Fitness Trainer Magazine

Fitness Trainer March/April 2017

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Page 65 of 67

Physical Therapy Management Treatment is almost always nonoperative for both types of bursitis. Acute manage- ment consists of rest, ice, and NSAIDs. The goal of physical therapy for both types is to decrease inflammation initially, then restore mobility, followed with stretching to restore full range of motion. Strengthen- ing focuses on targeting the weaker glute medius and glute minimus muscles (clam shells exercise figure 1). Ready for Training, Program Design Once discharged from physi- cal therapy, transitioning to the gym should be simple, and based on science, not guessing. It's important for the fitness professional to really listen to the client, paying attention to response to exercise and to gradually return the client to 'preinjury' level, slowly. The focus on post rehabilita- tion training is to continue to stretch hip flexors, ITB and quadriceps muscles. Strength- ening weak lateral stabilizers (glute medius and glute mini- mus) through diagonal hip ab- duction exercise, will decrease direct load to bursa in hip. Ultimately integrating travel- ing lunges, with progression to forward lunges with medicine ball trunk rotation, challenges core and trunk muscles. Lower body exercises that are safe based on biome- chanics include: • Horizontal leg press machine • Seated leg curls and leg Figure 1. Clam shell exercise Ask the Physical Therapist

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