Best exercises for weak hip/core muscles?

June 27, 2015 3:12 PM

I saw a sports doc for recurring issues with my calves, feet, and possibly the Achilles tendon. I'm going for PT on Tuesday but I'd like to look into local classes with exercises that target these issues in the meantime. Details below the fold.

I've been having problems with tight calves, foot/arch pain, and Achilles tightness and pain, specifically when running more than a block (yes, one block) and walking longer distances (1+ miles). Podiatrist said that I have very loose ligaments. I'm not sure if that's just in my feet, or everywhere. Sports doc said my heel flexibility, foot intrinsics, core and gluteal strength, balance, and proprioception "all stink." Despite the candor, she was excellent and very thorough with the testing, and I'm happy with the visit. She recommended the Strassburg sock, custom orthotics, calf compression socks, and most importantly, seeing a PT as soon as possible for a gait analysis. She also recommended soft tissue work and Active Release Techniques at some point (by a chiropractor? I'm not sure.) The goal is to get back up to be able to try a run/walk program, like C25K. To give an idea where I'm at, when I close my eyes and stand on one foot I look like I've been drinking.

My PT appointment is on Tuesday, but I'm not sure what questions I should ask, or what to expect. In the meantime, I'd like to get an idea of what classes are offered locally that may target these areas, but I'm not sure what to look for. This article by Runner's World really targeted the types of things she mentioned and one of the key points was consistency, which is why I would like to take a class with others and an instructor to ensure I'm doing everything consistently, and correctly, (i.e. not strengthening the wrong muscles).

TL;DR: I'm looking for boot-camp type classes that will strengthen my core and hips. What exercises should I look for? How can I get the most out of my upcoming PT appointment?

posted by onecircleaday to Health & Fitness (13 answers total)

Best answer: At your PT consultation, they'll take your history again, and probably repeat the diagnostic clinical tests the sports med did. (They might come to slightly different conclusions or recommendations, btw, although probably not, from the sounds of things.) So write down everything you can remember about the sports med's diagnoses and recommendations, and about your history and pains in case you forget anything. (Use point form.) If you have any reports from X-rays or other imaging, it might help to bring copies in (if they're not already forwarded by the dr).

Your PT can likely do the ART / soft tissue work. They might do a bit at the session. Then they'll prescribe you some exercises to do at home.

In my area, I've seen (but not tried) classes for foot strengthening, based on Pilates and other rehab approaches. Those are held at a local sports med clinic. But why not trust your PT, who'll give you individualized recommendations? They'll demonstrate the exercises, and also check your form, at your regular appointment.

(For core and hips, planks and glute bridges are the basics.)
posted by cotton dress sock at 3:29 PM on June 27, 2015

Sorry to be circular, but this is an excellent question for your PT! Mine have generally been less than excited about the "boot camp" model, especially compared to slower and more focused work like tai chi, pool-based classes, or machine-based strength training.
posted by teremala at 3:30 PM on June 27, 2015 [3 favorites]

Response by poster: OP here. Not trying to thread-sit, but I saw this and wanted to clarify:

But why not trust your PT, who'll give you individualized recommendations? They'll demonstrate exercises, and also check your form, at your regular appointment

Great question! I do trust the PT - it's myself I don't trust. I'm afraid that in between the appointments I'll drop the ball on doing the exercises because I don't have the confidence to do them correctly. I thought a class would be good because the instructor corrects as you go along, but you're right - I'll just ask the PT about this at the appointment. Teremala's tai chi suggestion made me think of yoga, which I hadn't considered, but might be a good thing to ask about too.

Thank you both for your responses! All good points, which I'll definitely take with me : )
posted by onecircleaday at 3:36 PM on June 27, 2015

Best answer: Oh, the PT will make sure you know how to do the exercises, and give you specific things to check your form by. For example, one of my exercises is getting on my hands and knees and then extending one leg back and the opposite arm forward, and the way it's checked is to balance a long ruler/stick on the back of my pelvis so I know when I'm wobbling/unleveled. Similarly, I like the Wii Fit yoga program because it gives constant feedback about how well you're balanced (though it can't stop you from having awful form, you do get better over time).
posted by teremala at 3:50 PM on June 27, 2015 [1 favorite]

You could also ask your PT if they'd be ok with you filming them (or yourself) at your appointment, for a reminder. Or take a lot of notes at the appointment. Because it's true, sometimes it's hard to take everything in (or you only remember one or two cues). But if you're off, you'll be corrected at the next appointment, don't worry :)
posted by cotton dress sock at 4:12 PM on June 27, 2015

Yoga is a good suggestion for strengthening the core; strength training is also something to consider. Deadlifts, squats, and kettlebell swings are great exercises for both the core and the glutes, and you can probably find classes near you that will cover them. (One place to start looking might be with StrongFirst. I've worked with a couple of StrongFirst certified instructors and they're great.)

