Ask Coach E
Episode 17

Welcome message from Coach E 

Hi Coach,

I’m currently rehabbing SI joint pain and following Dr. Ryan Peebles DPT’s CBT program (“Core Balance Training”). The rehab protocol advises avoiding asymmetrical exercises (side-to-side / single-side loading) for now until I build more stability, and focusing mainly on symmetrical forward/backward movements first.

I joined your program mainly for shoulder recovery and added thoracic spine + neck as extra focus areas. I really like the program and the daily exercise selection, but some exercises (eg side planks) seem to conflict with my rehab restrictions.

For context:

- Shoulder pain started ~9 months ago from years of desk work + being postmenopausal for 6 years (surgical menopause).
- Pain is much better now — currently around 4/10 vs 9/10 about 4 months ago.
- Neck + thoracic spine weakness/stiffness likely come from long-term posture issues and excessive sitting.
- My posture is much better now (when standing against a wall I have good 4-point contact), but some old imbalances remain, eg right shoulder still slightly rounds forward.
- I had a thoracic herniated disc ~7 years ago with severe pain for ~3 months, but no major pain there for the last few years.

What would you recommend?

* Skip asymmetrical exercises for now?
* Replace thoracic spine with hips/pelvis instead?
* Or reduce focus areas and do shoulders only for now?

I don’t have neck pain, but it clicks daily and feels unstable. Thoracic spine also isn’t painful, just feels weak with lots of clicking/repositioning sensations when lying on the floor.

Would really appreciate your advice 🙏

Hi Coach E,

I'd like to build a lifelong body maintenance plan that combines: strength training, cardiovascular conditioning, mobility, and long-term joint resilience.

Since 2020, I’ve been dealing with persistent tennis elbow pain that repeatedly interrupts my training consistency and long-term progress.

In January 2024, I discovered Precision Movement and immediately started the Elbow and Wrist Pain Solution program. Since then, I’ve been consistently working through the rehabilitation process.

At this point, I can complete the Foundation 1 phase without literally any pain. But every time I begin progressing into Foundation 2, something seems to flare the elbow up again before I can reach the Resilience phase. I’d rate the pain around 5 out of 10, tops.
I strongly suspect the brachialis curls and tricep pressdown exercises may be triggers. More generally, movements involving pushing, pulling, gripping, or arm stabilization still seem poorly tolerated - as do typing, playing the piano, and repetitive movements like slicing vegetables. Pull-ups, push-ups, and wall presses can all become problematic very quickly, even though I weigh less than 50 kg.

The frustrating part is that this creates a repeating cycle: I regain consistency, build momentum, start progressing again, then overload the elbow and end up needing to back off.

Because of this, my focus has shifted away from chasing performance and toward creating a long-term system I can sustain for decades. I've never given up the EWPS program. I completed the Foundation for Movement Longevity program a year ago, which helped shape how I think about sustainable movement and physical maintenance.

But is there any way for me to progress to a higher level?

Thank you for your mission.
Judit

After a couple of weeks walking on the treadmill using an incline of 4 to 6 I started to feel discomfort in the hip/buttocks area. What could be the cause and which program should I follow?

Thanks in advance.

What lumbar support do you recommend for the car and for the office.

I have had peroneal tendonitis pain on my right foot since August 2025. In February 2026, I did several sessions with the DPT who did active release therapy. This helped but I can still only wear sneakers. If I wear any other shoes for half a day I am in extreme pain. Is there any way to know if I have a tear in the tendon without an x-ray? I started ROM premium Foot and ankle exercises on 5/15/2026

I’ve fallen while driving an ebike and fractured my outer tibea on the plateau for weeks ago .I’ve been using a removable brace so am now doing some simple exercises when sitting to keep circulation going. I started with calf pumps and then tried doing the two suggested for knee pain.I notice that bending past 40 degrees feels really tight both under the knee and above. My appointment to see an orthopaedic specialist won’t happen soon so I’m wondering how much bending motion I should be doing. Thé injury happened when the lower right leg was twisted ninety degrees to the left so there are tendons and ligaments that really stretched. I’m very flexible so it likely saved me from a bigger break. I’m hoping to not lose to much muscle as I’ve only got two more weeks before I’m allowed weight bearing. But I’m noticing swelling in the top of the knee which is more apparent than on the other knee. Should I postpone any bending until an mri ( which may or may not happen)and what signs do I look for that tendons are injured ? I’ve been appreciative of all your evolving support measures for several years and until this injury was making good progress with keeping moving despite arthritic hip.

Is there a barefoot shoe you recommend?

Hello. I love your programs and your overall approach to health and fitness. Thank you for that. I am hoping you can help me with pain in my side/hip area (I don't actually think it's my hip) that has been an ongoing battle for more than 5 years. I am a 56 year old female. I run 3 days a week and do strength training 2-3 days a week. When the pain started, I was running 2 marathons a year. My last marathon was in October 2019. Since then, my runs have been 3-8 miles.

