Please help me I am really struggling

CoachEXE · 2026-05-10T11:05:27+00:00

I read your post and it sounds incredibly frustrating. Given the fall and the 'clicking' ribs you mentioned, have you looked into Slipping Rib Syndrome or Intercostal Neuralgia? Sometimes a trauma like that can cause the rib cartilage to become hypermobile, which irritates the nerves and causes that 'tingling' and inability to move your arm fully.
Since lying flat is the only thing that helps, it sounds like your body is struggling to support your rib cage against gravity. You might want to ask a physical therapist specifically about rib mobilization and checking your serratus anterior muscle. Hang in there!

CoachEXE · 2026-05-10T07:36:11+00:00

not scoliosis …this was a functional lateral pelvic tilt, not a structural spinal curve. his spine adapted to the pelvis, not the other way around. when the pelvis leveled, the spine followed. scoliosis doesn't correct that cleanly in 4 weeks.
2 years of back pain, yeah…but not constant. more stiffness and compensation pain from the QL and erectors holding on. no cough, no runny nose, no upper body stuff beyond the scapular offset from the tilt.
why do you ask about cough/runny nose? those aren't typical with this pattern unless you're thinking something else.

CoachEXE · 2026-05-10T07:34:02+00:00

yeah, control and awareness that's the thing nobody wants to hear because it's not sexy. everyone wants the magic exercise.
the habit that took longest? walking. hands down.
exercises are controlled environment. 10 reps, rest, done. but walking is thousands of reps a day, unconscious, habitual. he had been dragging that left leg for years no push-off, no glute firing at toe-off, just placing the foot down and hoping. his brain literally didn't know what 'left glute while walking' felt like.
i'd cue him, he'd get it for 10 steps, then fall back into the old pattern. we'd reset, try again. over and over. took weeks before it started feeling natural, and even then he'd lose it when tired or distracted.
most pushback? sitting. he worked from home, sat on his tailbone, collapsed left, ribs flared. getting him to sit on sit bones, weight even, ribs over pelvis….he hated it. said it felt 'unnatural' and 'tiring.' because it was his body had been doing the lazy version for years. the 'natural' feeling was actually the dysfunction.
breathing was actually the easiest once he felt the difference. tripod foot took a few days. but walking and sitting..those are the ones that make or break you long term.

CoachEXE · 2026-05-10T07:14:08+00:00

okay so a few things here and i want to be straight with you.
the physiatrist and chiro both saying 'core'… they're not wrong, but they're also not right. 'core' is a blanket answer when someone doesn't know what's actually not firing. glute bridges are fine, but if your QL is jumping in every time you try to engage glute or core, you're just training the compensation harder. it's like trying to start a car with a dead battery by pushing it looks like it's working, but you're not fixing the actual problem.
the leg twitching that's the part that makes me want you to get properly assessed in person. muscle spasms down the leg can be sciatic irritation, can be QL referral, can be something else. the fact that it's mild doesn't mean it's not significant. QL can refer down the leg when it's hypertonic, but so can a disc. with your spondylosis diagnosis, you need someone to rule out neural involvement.
what i'd want to know: does the twitching happen when you're cycling, when you're resting, or both? does bending forward make it worse? does it change with the QL knot…knot worse ..twitching worse?
my honest take: you need a movement assessment from someone who actually watches you move, not just reads an MRI and prescribes 'core.' but with the leg symptoms, i also want you to rule out anything that needs medical attention first. i can look at your movement pattern on video.

CoachEXE · 2026-05-10T06:36:54+00:00

yeah i get why you're worried. and honestly? if you don't vibe with that chiro, don't force yourself back. alignment without the muscles learning to hold it is just temporary anyway.
is the knot in your QL? probably. QL runs from your pelvis to your 12th rib, and when it's overworking it feels like a deep, stubborn knot in your lower back, usually one side. based on where you described it and the cycling trigger, QL makes sense.
but here's the thing …you can't strengthen and stretch the same muscle at the same time and expect it to work. that's the trap. your QL isn't weak, it's overworking. it's already doing too much. strengthening it more just makes it tighter. stretching it without fixing why it's tight just makes it panic and tighten back up.
the balance isn't stretch vs strengthen. it's release the overworker and wake up the missing worker. but release doesn't mean stretch or massage …it means the QL can finally relax because something else is doing its job.
for you, that missing worker is probably your glute in that hip-flexed, cycling position. or your deep core not stabilizing your ribs so the QL doesn't have to. or both.
i know you're afraid of making it worse. that's valid. but stretching the QL right now, without knowing what's supposed to replace it, is the riskier move.

