Hello, I have a client who has arthritis in her right hip. During mobility tests, she has an asymmetrical weight shift to one side (her right side) during any squatting and hinging movements. I’ve been showing her many Glute Medius exercises (due to the imbalance). The only problem is, there’s pain whenever these exercises are performed (whenever she performs abduction with her right leg in general) I’ve also showed her some adductor and TFL stretches to incorporate.
I’m trying to program further leg training without machines, but I don’t want to worsen her imbalance. What’s your advice? Sorry for the complication.
Difficult to give an answer without complete history and assessment of the client.
I would want to know what type of arthritis she has (osteo?), is she overweight? Has she had doctor’s release and/or any PT? Also, although I understand the functional purpose of wanting to keep her off machines, perhaps one could help her simply because of this imbalance–she is only as strong as her weakest point, and multi-joint exercise may not help her in this case.
Regardless, you want the client to work in a pain-free range of motion.
Christine gave you sound advice – my first thought was to send her to a doctor to rule out underlying issues that are beyond your scope.
I also agree that a machine-based exercise for correcting imbalance and / or rehabbing an injury is valid.
I love that you wrote you don’t want to worsen your imbalance. Perfect. In all cases, insist on good movement. I’ve been listening to Gray Cook lectures for the last couple of weeks (he’s on audible.com for cheap!!!), and the thing that comes to mind is that it’s easier to take 4 steps back than 1,000. Meaning, insist on impeccable form, even if the movements are small. Get good movement, repeat, repeat, repeat until she’s got more neural efficiency, before you add load or change exercises.
Hello Tyler Freitag,
You want to do reduced ROM exercise until the body lets her progress while using proper form at all times. Also work from the shoulder to the ankle with strength and flexibility; do not go after the victim (hip), let the rest of the body help and become balanced while the hip rests and recuperates.
Natalie aka NAPS 2 B Fit.