P. is a male in his mid 20s. He is an electrician who works for a hospital chain. He is active, goes to the gym regularly and likes to skateboard. He reached out to me for a Skype session after practicing some of my yoga videos online. |
PROBLEM |
P. complained of recurring pain in his lower back (right side) and outer right hip. He said that doing yoga online helped him become more aware of the body, strengthen his core and overall was helpful for relieving tension, but the discomfort kept coming back. |
INVESTIGATION |
In the course of our conversation it became clear that P. did not have any particular injuries or incidents that would explain his discomfort. He was young, healthy and active. He explained that he had more pain at the end of the day, and sometimes it bothered him at night. He couldn’t pinpoint any particular activity or movement that triggered his discomfort. I asked him to describe his usual day to me. He explained that as an electrician he spent most of his day standing on a ladder looking up and working on the lights in the ceiling. He used an industrial ladder with a platform on top, so he was steady and symmetrical in his body positioning while he worked. Despite holding his arms up and head raised for most of the day, his neck and shoulders never bothered him. Then he said: “That’s my day – get up the ladder, work on the ceiling light, get off the ladder, move the ladder, get up the ladder…” I asked him to show me how he moved the ladder. |
STAND-OUT FACTOR |
P. demonstrated how he picked up the ladder by lunging forward with his right leg, leaning on it, twisting his entire upper body to the right and lifting the ladder from the outside of his right leg. At one point his right leg was supporting most of his body weight, the weight of the ladder and propelling all that weight upwards. His right knee leaned inward in the process. I asked him to pretend to do the same thing on the other side of the body, as if the ladder was to his left. He was not able to do that. His left leg wouldn’t support the weight, his torso couldn’t rotate that far to the left, and the whole movement felt very awkward and unstable. |
HYPOTHESIS |
P. was amazed at how asymmetrical his body felt on this one movement that he’s been doing many times every day. It was clear that he was overusing his right leg to support the weight of his body and the ladder, while at the same time repetitively twisting his torso while holding the ladder. I told him my favorite quote that in the body it’s usually the victims who cry out, not the criminals. His right hip and his lower back on the right side were the victims of this repetitive action, while the other side wasn’t doing enough to support it. I asked him to show me his gym routine. It became clear that his movement patterns from work followed him to the gym and were exacerbated by his gym routine. |
COURSE OF ACTION |
We focused on creating a short yoga practice that he could do after work before his workout at the gym. My goal was to mimic the movements that he did at work with better form and more body awareness, to strengthen the muscles on the other side of his body, to release chronic tension in his lower back and right abductors, and to develop more symmetry between the two sides. We were looking to “neutralize” the asymmetrical load on his body at the end of his work day, so that his gym workout would be more effective in strengthening his body. He also committed to lifting the ladder from the other side throughout the day. We tried the following practice together during our session and P. felt immediate relief. He committed to doing this practice on his own at least 4x week. |
