear and tear on it) and eventually you have pain.  The funtional dependency of the hip, knee and ankle is vital for figuring out why you have pain and how to fix it. Enjoy!!! 

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    90/90 Hip mobility 

    DO's: 

    • Go slow
    • Make sure to hold each position for 30-45 seconds and feel the stretch through both hips
    • Start small and improve each week until you are able to move from side to side without using your arms

    DO NOT's: 

    • CAUSE PAIN 
    • Push yourself to hard at first, develop the mobility over time

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    Supine Pelvic Tilts

    DO's: 

    • Breath while you are performing this
    • Make sure you are bracing your rib cage and core properly, follow the cues and take your time
    • Tilt the pelvis with your glutes and ab brace 
    •  Hold this position in accordance with your program 

    DO NOT's: 

    • Use your legs to create movement 
    • Hold your breath
    • Use your neck or back muscles to create or hold any position 
    • Have any pain while doing this 
    • NO stiffness or tightness in the low back or neck while performing 

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      Clams

      DO's: 

      • Breath!!! 
      • Maintain ab brace 
      • Move slowly and deliberately 
      • Feel the muscles in your hip doing the work 

      DO NOT's: 

      • Have pain anywhere 
      • Hold your breath
      • Use your back or body to create movement 
      • You should not feel this exercise in your quads, hamstrings, ankles or low back - ONLY your glutes
      Low Back Pain with Disc Involvement

      Symptoms

      • Pain, deep in the hip
      • Pins and needles down the leg, into the calf and/or foot and toes
      • Numbness in the lower leg, foot and/or toes
      • Weakness: you can not move your toes, walk on your heels or toes

      Causes

      • As above, when the disc becomes involved at this level there have been micro-traumas to the disc over the years and it is finally weakened enough to bulge, protrude or herniate into the nerve root space

      What to do?

      • Typically this one is an immediate spinal ortho referral, MRI to gauge severity and possible surgery depending on severity. NOT ALL DISC problems are surgical. Quite a few can be handled conservatively.
      Sciatica

      Symptoms

      • Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg
      • Usually only one side of the body is affected
      • Pain in the rear or leg that is worse when sitting
      • Hip pain
      • Burning or tingling down the leg
      • Weakness, numbness, or difficulty moving the leg or foot
      • A shooting pain that makes it difficult to stand up

      Causes

      • Irritation of the nerve root of the lower lumbar and lumbosacral spine
      • Muscle spasms in the back or buttock
      • Sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone on your vertebrae.
      • True Sciatica is generally linked to disc involvement but not usually as intense as far as pain and nerve symptoms (loss of feeling and strength in the lower legs and feet)
      Piriformis syndrome

      Symptoms

      • Acute tenderness in the buttocks and sciatica-like pain down the back of the thigh, calf, and foot
      • Symptoms often become worse after prolonged sitting, walking, or running and may feel better after lying down on the back

      Causes

      • Lumbar herniated disc
      • Degenerative disc disease
      • Piriformis muscles runs from your lower spine to the top of your thigh bone. When this muscles presses on your sciatic nerve the pain is caused.

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