My pain has been almost always at night. I would lay on one side until the pain woke me up then on the other side, going back and forth all night. There was so much pain (level 7-8 out of 10) that I couldn't pinpoint where the pain was coming from. I tried to take a break from running but that made it much worse. It got so bad that I went for a short run one day to get relief. I rarely have pain when I am running or during the day when I am moving around so there is no cause and effect relationship to tell me what activities were problematic. The pain seemed to come around as my muscles tightened up. It seems that sitting in a car, going up stairs, doing squats or lunges, hip hikes, running uphill, and core strenghth exercises that require me to hold my legs up or lift them to the side are triggers. When I massage the area with a lacrosse ball against the wall, there is a very painful spot just below my iliac crest.

I have been to chiropractors, orthopaedic doctors, accupuncture treatments, laser treatments, massage, and multiple physical therapists, each with a different theory on the source of my pain - hips, lower back issues, "dead butt syndrome" (inactive glutes), labral tear, TFL, psoas, and hip flexor. Your TFL program was the first thing that got rid of my pain but as soon as I tried to ease back into the triggering activities, the pain came back. I recently tried the Hip Pain Solutions program but, unlike the TFL program, it made things worse. I got to Hip Foundations 1B then had to stop. I think it was the side-lying hip abduction that was a problem since I could feel some strain when doing it.

Imaging showed no arthritis but I have labral tears on both sides. My most recent PT, who happened to be a pelvic floor specialist, was able to get me pain free again in December but, like with the TFL program, it was temporary. She doesn't think that the labral tears were the problem and doesn't think it was coming from my hip joint based on her strength measurements and the hands on therapies that provided relief. As the pain started creeping back, I was able to pay more attention to where it started. It seems to start with soreness along my side in my glutes. As it gets worse, I start to feel it through my hip, hip flexor or psoas, and into my thigh. Recently, it seems to be mostly on my left side (pain level 3-5). My right side has been holding up pretty well (pain level 2-3 and much less frequent). I had a cortisone shot in my hip joint two weeks ago that did nothing.

Should I repeat the TFL program to get back to being pain free? What do you recommend for long term relief and returning to full training (hill running, lower body strength training) without the pain returning?

I will complete my third round of the Strong For Life Program this week. I am very pleased with the results I have seen over the past 15 months. I have never stuck with a strength training program as I have SFL. I was terrified of injuring myself when I began ( I'm 75) and I made lots of modifications. It was gratifying to see the progress I had made when I began round 2. I saw lots of improvement in functional movements. I don't want to lose these gains, but after 3 rounds, I am a bit bored with the program and just need a change. What can I do so I won't lose my strength gains? I plan to go back to the program, but just need a break without losing my gains. What do you think of routines that use straps like TRX?

Any suggestions would be appreciated.

Would you recommend using a lumbar support when sitting in an office chair or in the car, and if so, what do you recommend?

I obtained a level 2 injury in my right piriformis muscle after playing racquetball in April of 2025. (I have played racquetball for 45 years and still play twice a week.)I may have had hip osteoarthritis as well but didn’t get an X-ray with diagnosis of moderate right hip osteoarthritis and minor left hip osteoarthritis in March 2026 after completing all phases of the HPS with average pain remaining around 3.5 of 10.

I purchased the HPS with ROM Coach premium May 2025 and began doing the HPS pain reduction ASMR immediately. I continued with racquetball as soon as my pain went down after a couple weeks of ASMR exercises. I started HPS foundation exercises in late May but progress was very slow due to hypothyroidism (diagnosed August 2025) and successfully resolved November 2025. I completed both foundation phases in December with 3/10 remaining pain. I pushed through the two resiliency phases before going to the doctor for X-Rays due to pain not fully resolving.

After receiving the hip osteoarthritis diagnosis I went to a chiropractor and to a massage therapist and discovered I had instability in my right hip. I went back to the HPS and repeated only hip stability exercises in the two foundation phases. This has helped significantly with my pain reducing to about 2/10 on average and sometimes 0/10 on good days!

I will finish repeating the HPS Sustaining exercises this week and I’m wondering what to do next. Can I expect my pain to fully resolve? Should I do certain exercises to maintain what I have already accomplished? I’m very happy with the results so far and I’m able to play racquetball twice a week, HPS and Daily Tuneups six days a week, mow the yard and other outside chores 2-4 times a week plus playing with grandkids! I jogged slowly to the car on a rainy day with minimal discomfort. Also can climb ladders as needed with extra caution so as not to slip or fall. My mobility is above 90% on both sides but right side pain and stiffness can flare up when overdoing it. My glutes are much stronger but still have some muscle tightness after racquetball and exercise usually in hip flexors, quads and piriformis. This usually resolves after using the pain killers exercises.

Hi Coach E - I was diagnosed with piriformis and gluteus medius syndrome at the San Diego Running & Sports Injury clinic. It has been pretty debilitating (struggling to stand on one foot to put clothes on / can’t run long distances without it flaring up). It’s unfortunate as otherwise I’m in great shape and former athlete. My question is what 3 exercises or stretches would you most recommend to directly target those issues? I’ve heard both stretching and strengthening those areas are equally as important

Video Mentioned Your Piriformis Isn't Tight, it's WEAK! [4 Exercises to Get it Strong]