This podcast episode zeroes in on a scenario many physical therapists face: patients diligently following their exercise routines but not seeing the expected progress or recovery. Why? Maybe there is a secondary driver that was missed. Or perhaps the exercises are not targeting the driver. An example of this is when someone has low back pain and their driver is their foot. Yes, that does happen. I have seen this happen more often than you think!
So traditional exercises for the low back will not cut it here as their lumbar spine is not the driver. The movement program MUST take into account the foot as that is what’s driving the low back problem.
We discuss thorax, foot, and knee drivers as examples and why there can be holes in someone’s program even after they’ve been doing advanced exercises. Being able to identify the patient’s impairments is a good start.
We discuss common strength holes along with typical overactivity patterns in these patients. We also discuss a patient who is a high-level athlete with a fear-based movement that is a big hole in her program.