Forum / Let's Discuss! / Hip%20Flexor%20dominant%20-%20needing%20to%20strengthen%20the%20outer%20thigh

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Anna A
On: March 13, 2015 20:15 PM
My client Jeff experienced an aneurysm and stroke that left him paralyzed on his right side. As we continue to do movement therapy to reestablish nerve connections (he can now, walk, drive, etc.) he still has a deficiency on his right side and to him his right leg weights about 300 lbs (it used to feel like 500 :). The muscular structure on the outside of his hip which helps to stabilize his pelvis and femur in the hip joint is lacking. He is, however, able to walk but what has happened is his right hip flexors and quads are so tight (from picking up his leg) that when we attempt side lying series to strengthen his hip - as he makes an attempt to lift his right leg, it automatically bends as he lifts. So, unlike most who need to release their IT band and TFL, we need to strengthen Jeff's, without the hip flexors and quads taking over. Suggestions? We are doing side lying leg presses on the reformer while he is over the arc, which seems to help but I need to get a good side leg lift option. Thanks as always!
Casey H
On: March 15, 2015 20:25 PM
Hi Ann, Thanks for writing in. Jeff is a fascinating client. He is amazing. And so are you. You have accomplished so much with him. I have a number of ideas but let me start with one that might be a jumping off point and we can go from there. Have you tried the One legged Yoga Block work? I don't think we have a video of this under the Pilates Tips but I will check. I know that this will be challenging for Jeff b/c of the balance so have something sturdy for him to hold onto. I am thinking at the Cadillac so he can grip one of the poles as he begins to find his placement with this one. It will take some repetition for him to feel like he has it. Have Jeff start by having his sturdy leg and foot on the Yoga Block ( I think this would be his left) Make sure the balls of his feet and heel are reaching into the block. The toes can be hanging off. He would be holding onto a Cadillac pole with his left hand. His right foot has nothing under it and to begin with he is trying to level his pelvic halves and feet. It is as if he has a fake floor under his right foot. This will create a lot of good stabilization work for the outside of his left leg ( IT band etc). Just stopping here and adding alignment, breath and core cues will be enough at first. From here there are a number of small movements you can add on. I'll give you 2 to start. 1) Hip drop. Allow the left hip to hike to the left armpit and the right hip to drop along with the right leg. On an exhale step into the left foot and level the hips and legs once more. 2) Abduct the right leg to the side. Keep the hips level. No hip hiking here. This will be a small movement. Both of these will be great for Jeff but he will need to rest in between especially at first. There is a ton of work going on in that standing leg. Let me know what you think. If there is not enough support for him in this exercise let me know and I will give you my next thought. Love Jen
Casey H
On: March 15, 2015 20:28 PM
Hi Ann, We do have a video in the Pilates Tips. Search Yoga Block Foot work. Love jen
Anna A
On: April 16, 2015 20:40 PM
Hi Jen, Yes, we have been doing the yoga block moves with Jeff and they have been very helpful. He has been traveling for the last three weeks. I will post again once I see him next week. Ann
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