Now that I caught you with the title...we know nothing in Physical Therapy is 'all about' one thing. The beauty and difficulty of the human body is our unique differences. There is not one thing that is the same for all of us. However, when dealing with back pain, we know the importance of proper strength and mobility of the hips is essential.
Throughout my lumbar evaluation, I look at the function of the hips in several planes. From the functional movements of gait analysis and squatting to AROM and strength testing, I try to gain an understanding how people use their hips. If a patient is lacking range of motion, their mobility will likely arise from the lumbar spine. Contrarily if the hips are lacking strength, the low back will attempt to compensate for the weakness. For example, when someone performs a squat, if they are lacking hip strength, they will likely use their low back to ascend from the squatted position. This excessive lumbar hyperextension demonstrates an inability to stabilize the trunk.
The hips are inherently stable and facilitate the overall health of the lumbar spine. When rehabbing the lumbar spine, we must focus on hip mobility, strength, and retraining functional movements. In my therapy sessions, I start retraining the gluteals with basic table exercises such as bridges and clamshells. When pain decreases, I advance to quadruped exercises, standing hip extensions with TrA activation, and dynamic single leg balance activities. Regarding function, I start retraining the hip hinge technique as well as squat and lunge patterns. We must check the hips on every lumbar evaluation!
James Heafner PT, DPT, OCS:
Owner and lead physical therapist at Heafner Health, cash-based physical therapy in Boulder, CO. Areas of expertise include orthopedic and manual therapy, functional movement, pain science, and movement science.
In May 2013, I earned my Doctorate in Physical Therapy from Saint Louis University. After graduating from the Harris Health Systems Orthopedic Residency in October 2014, I moved to Boulder, CO. Since living in Boulder, I have started my own cash-based PT practice, earned my OCS certification, and teach for the OPTIM Fellowship and COMT program in Houston TX and Scottsdale, AZ.
Chris Fox PT, DPT, OCS: Physical therapist at Foothills Sports Medicine & Physical Therapy in Scottsdale, AZ and regularly lectures at the Phoenix Campus for NAU's DPT program and for Optim Manual Therapy's COMT program. Completed multiple advanced manual therapy courses implementing aspects of biomechanical analysis. He received his DPT from Saint Louis University in 2013. Completed Scottsdale Healthcare's Orthopaedic Residency (now Honor Health) in July 2014. He became a Board Certified Orthopaedic Specialist in 2015. Level I Expert in FMS and SFMA , Kinetacore FDN Level 1 certification, and IASTM Technique course completion. He would like to pursue further education in McKenzie Technique, Dry Needling, Strength & Conditioning, Orthopaedic and Manual Therapy.
Brian Schwabe PT, DPT, SCS, CSCS:
- Board Certified Sports Physical Therapist (SCS) at Elite OrthoSport in Santa Monica, CA which specializes in treating collegiate/professional athletes and clientele from the Beverly Hills, Hollywood, and Santa Monica areas.
- USC Sports Residency Trained Physical Therapist (<1% of all PT's residency trained)
- DPT from Saint Louis University
- Future plans/interest include:
1. USAW, SFMA & Catapult Systems technology for NBA teams
2. Pursuing a position as a sports physical therapist &/or Strength coach for a Division 1 athletic medicine department or professional sport team.
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