I have a client who has been told by his physiotherapist he has an arthritic hip. His movement is very restricted. He has therefore been advised to avoid running and any weight bearing exercise but to strengthen his glutes and the muscles supporting his hip. The physio has recommended the disc loaded leg press with a short range of motion - what other exercises would you recommend? A squat and a lunge are out of the question. Would a deadlift and straight legged deadlift be classed as weight bearing? Would you advocate the use of machines like the abductor?
Thanks for your question! Please understand what I’m about to state in no way should go against your client's doctors advice! However, your client’s current protocol will most likely not assist him to the degree that a “functional approach” will. First, function should be defined as your client's desired needs. In other words, its individually based and should be viewed as an outcome (what you're trying to achieve). To achieve a functional outcome (walking better, lifting, carrying, bending, etc), your client's program should be based on principles and concepts that relate to everyday life such as:
- Ground reaction forces
- Three dimensional movement
- Varying speeds of contraction
- Subconscious movement control
By placing your client in a machine, you do not apply any of the above life principles that we all deal with each day. Remember, your client most likely walked in to see you and therefore walks (at some level). Your client most likely steps down stairs, lunges to pick up objects, bends to sit and stand; therefore, he is already applying the principles stated above (Note: Squats and lunges are simply names placed on movements – squatting is also sitting, lunging is also walking). Your job is to improve his ability to do what he’s already doing. If you apply one-dimensional training in an artificial environment, you will make muscles stronger on the machine - not the movements of life.
Please review Paul Chek’s articles as well as Gary Gray's on functional movement. These articles on the site will give great insight to the various exercises that will benefit your client without injuring his already damaged hip. As always, an assessment (not protocol) will help you to determine what exercises are best for him.