So, to begin, low back pain is caused by as I stated occurred to me the piriformis being inflamed causing sciatica. Now the other issue that arises is that there is a weakness in the core musculature that causes the other muscles to over compensate. The original injury may stem from Gluteus Medius weakness or tightness. The over active muscles are the hip flexors, erector spinae and the latissimus dorsi. But aside from the NASM definition of Anterior pelvic tilt problems and the lordosis, we need to find a corrective exercise plan for the client. I would work on strengthening the Abs without involving the hip flexors, because the hip flexors can be overly dominate and cause more pain.
To develop a treatment exercise plan for the individual we need to focus of the core, issues that arise in the core often cause these problems. The lower portion of the core is the Gluteus Medius and Gluteus Maximus, weakness in this region causes over compensation and low back pain. If we go with straight squats we may increase strength, but not every client is going to be able to perform this off the bat. So, I would stretch out the client whether it be through foam rolling or dynamic warm-ups. I would use body weight air squats to start off with the workout, if the client can’t perform this comfortably. I would use a exercise ball against the wall to make the squat easier.
My goal for the client would be to build strength is all of his glute muscles, thus fixing his glute stiffness. Then working on things such as hip thrusters to correct the anterior pelvic tilt. I would incorporate flexibility exercises to lengthen the muscles and fix the length tension relationships. I would use this guideline for correcting the pain and weakness before transitioning him into heavier workloads. As we discussed, dependent upon his strength and improvements I would add or change variables. Things such as bosu balls and exercise balls can create better stability and fix the core strength.