I have a new client who needs to avoid hip flexion exercises because of low cartilage. (She is young and otherwise fit.) I’m trying to compile a list of lower-body exercises. She’s allowed to do body-weight squats. She’s not allowed to do lunges or anything that brings her hip up more than 90 degrees. I’d imagine things like reverse hypers or hamstring curls or bridges are okay. What about romanian deadlifts? Hip thrusts?
I’m seeking to understand her limitations. No more than 90 degree flexion at hip? Any limitations at the knee? Is she limited in the frontal and transverse plane as well? Is she only allowed to lift her own bodyweight, or is that limitation solely with squats?
If she’s not limited in the frontal plane, you have options for adduction and abduction.
If she’s not limited in the transverse plane, you have options for external rotation in squats, i.e. plies.
Another good sagittal plane exercise, if she can do seated exercises, are seated knee extensions, perhaps with a band for resistance or small ankle weights. In that case, her hip would be at 90 degrees but the load is on the knee, not the hip flexor.
Thanks, Nancy! Here’s what she’s told me: Due to cartilage damage, I am restricted from running (high impact), lunges, weighted squats/side squats (well, most lower lifting), and have limited range of motion. I had surgery in December and am still figuring out what I can and can’t do to get a good workout in.
Her doctor told her that cartilage issues do not improve, they only worsen, so I think a conservative approach would be best. She’s not limited at the knee, so any isolated knee extension or flexion exercises would be fine.
what kind of surgery did she have? Since it was in December, she can be at best 6 weeks post-op. Do you have a physician’s approval? Did she see a physical therapist?
All good stuff in these answers. Swimming and deep water, and maybe shallow water exercises are my first thought. I would run it past her surgeon, physician and/or Physical Therapist. Working with anyone post rehab/surgery should include getting regular recommendations from her healthcare team. I would ask these folks if they want you to update them on her program as well. If she is young and has a cartilage issue, it will be an evolving treatment plan.