Meet Valerie. She’s a 41-year-old mother of a 7-year-old son, who used to work as a dental hygienist.

               Valerie used to be very active, exercising 5 days a week for over a decade, until December 2020. She was diagnosed with hip impingement, and all her activity was quickly halted, and her condition had quickly deteriorated, to the point where she was bed-bound for a ton of the time, popping pain killers, and even using a cane to walk.

               Eventually, she started working with us, and in 3 short months, she’s seen a dramatic turnaround. From no longer using the cane, to stopping the painkillers, to regaining lost function, and along the way, losing 8-9 pounds. How did she do it?

               That’s what we’ll cover in this article. We’ll address:

  • Valerie’s situation, and how she went from fit and exercising 5 days per week, to bedridden and in pain for a lot of the time.
  • What she’s tried in the past to help her get rid of the pain
  • What her trainer, Davin learned about her during their initial assessment
  • The exercise strategies that Davin used to restore her function, get rid of the pain and painkillers, as well as the thought process behind them
  • The results she’s achieved
  • The challenges she’s experienced along the way
  • How her life is different now that she’s nearly completely pain-free, more toned, and 8-9 pounds lighter

If you’d like to hear Valerie tell her own story, you can check out her case study in the video below:

And if you or a loved one is in a similar situation to Valerie, we have a special program called “Rapid Rehab.” If you want to see whether this program is for you, just email me with the words “Rapid Rehab” in the subject line.

Valerie’s Situation

               Most of her life, Valerie was a pretty fit person, and exercised 5 days per week for over a decade before her issues afflicted her.

               Then, in December 2020, she was diagnosed with hip impingement. What’s hip impingement? It’s “simply” when the head of the thigh bone (the femur) pinches into the hip socket (the acetabulum). If left there long enough, it can grind away the cartilage, and lead to hip arthritis. You can see a picture of this here.

               Usually, hip impingement is not that big of a deal, and is simple to deal with. But Valerie’s case wasn’t usual.

               Over time, Valerie’s hip got so bad, she completely stopped exercising. From 5 days a week, to 0. Just the thought of exercising made her hip hurt.

               As she stopped exercising, of course, she got weaker. As she got weaker, her hip started hurting even more. After some more time, the back started to hurt as well.

               She got to a point where even just lying down was painful, and she described the pain as a 10/10. Really, really bad.

               She started using a cane to walk, and taking 4-5 painkillers per day.

               She went for an MRI, which showed a whole gamut of things:

  • Degenerative disc disease (DDD) – that’s spinal arthritis
  • Disc herniations
  • Disc bulges

…basically, things you hope not to have. So things were looking pretty bad.

This whole situation went on for 6-8 months.

What Valerie has Tried in the Past

               When the pain is that debilitating, you definitely feel a sense of urgency to feel better as fast as possible. And Valerie was very proactive about her recovery… even though unfortunately, much of it had no effect.

               Here’s what she’s tried to help with the pain:

  • Steroid injections into her spine – but those didn’t achieve any pain reduction
  • Medications – both over the counter, and some heavy-duty prescription painkillers. They worked for a few hours, but just blocked the pain – didn’t fix the problem.
  • Massage therapy – same as painkillers: temporary symptomatic relief (for a few hours), but didn’t fix the real issue, and it would always return.
  • Physiotherapy. She went to one physiotherapist, but it didn’t do anything. She went to a second physiotherapist, and that was a bit better, but not quite as good as she’d hoped. She was going 2-3 times per week for 6 months, and only saw a 30% improvement.
  • Chiropractic decompression – didn’t have much of an effect
  • Exercises on her own, at home: she didn’t really know what she was doing, so those weren’t effective.

It got so bad that she was at her wits’ end, and was even considering surgery. But before she went there, she posted on a Facebook group about her situation, and someone in the group recommended my team and I.

At first, Valerie was a bit put off, because in her mind, “personal trainer” meant someone who made the fit well… fitter. Not someone who helped with rehab. And that may be the case for the average trainer, but if I may toot our horn for a bit, I’d like to think of ourselves as a bit better than average. We have a long list of clients who went through our Rapid Rehab program, and avoided or delayed surgery, got off painkillers, and more. Clients like, Pat, Carole, Jaime, and others.

So Valerie put her skepticism to the side, and contacted me. After chatting with her, I decided to set her up with one of my team members, Davin, to do some online personal training.