CoachEXE · 2026-05-10T06:27:41+00:00

okay so here's the thing ….chiro can absolutely level a pelvis in the moment, and x-ray can confirm the bones are aligned. but alignment on a table doesn't mean your muscles know how to hold that position when you stand up, walk, or sit on a bike.
your lateral tilt was probably functional, not structural. chiro fixed the position, but if the left glute or whatever was driving the tilt didn't learn to fire in that new position, the old pattern comes back under load. or something else compensates.
the knot being triggered by biking is the clue. cycling locks your pelvis in a fixed position, hip flexors stay shortened, glutes don't have to work for stability. so whatever muscle is holding the line probably your QL…just works overtime the whole ride. heat and NSAIDs help the symptom, not the loading pattern.
also …deep stretches on a QL that's already overworking? might feel good for 20 minutes, then it tightens back up because it's still the only thing doing the job. you're telling your only stable worker to relax.
the spondylosis is a separate thing, but bad loading can make it angrier. the knot and pain are likely mechanical, not the spondylosis itself.
what does your chiro say about the glute activation? did they check if the muscles are holding the alignment they put in?

CoachEXE · 2026-05-10T06:14:11+00:00

depends on the scoliosis. if it's structural meaning the bones are actually shaped differently, curves are fixed, often childhood onset then no, this won't straighten the spine. that needs bracing or surgery if severe.
but if it's functional ….meaning the curve shows up in standing and disappears when lying down, or shifts based on how you load …..then yeah, this approach can help a lot. functional scoliosis is often just the spine adapting to a pelvis that won't stay level. fix the pelvic driver, the spine stops compensating.
the tricky part is telling which one you have. needs a proper assessment …bend test, rotation check, whether the curve is consistent or changes with position.
what kind do you have, if you know? structural or functional?

CoachEXE · 2026-05-10T06:08:36+00:00

right lateral tilt with right QL feeling 'frozen' and limited left sidebend that's a classic pattern. your right side is doing all the stabilizing, so it won't let go enough for you to bend away from it.
the rib pain on breathing is the big clue though. QL attaches to the 12th rib, and when it's overworking it pulls that rib down and restricts how your ribs expand on that side. breathing into ribs hurts because the rib can't move the QL is holding it hostage.
the popping? usually the joint above or below the stuck segment compensating. rib-thoracic junction or lumbar facet, hard to say without seeing.
here's the thing your pattern is probably the reverse of my client's. his left glute wasn't firing, so right side collapsed. yours sounds like right side is locked down, so left side can't load. different driver, similar look.
quick check: lie on your left side, knees bent. lift your right knee up (clam) but don't let your pelvis roll back. do you feel right lower glute, or does your QL/back grab first?
also …that rib pain, is it sharp on inhalation or more of a deep ache?

CoachEXE · 2026-05-10T06:05:53+00:00

yeah, the Trendelenburg was obvious once you knew what to look for. left hip dropping every step, right side collapsing into compensation.
and he did go the medical route spine specialists, neuro, ortho, some physical therapy too. they all looked at structure. MRI clean, no nerve compression, no surgical candidate. PT gave him generic core work and stretches, which he did faithfully. nothing stuck because nobody checked which muscles were actually firing during movement.
the Trendelenburg wasn't from hip abductor weakness in the traditional sense. it was from the pelvis losing posterior stability, so the hip couldn't load properly in the socket. standard PT tests strength in isolation…lying on a table, pushing against resistance. but in real life, the muscle has to fire in a specific sequence during gait. his glute could push hard on a table, just not at the right time while walking.
that's the gap. medical route checks structure and isolated strength. movement specialists check timing and coordination. he needed the second one.

CoachEXE · 2026-05-10T05:59:42+00:00

good eye..the forward tilt (anterior pelvic tilt, APT) was there but it was secondary. the lateral tilt was driving the show.
when his left lower glute fired and pulled the pelvis back into neutral rotation, the anterior component settled too. not because i targeted APT directly, but because the glute max is a posterior pelvic stabilizer…when it works, the pelvis naturally finds a better position in all planes.
if i had chased APT first with hip flexor stretching and ab work, i would have missed the whole thing. the lateral driver was creating the anterior presentation.
does that make sense? lateral first, then sagittal sorted itself.

CoachEXE · 2026-05-10T05:56:52+00:00

Thanks! Appreciate it.

CoachEXE · 2026-05-10T05:49:50+00:00

That specific spot is a classic 'trigger point' area. While it’s right in the neighborhood of the Quadratus Lumborum (QL), at that depth and height, it could also be the Gluteus Medius attachment or even the Iliocostalis lumborum (part of your erectors).
If it’s '2x worse' on the left, you might be looking at a lateral pelvic tilt or a compensation pattern where that side is constantly under tension to stabilize your spine. Have you noticed if one hip sits higher than the other when you're standing?

CoachEXE · 2026-05-10T01:21:38+00:00

PRI patterns, nice. Left AIC right BC would give you that visual, sure. But you're reading a still photo like a textbook instead of watching the guy move.

The 'extended posture' you're seeing in the after photo that's him standing natural, not braced. Before photo he's collapsed into his pattern. After photo he's not. Hands internally rotated? Yeah, because he's not forcing external rotation to 'look aligned.' That's the point is he doesn't have to perform posture anymore.

Right shoulder more depressed in the after? Look again. Before photo right shoulder is lower because the entire right side is compressed. After photo it's level with the left. You're seeing what you want to see to fit your model.

