My following post was featured as a guest contribution to WODMedic's blog upon my induction to their network of Elite Facilitators. Founder Dr. Ryan Davis is a Doctor of Chiropractic who created WODMedic to unite movement-based physical therapists, chiropractors and other like-minded providers in order to better connect athletes and fitness enthusiasts with the effective health care they need.
It's 2015 and physical therapy can be so much better than painkillers, hot packs, bed rest, unnecessary MRIs, and generic low-level exercise prescriptions. Yet how often does one see these things in a traditional rehab setting?
I love what Dr. Davis is doing and believe that the future of sports and orthopedics rehabilitation is headed in a direction consistent with WODMedic's mission--to redefine the traditional model of healthcare by empowering movement-based, fitness-minded providers and connecting them with the masses.
Mobility Drills for Returning Low Back Patients
Last week, Dr. Joseph Lavacca’s blog post taught us effective exercises and mobility drills of the shoulder, scapula and thoracic spine for athletes returning to overhead exercises. I thought I would switch gears and talk a little bit about some lower body mobility drills for athletes with sciatica, hamstring pain or other lower body issues as they return to resisted lower body strength training, especially barbell exercises such as the back squat and deadlift.
Those recovering from bouts of sciatica may experience discomfort in the low back, the posterior thigh or buttocks which may compromise their performance of the squat or deadlift. Addressing hip, lumbar spine mobility and neurodynamics of the sciatic nerve may help encourage appropriate joint mechanics and desired movement patterns for pain-free strength training.
These are some of the common drills that I have some of my clients perform prior to their warm-up sets. As always, make sure to consult with your physical therapist, physician or other appropriate health care professional for clearance to perform exercises of this nature.
Is this not the coolest name ever for an exercise? The tactical frog can be a great mobility drill to promote motion in the hip joint capsule in a gravity-eliminated position--you’re basically mimicking the squat in a horizontal position. In quadruped with both hips slightly abducted, gently guide your body towards the direction of your feet. Maintain a neutral lumbar spine and work within the limits of your mobility, gradually sinking your hips deeper and deeper. I usually have my patients shift as far back as they can before their back starts to round. Motion need not be limited to an anterior-posterior direction, and you can play around with different angles depending on where you perceive the tightness to be.
Squat with Thoracic Rotation
At the base of a deep bodyweight squat, use one hand and grab the outside of your opposite foot. Rotate your torso slightly and extend your other hand upward towards the ceiling. You should be able to feel a stretch in your mid-back as your shoulder blade protracts and thoracic spine rotates. Repeat for the other side.
Sciatic Nerve Floss/Dynamic Hamstring Stretch
A lot of times people mistake sciatic nerve tension for muscular hamstring tightness. Sometimes people will present with both, and the following drill helps address both issues. Lie on your back with the unaffected leg laying straight out. Cradle your affected leg in a vertical position with both hands behind the knee. Straighten your knee while simultaneously pointing your toes toward the ceiling (plantar flexion), and then bend your knee while pulling your foot the other way (dorsiflexion). Perform one set of 20 repetitions, and repeat for the other leg.
Dynamic Toe Touches
Here’s a functional way to improve toe touch ability that encourages mobility at the lumbar spine, hips, knees and toes, knees and toes (ha). Reach down towards your toes (or as far as you can go) with your knees extending as your trunk flexes downward. When you arise, allow slight flexion in both knees to occur. This can be effective for patients with sciatic or low back pain whose symptoms present a little more proximally or have more nerve root involvement. Also a great way to address neurological tone in the posterior chain, especially in the setup for the deadlift.
Another precaution to take into account when returning to the lower body powerlifts after a hiatus is to gradually progress the load and volume. That progression at first may be more linear and slower than what you’re used to, but it’s important to re-establish these neurological and strength adaptations which serve as a foundation for more advanced training later on.
Feel free to leave comments, feedback or any additions in the comments below!