I start all my groin and low back pain sessions with supine 90/90 diaphragm breathing and slight adductor engagement with a foam ball - 6 inch diameter (think feet on the wall, make a perfect box shape, just enough pressure to not let the ball fall). A lot of times these patients are coming to me in a significant amount of pain and guarding and this intervention allows me to dial their nervous system down so we can really get to work with our later manual therapies and therapeutic exercises!

Love this! I've worked through several lower leg stress injuries over the last year and made tibial internal rotation and great toe work a huge component of their care plans. One pearl I recommend, especially for my volleyball girls jumping all of the time, is looking at functional movements like the squat and lunge in both static and dynamic movements. I'll usually see one of two things: 1) Feet spin out to compensate for a lack of tib IR or 2) Perfect squats, but as soon as they go to jump, feet roll into pronation and rearfoot eversion and knees collapse in. These gives me pretty good feedback on what to target in our sessions, whether it's deceleration strategies, reactivity, foot and ankle stiffness, or mobility. Since this is one of my more common injuries, I'm thinking about how I can incorporate this into a pre-season movement screen if anyone has any recommendations for how to systematically evaluate this? Thanks in advance!