John's Physical Therapy

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Raw STATUS.md

# John's Physical Therapy

**Goal:** Run pain-free  
**PT Frequency:** Every 1-2 weeks  
**Exercise Tracking:** John uses a separate app — Minna provides context, not tracking  
**Status:** Active treatment

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## Key Deficits (MSK Assessment)

| Area | Finding | Priority |
|------|---------|----------|
| L Hip Internal Rotation | Severely limited (L: 5°, R: 20°) with signs of FAI | HIGH |
| Psoas | R>L guarding and fibrosis | HIGH |
| L Gluteus Medius | Weakness asymmetry | HIGH |
| Quadriceps | L>R tightness | MEDIUM |
| Intrinsic Foot Control | Poor bilaterally (toe yoga unable) | MEDIUM |
| Tibialis Posterior | Mild insufficiency on L (rearfoot pronation) | MEDIUM |
| Proprioception | Mild deficits (moderate sway, single leg eyes closed) | LOW |
| Upper Trunk Torsion | Poor rotational control | LOW |

---

## Running Form Issues

| Issue | Impact |
|-------|--------|
| Scissoring gait | Foot crosses midline during swing |
| Excessive ankle pronation | >10°, continues past midstance |
| Limited hip ER | From mid to terminal stance during knee extension |
| R pelvic drop | During L leg loading phase |
| Overstriding | Low cadence, initial contact in front of body |
| Upper trunk rotation | Slight, contributes to inefficiency |

**Root cause pattern:** Overstriding + L hip loading dysfunction → increased vertical displacement, ground reaction force, decreased pre-strike glute activity

---

## What Minna Should Know

- John is actively running (not paused for PT)
- Don't nag about exercises — he tracks separately
- If John mentions hip pain, posterior aching, or running discomfort, this context is relevant
- L hip internal rotation and gluteus medius are the primary mechanical issues
- The goal is pain-free running, not performance optimization

---

## Home Exercise Program (HEP)

From Mark Craig-Jones @ Pipeline Physical Therapy — updated 2026-02-06.  
Access code: `85e-063764` | Portal: https://portal.strivehub.com/

| Exercise | Sets × Reps | Notes |
|----------|------------|-------|
| Shin Boxes | 2×15 | Floor rotation drill |
| Prone Hip Extension (knee bent) | 3×10 | Softball/ball against psoas, push pressure as you lift |
| Hover Fire Hydrants | 3×10 | From quadruped hover; CARs — rotate around hip ROM arc |
| Toe Yoga | — | 2-3 min bilateral; alternate big toe vs outer toes |
| Single Leg Heel Raise | 2×20 | On MOBO board; focus rear foot inversion + femoral ER |
| 90/90 Marching in Place | 3×5 | Resistance loop on feet + band in neutral ER; overhead variation; avoid trunk extension |
| Farmer's Carry | 3×10 | High knees, core engaged |

**Email context from Mark (2026-02-09):**
> Symptoms are fairly textbook proximal hamstring tendinopathy based on running form and mechanism.

---

## Documents

- `docs/msk-assessment.pdf` — Full MSK assessment table
- `docs/running-form-analysis.pdf` — Treadmill running form analysis
- `attachments/JG-HEP.pdf` — Home Exercise Program from Pipeline PT (2026-02-06)

---

*Last updated: 2026-02-09*

Last activity: 2026-04-02

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Raw STATUS.md

# John's Physical Therapy **Goal:** Run pain-free **PT Frequency:** Every 1-2 weeks **Exercise Tracking:** John uses a separate app — Minna provides context, not tracking **Status:** Active treatment --- ## Key Deficits (MSK Assessment) | Area | Finding | Priority | |------|---------|----------| | L Hip Internal Rotation | Severely limited (L: 5°, R: 20°) with signs of FAI | HIGH | | Psoas | R>L guarding and fibrosis | HIGH | | L Gluteus Medius | Weakness asymmetry | HIGH | | Quadriceps | L>R tightness | MEDIUM | | Intrinsic Foot Control | Poor bilaterally (toe yoga unable) | MEDIUM | | Tibialis Posterior | Mild insufficiency on L (rearfoot pronation) | MEDIUM | | Proprioception | Mild deficits (moderate sway, single leg eyes closed) | LOW | | Upper Trunk Torsion | Poor rotational control | LOW | --- ## Running Form Issues | Issue | Impact | |-------|--------| | Scissoring gait | Foot crosses midline during swing | | Excessive ankle pronation | >10°, continues past midstance | | Limited hip ER | From mid to terminal stance during knee extension | | R pelvic drop | During L leg loading phase | | Overstriding | Low cadence, initial contact in front of body | | Upper trunk rotation | Slight, contributes to inefficiency | **Root cause pattern:** Overstriding + L hip loading dysfunction → increased vertical displacement, ground reaction force, decreased pre-strike glute activity --- ## What Minna Should Know - John is actively running (not paused for PT) - Don't nag about exercises — he tracks separately - If John mentions hip pain, posterior aching, or running discomfort, this context is relevant - L hip internal rotation and gluteus medius are the primary mechanical issues - The goal is pain-free running, not performance optimization --- ## Home Exercise Program (HEP) From Mark Craig-Jones @ Pipeline Physical Therapy — updated 2026-02-06. Access code: `85e-063764` | Portal: https://portal.strivehub.com/ | Exercise | Sets × Reps | Notes | |----------|------------|-------| | Shin Boxes | 2×15 | Floor rotation drill | | Prone Hip Extension (knee bent) | 3×10 | Softball/ball against psoas, push pressure as you lift | | Hover Fire Hydrants | 3×10 | From quadruped hover; CARs — rotate around hip ROM arc | | Toe Yoga | — | 2-3 min bilateral; alternate big toe vs outer toes | | Single Leg Heel Raise | 2×20 | On MOBO board; focus rear foot inversion + femoral ER | | 90/90 Marching in Place | 3×5 | Resistance loop on feet + band in neutral ER; overhead variation; avoid trunk extension | | Farmer's Carry | 3×10 | High knees, core engaged | **Email context from Mark (2026-02-09):** > Symptoms are fairly textbook proximal hamstring tendinopathy based on running form and mechanism. --- ## Documents - `docs/msk-assessment.pdf` — Full MSK assessment table - `docs/running-form-analysis.pdf` — Treadmill running form analysis - `attachments/JG-HEP.pdf` — Home Exercise Program from Pipeline PT (2026-02-06) --- *Last updated: 2026-02-09*