But get the all-clear from your PT before you start weight training.
posted by asterix at 7:21 PM on June 27, 2015

Best answer: You want an adult beginner's ballet class, focused as strictly as possible on technique, preferably an extremely traditional one where you're only on the floor for stretching and warmup and remain glued to the barre the rest of the time, with a teacher coming around to make corrections, in a room where you are surrounded by full length mirrors covering at least two walls.

Yoga's great but it ain't gonna do shit for your feet and won't really all that much more for your calves and achilles. Ballet will do wonders for all those, although it will be slow going and embarrassing at first, and also all the other things your sports doc mentioned.

No, really.
posted by The Master and Margarita Mix at 8:19 PM on June 27, 2015

Best answer: Pilates, especially clinical Pilates (in a small group, with an instructor following you closely) will most likely help. The three physiotherapists I've seen (in different cities/states) have all recommended it for my own weak core and tight hip muscles. It has made a tremendous difference in my overall health.

Clinical Pilates, in particular, is great if you need that "boot camp" experience. It's not cheap, but I never skip it because I've already paid.
posted by third word on a random page at 8:58 PM on June 27, 2015 [1 favorite]

After the visit to the PT you could try some stretch excercises to ease into the more advanced stuff.
posted by KMB at 2:30 AM on June 28, 2015

I'm not qualified to answer your question, but I will say as a layperson that I was BLOWN AWAY by what heavy (below-parallel) squats and deadlifts did for the way my core feels. It seems to me that I could have done yoga/crunches/planks/pilates for years without feeling anything similar to the results that heavy lifting started to get me within months.
posted by callmejay at 5:20 AM on June 28, 2015 [1 favorite]

Best answer: Glutes are really straight forward to take care of in PT. You will get exercises like:
- clamshells
- glute bridges (not yoga bridge!)
- side lying hip abduction plus variation
- single leg balance work
- step ups
- glute band walk

These are all predecessors to the squat, lunge, and deadlift. Bodyweight versions of these belong in the more advanced program. I would wait to start in this until after 4-8 weeks of physio to avoid further injury.

I take pilates on the reformer and it is great for rehabbing injuries like these.
posted by crazycanuck at 9:30 AM on June 28, 2015

I second crazycanuck as those were a lot of the exercises that I got for PT. I'm a runner who was also told that not only were my hips weak, but my entire right side was significantly weaker to the point that my calf was visually smaller.

Trust your PT, and trust in yourself to make yourself better. I started seeing my PT every 2-3 weeks apart; if you don't do the exercises, you're not going to make progress.

On the point of classes, most will be weekly (I.E. not frequent enough), and I'd be really surprised if there was a class that would even spend 50% of the time on appropriate exercises to you. Worse, if you're trying to work on strengthening some specific muscles, doing something strenuous like a boot camp might just overwhelm your body.

Back to the PT and exercises, I'm not going to lie to you. They're boring, and for a number of exercises with the reps, holds and slow downs (I.E. one leg calf extension; for each leg extend to full height, then over a slow count of 10 descend to your heel on the ground. 10 reps per leg per set, 3 sets per night. That's 600 seconds of descent, not including minimal time between reps, or the time for the lift, or the time to rearrange yourself between sets. Realistically that was 14 minutes of calf raises.), they're going to take a while. So schedule your time; this is your class. 40 minutes of strength training per night (or whatever your PT recommends for you).

As I think on this, I think that signing up for anything new would be a distraction that you might make as an excuse to not do your exercises. And given that you won't have a class fully designed for you and your current needs, you have to cut that shit out until you're better. Your new class is the work your PT assigns, and you need to tell yourself that if you want to not be in pain you need to do it.

(after ~6-8 weeks my IT band pain went away and after another 4-6 weeks I was running the same distance before I got hurt. Currently my weekly mileage is 50% greater, and I feel so much stronger. I'm not longer seeing my PT, but I've continued with simple leg/hip/core exercises and I really wish that I'd started this as soon as I'd started running)
posted by nobeagle at 7:03 AM on June 29, 2015

Response by poster: OP here. I'm following up to favorite the recommendation for barre - thank you! I've started the classes 3 times a week and it's going great. It's not too much for me, and I feel a difference already after only a few classes. I know I have a long way to go, but it's a great strength-based low-impact workout.

To reply to nobeagle's good point about making the P.T.'s exercises my "new class" - I have 3 exercises, twice a day, which take about 15 minutes to do. This is simply not enough exercise for me, as I sit 9 hours a day in a desk job give or take an hour for lunch and breaks. I've completed them as instructed and I don't treat the barre class as a substitution. Actually my PT agreed that I need to do more, not just what he assigned, and was fully on board with yoga, pilates, whatever I wanted to do (minus running of course.) So yeah, I can see your point, but stretching a couple times a day just doesn't do it for me. I need a real workout : )
posted by onecircleaday at 4:31 PM on July 5, 2015