Prehab edition

Here's this week's round up of your questions! If you want to submit your question, you can do so here:

What kind of things should I do to help strengthen my wrists and ankles?

So essentially with these, you're going to strengthen the muscles around them or those that impact how that joint moves. So basically, for the ankle, you want to strengthen the foot and calf, but also the hip. For the wrist, you want to strengthen your grip/forearm muscles, but also the shoulder.

I do have the foot and ankle prehab program in the app as well as a follow along wrist prep program, that's great for building strength and mobility of the wrists for weight bearing activities like handstands!

Or, if you're looking for some free resources, you can check out my youtube channel. I have a lower body workout with a foot/ankle focus here and an educational video on wrist discomfort here that includes some exercises!

I recently had a stronger case of lumbago, got 3 shots. Can I still safely do the pistol program?

This would probably be more of an individual basis. But it partly depends on what bothered the back, how you're currently moving, your previous training, etc.

A lot of times with an injection it's a corticosteroid injection (although there are other types too, so I'm making assumptions here), which help with inflammation and can reduce some pain. BUT, what they don't do, is actually address the cause of the issue and why it happened in the first place.

I'd probably recommend starting with an individualized program to make sure you're moving well first and appropriately build back to a certain level of strength before progressing to the pistol squat program.

That being said, it may be okay to safely do, but it's impossible for me to say without seeing how you're moving/some additional info! But generally speaking if it is painful with anything, you should modify or if you're sore for >2 days, reduce the intensity until your body is able to adapt to the new stimulus.

When I run my L foot’s lateral arch aches. Does that improve with time?

There are TONS of things that can contribute to this, so it does depend on what structure is involved.

In this video, we talk more about the lateral ankle, but some of these can contribute to the lateral foot too.

It could also be impacted by the type of shoe that you wear or where/how you strike the ground while your running, so it's possible it may be a repetitive stress injury in the making. Typically, you may want to listen to your body as it may be telling you something - either you increased running volume too quickly or made another change too quickly, or don't have the pre-requisites for that activity quite yet (ex. strength, endurance).

I do have a foot and ankle prehab program in the app that may be helpful, but it's hard to say what specifically may be happening, so if you're unsure, an individualized program may be a better route to go!

Best stretch for the psoas. Do you have any great stretches for really tight hip flexors?

I actually made a post on this I want to say in December over on IG about some principles/options for you!

Overall, there isn't one "best" stretch, but because the psoas does hip flexion (bringing the knee to your chest) and can assist with external rotation (twisting the knee outward), so doing the opposite motions will provide a stretch - aka anything going into extension will stretch this (as hip flexion is the main action).

Simple workout for moms of littles who want to get fit after baby?

First of all, it's important to consider how crazy life can be during this time so workouts that can be done quickly, possibly with a child around or with minimal assistance is helpful.

Understanding core control is also super important as with pregnancy and delivery your abdominals and pelvic floor are stretched significantly so you need to retrain these for optimal function. I do have a core control mini training series in my app that goes over this, granted, I don't personally have a program for postpartum currently (although it's on the list). So if you want to work with me, I'd probably recommend an individualized program, BUT, my amazing friend and colleague, Dr. Meghan, has a program called Barbell Before Baby that can be modified to any stage (pre-pregnancy, pregnancy, or postpartum) and she does an amazing job ad educating on core control as well (in fact, one of the mini core control trainings in the app is something we filmed together)!

I may have a herniated disk, MRI scheduled. What future exercises do I do for prevention

First, granted, I'm assuming since you're asking this, I'm assuming this is symptomatic for you, but I still feel like this is important to say:

Just because you may have a herniated disc on your MRI doesn't mean it was or wasn't there before your symptoms. And just because you have a herniated disc doesn't mean it is symptomatic.

A high quality study of over 3000 asymptomatic individuals (aka they didn't have any pain) showed that a lot of them have abnormal findings on an MRI.

So what the table shows is that 52% of 30 year olds without pain have some sort of disc degeneration, 40% of them have a disk bulge, 31% have a disc herniation and this increases with every decade of life.

Keep in mind a disc protrusion/bulge are forms of a herniated disc and an annular fissure can increase the risk of a herniated disc (the annulus fibrosis is essentially a fibrocartilagenous ring that surrounds the nucleus pulposus and the nucleus pulposus is what protrudes/bulges/herniates). These words sound super scary, but basically all this is saying is that all these things can be normal and asymptomatic.

Literally, the conclusion of the systematic review (aka high quality study cause it's looking at a ton of other studies) states "many imaging-based degenerative features are likely part of normal aging and unassociated with pain."

For things to consider to reduce the likelihood of it happening again, that would be:

• Moving well - aka how are your fundamental movement patterns (squat, lunge, hinge, etc.)? How is sequencing of firing of muscle groups (ex. when you're laying on your stomach and lifting your leg, does your low back fire first to stabilize, then your glute, then your hamstring? or does the hamstring and low back take over for the glutes)? *sorry, I know this is vague, but it truly depends!
• Understanding proper core control - you can do this in my core control training series in my app!
• Balance of strength and mobility in different joints/muscle groups - remember it's not just your spine, but your hips, shoulders, and even your feet can impact the low back

The exercises would partly depend on how you're moving and what deficits are noted with a movement screen. For example, how is the motion through the back in different planes, how is the motion through the hips in all different directions, what does your squat and hinge patterns look like, do you have full overhead shoulder motion (and is that relevant based on what you do in life or training)? If you'd like to get an individualized training program taking all these things into consideration to learn more what your body could benefit from, check out more info on that below!

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That's it for this week! If you have any questions to clarify my answers or found it super helpful, go ahead and hit that reply button!

Don't forget you can ask your questions below to be featured in an upcoming email!

Best, Laura Kummerle No one is perfect, and that in itself, is perfect!

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