Valerie’s Initial Assessment

               As I always say, “if you’re not assessing, you are guessing.” And as I talk about in my articles on back pain, and knee pain, you can’t give a generic set of exercises. Why? Because pain is a symptom – not a diagnosis. There are a million different things that can cause pain in the knee or hip or anywhere, and approaches that may be good for some of these problems may be bad for other problems.

               Hence the need for assessments, to figure out the cause of the pain. Once we have some precise data, we’re able to be precise with our exercise prescription. No assessment, no precision. So that’s where Davin started with Valerie – with an assessment.

               Davin ran a bunch of range of motion tests with her, and while many ranges were good, here are a few that stood out to him as having an opportunity for improvement:

  • Deep squat attempt: foggedabout it (that’s “forget about it” with an Italian accent). Valerie wasn’t having it.
  • Glute bridge: to test for hip extension range of motion and glute strength. Not good.
  • Cook hip lift: another test for hip extension, and hip stability. Impossible for Valerie.
  • Cobra extension: to test both the flexibility of her abdominals, and the strength of her back. Not too bad, but didn’t go as high as Davin would have wanted.

Davin’s conclusions:

  • Valerie had weak glutes, hamstrings, and spinal erectors (the long muscles that run along the spine)
  • She had poor coordination. Makes sense, because in cases of chronic pain, the brain “blurs” the map of the body, so you lose a sense of your body’s position in space.

After the assessment, Davin was ready to put together Valerie’s program.

Valerie’s Exercise Program, and the Results She’s Achieved

               The assessment made it clear to Davin that one of Valerie’s biggest weaknesses were her “backside” – her glutes, hamstrings and lower back. So that’s what they went after in terms of strengthening.

               But what kinds of exercises do you give to someone who’s in extreme pain, all the time? Davin started Valerie off with floor exercises. Not intimidating, and not difficult. But challenging enough for someone in Valerie’s situation.

               Valerie’s first workout looked like this:

Prone cobra extensions – 3 sets of 10 reps (bodyweight)

Supine hamstring curls – 3 sets of 12

Supine hip thrusts – 3 sets of 15

Side lying abduction – 2 sets of 30 seconds per leg

Yes, just 4 exercises. But if you just look at the exercises, you miss the “secret sauce.” There was A LOT of talking during their sessions. What were they talking about? First, Davin explained to Valerie where her pain was coming from, and a lot of the talking was basically to calm her down, explaining that these exercises won’t damage her. They had to distinguish between the discomfort of exertion, and the pain of injury.

Why was the talking such a crucial part of Valerie’s program? I mean isn’t it enough to just do the exercises without understanding the reasons behind them? Not for someone in chronic pain. As I talked about in my article on pain, a lot of pain is in your head, and knowledge of pain can change your pain. That’s not to say that Valerie’s hip and back pain weren’t real – they were. But the brain contributes just as much to the pain as the hip and back. So it was important not to neglect a whole 50% of the pain.

Valerie was training with Davin twice per week, but in addition to that, Davin gave her homework to do on her own once per week. Plus, some optional homework that was under 10 minutes an additional 2 days per week.

One of the hallmarks of our Rapid Rehab program is frequency – the more you do it, the faster you make progress. It’s a very different mentality than strength training. With strength training, you want to push your muscles close to the edge, fairly infrequently (2-4 times per week). With Rapid Rehab, that’s not the case. You want to give just enough stimulus to make some progress. But you want to do it often. More often than strength training.

However, the program didn’t stop there. An exercise program shouldn’t be static – you shouldn’t repeat your day 1 workout after 2 or 3 weeks. The program should evolve as the person’s body evolves.

And as Valerie’s body became stronger and more resilient, Davin was able to progress her program.

After about 2 weeks, Valerie was ready for the next phase.

But how did Davin know that she was ready? It wasn’t just because they were bored, and it was “time to mix it up.” It wasn’t just an arbitrary “well, it’s been 2 weeks, time for a change.” No. I believe that every part of an exercise program needs to be justified (including the exercises, the sets, the reps, the frequency, the order, etc.). That means the progression as well.

So how did Davin know that it was time to progress? By the improvement in Valerie’s number of reps, body control, range of motion, and weight.

So what was the next phase? Standing exercises.

