Dr. Boatman was so impressed with his results that he recommended my therapeutic and exercise services to Tom Reed.
Similar to Dr. Boatman, Tom has a history of lower back pain from stenosis of the lumbar spine (lower back) that he alleviated with steroid injections. However, Tom also has osteoarthritis – a very common joint disorder – that causes pain and stiffness around the joints.
After completing a medical and exercise history review with Tom, I decided to perform a specific functional movement assessment (SFMA). Tom had a great deal of tightness. Additionally, he lacked of stability in his hips, lower back, middle back and cervical spine. His physical movement dysfunctions were contributed to by pain from his spinal stenosis and arthritis. His pain caused his body to go into protection mode. Tom’s body began compensating during movement by creating stiffness to help stabilize his body and reduce his pain and instability. This stiffness caused myofacial knots in his lower back, gluteus muscle group, piriformis, hips, thoracic spine (middle back) and cervical spine (neck). These fascial restrictions lead to poor movement patterns and pain.
Tom’s lower back pain was not subsiding as much as we would have liked. He decided to get a steroid shot. The shot removed most of the inflammation in the lumbar spine decreasing his pain allowing him to move better and allowing us to make better gains in his therapy. Our goals were to reestablish proper movement patterns, reduce or eliminate the myo-fascial restrictions, increase stability/strength, and reduce or eliminate pain for longer than three months.
Tom’s treatment began with lots of myofascial (specific messaging and trigger point) work.
I also introduced him to a four pound medicine ball. I taught Tom how to roll on the ball, utilizing it for myofascial work when he was not with me. He was very consistent in using it every day. This, of course, helped in speeding up his progress.
His hard work and consistency was paying off. He started reducing the fascial restrictions, began to move better and was able to begin more advanced therapy. I had Tom start with supine (back) bridges. The purpose of this exercise was to help activate his gluteus maximus. His lack of gluteus activation caused tension on his hamstrings due to them performing stabilization for the inactive glutes. Once he established reactivation of the gluteus maximus, it allowed him to gain greater bending/squatting flexibility. The next step of his therapy was to start expanding his exercise regimen. He started doing Bird-Dogs and kneeling single knee balances to help strengthen and stabilize his hips.
After he started to make good gains performing these exercises we began working on supine/prone rolling, assisted squatting patterns and proper standing hip hinging. After four months of exercise therapy Tom is moving better than he has in many years. His lower back pain is almost nonexistent.
Tom still is performing all of his therapeutic exercises every day. He has progressed to a workout program designed using dumbbell and Kettlebell multi-plane circuit routine. These challenging dynamic weight resistant exercises are helping reinforce the gains in strength, stability and flexibility he has achieved over the months.
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Denny Boatman, MD