Now, they started to incorporate:

  • Goblet squats (10 pounds, 3 sets of 15 reps),
  • Biceps curls (3 sets of 12 reps with 10 lbs.)
  • Overhead press (3 sets of 16 reps with 5 lbs. per side)

Why did Davin add upper body exercises for hip and lower back pain? Because by the 2-week mark, Valerie was so surprised that there were actual motions she could do pain-free, she wanted to open up her range of exercises, and now, in addition to just pain relief also wanted to get toned.

By about 3 weeks in, Valerie was doing deadlifts for the very first time. Yes, there were significant modifications that Davin made, like:

  • The weight was super light – just 3 lbs. per hand
  • The range of motion was super limited. Just to slightly above the knees, and that’s it.

Fast forward to now, and she’s lifting a total of 75 pounds, and her range of motion is better. Not full range yet, but she’s lowering it to about 5 inches below her knees.

Another big win: the test she had horribly failed during her assessment – the squat. After about 2.5 months, she was squatting pain-free, and 3 months in, she’s squatting pain-free, with great range of motion, and an additional 30 lbs., for 12 reps.

Valerie’s Challenges Along the Way

               Progress is rarely a straight line upward and forward. Sometimes (OK, almost always) there are challenges along the way. And that was certainly the case for her, and that’s normal.

               The first challenge was before she even got started. The fear of exercise making her pain worse. She got over that one after both reading case studies in my newsletter of other clients who were in pain, and now aren’t. It also helped to have the initial assessment with Davin.

               The next challenge was squatting. Yes, she couldn’t do it initially, but even after a few weeks, when she was ready for it, she could now squat, but it wasn’t pain-free yet.

               Knowing that Valerie had a vacation coming up in a few weeks, Davin decided to not push things, and switch from squats to lunges. Of her own volition, Valerie decided to try a squat while on vacation. Not only was that her first pain-free squat in over a year, it was also done with really good range of motion.

               Another interesting challenge that occurred was her knee. As her back felt better and better, she started to develop some “phantom-like” pains in her knees. The reason I say “phantom-like” is because there was no mechanical reason for the pains. To alleviate that, Davin kept hammering the point home about safety. Again, the brain may localize pain to a specific joint if it feels unsafe… even if there’s nothing mechanically wrong with the joint. The technical term for it is “non-nociceptive pain.” So having the peace of mind that what she’s doing is safe made her knee pain go away… without doing anything directly for the knees.

How Her Life is Different Now That She’s Almost Pain-Free

               Now you know the program that Davin put Valerie on, but what were the bottom-line results that she was able to achieve? After all, she didn’t sign up for personal training to improve her biceps curls from 10 to 12 pounds. She wanted her pain to go away, and all the effects that were associated with it.

               She talks about her results with elation at about 5:51 of her video. In her own words, she was “blown away” by the results.

  • Before she started working with us, she had to organize her schedule around 1 activity per day. So just grocery shopping, or just laundry. Because even just that 1 simple activity would put her in so much pain, she had to lie down for an hour. Now, she can pretty much do anything she wants. Her limitation is no longer pain or energy levels. Her limitation is now just how many hours there are in the day.
  • When she would make dinner before, she would have to mentally brace for it. From the cooking, to the cleaning, etc. Now – she just does it. It’s not a big event in her mind.
  • She has a 7-year-old son. Forget about playing with him while she was in pain. Now, she can.
  • Before, she couldn’t even bend down to tie her shoes. Now she can.
  • Her worst pain level now is only a 1/10… occasionally. Before, it was 10/10… all the time.
  • She went from using 4-5 painkillers per day to now, almost never.
  • She hasn’t been to physiotherapy in over a month…. And feels just fine.
  • A huge win – she went on a vacation during March break. That’s something that was completely unthinkable to her while she was in pain. During her vacation, she did whatever she wanted, without limitations, and was able to enjoy it.
  • Because of her improvements, she can move more, and is down 8-9 pounds.
  • Her clothes fit better.
  • She now loves looking in the mirror.
  • At 9:45 of her video, she mentions how strong and tight her core is – something she couldn’t achieve on her own, even before the injury, despite exercising 5 days per week for 10 years.

Overall, we’re very proud of Valerie and the progress she’s achieved, as well as how much better her life is now that she’s almost pain-free.

If you have certain pains that the traditional approaches haven’t been able to solve, we have a special program called “Rapid Rehab.” If you want to see whether you qualify for that program, just email me with the subject line “Rapid Rehab.”