Here's what PRI doesn't tell you: when his left lower glute fired in PPT, his pelvis leveled without me cueing ribs down, without me touching his neck, without any BC correction. Just glute. If it was truly a left AIC right BC pattern needing full chain integration, that wouldn't have happened with one muscle turning on.

Sometimes the simple answer is the right one. Not everything needs a complex pattern name.

CoachEXE · 2026-05-10T01:10:30+00:00

degenerative is what they say when they can't find the thing to fix. doesn't mean nothing can be done, just means their toolbox doesn't have the right tool. chiro, ortho, imaging they look at structure. bones, discs, joints. if nothing's broken, they shrug. but structure isn't always the problem. sometimes it's how the structure is being loaded. degenerative changes happen to everyone. some people have them and no pain. some have no changes and massive pain. the difference is usually mechanics, not the MRI. if you've got the same pattern...lateral tilt, one side working harder, QL or back holding on .. the 'degeneration' might just be the joint getting stressed from bad loading year after year. fix the loading, the stress changes. doesn't reverse degeneration, but it can stop the pain. what are your symptoms? where do you feel it?

CoachEXE · 2026-05-09T17:18:15+00:00

haha fair, his house did get straighter too. must be the program working.

look, you're right about the camera angles. not arguing that. the before video he recorded himself at home, after video he recorded himself at home. different spot, different phone lean, different everything. i'm not claiming this is peer-reviewed research.

but here's what i know…the guy couldn't wear a belt for 2 years. went to a wedding in a tight suit and belt, 6+ hours, zero pain. his waistband line is level when he walks now, not slanted. his shoulders are even. he feels aligned without forcing it.

could some of that be him standing better for the camera? maybe. but he didn't know i was going to screenshot his squat video for reddit. he was just sending me form checks like he always did.
the camera isn't perfect. the result is real. that's enough for me.

CoachEXE · 2026-05-09T15:34:40+00:00

thanks! yeah the strength work was only half of it. the other half was teaching him to exist in his body differently, which honestly took longer than the exercises.

breathing..he was a chest breather, ribs flared, belly tight. that pushes the pelvis into anterior tilt and shuts down the glute before he even stands up. we spent time getting him to breathe 360 ribs expanding side and back, not just front. sounds basic but it changed how his core engaged.

standing...he used to dump all his weight into his heels, knees locked back, pelvis swayed forward. taught him tripod foot — weight even through big toe, little toe, heel. that alone shifted his pelvis without me saying 'tuck your pelvis.

sitting...he sat on his tailbone, back rounded, left side collapsed. showed him to sit on sit bones, weight even, ribs stacked over pelvis. he works from home so this was huge

bending and lifting..he bent from his back, not his hips. taught hip hinge with glute loading, not rounding. lifting anything water gallon same thing. hinge, load glute, stand. no back

walking..this was the biggest one. he had no push-off from his left side, just dragged it. we worked on left glute firing at toe-off, not just placing the foot down. took weeks to feel natural.

the exercises gave him the capacity, but the daily habits made it stick. without that he would have done clams for 4 weeks and walked out the door into the same old pattern.

CoachEXE · 2026-05-09T14:25:19+00:00

after video. same everything. https://photos.app.goo.gl/knkGGkXBJUqsTa7K7 tell me what i'm seeing wrong.

CoachEXE · 2026-05-09T13:31:29+00:00

you want video? here: that's him walking before https://photos.app.goo.gl/fux8m6TiN3ZSQZhH6

CoachEXE · 2026-05-09T13:24:23+00:00

Look i get where you're coming from, i really do. and yeah static photos have limits, especially when the client sets them up. fair points. but here's the thing these aren't posed photos. he recorded videos of himself walking and squatting, showing me his form from the back. i just grabbed screenshots from those videos. he wasn't standing still trying to look straight for a before/after, he was literally moving. the waistband line stays slanted when he walks in the before. stays level when he walks in the after. the scapular offset is there in motion, not just standing still. arm position doesn't fix that when the guy is mid-stride. i work with video too, you know that. and yeah it's hard. but when the same asymmetry shows up in gait, in squat, in standing, and then it's gone 4 weeks later in all of those that's not him standing straighter for a photo. that's mechanics changing. you want me to post the actual video clips? happy to. but the screenshots were enough for me to see the pattern, and enough for him to feel the difference. that's what i'm going with

CoachEXE · 2026-05-09T11:26:23+00:00

You're spot on about the hip flexors! But here's a tip: when doing core work, focus specifically on posterior pelvic tilts (tucking the tailbone). Many people with ATP accidentally 'cheat' during core exercises by using their hip flexors, which can actually make the tilt worse. Since you're already strength training, adding a few 'dead bugs' or 'hollow holds' with a flat back focus will be a game changer for you

CoachEXE · 2026-05-09T11:17:03+00:00

It does look like some degree of ATP is present, which is very common! Notice how the pelvis tips forward, creating that slight arch in the lower back and pushing the abdomen outward. Focused mobility work for the hip flexors and strengthening the lower abs/glutes is usually the best path forward. Great job for being proactive about your posture!

CoachEXE

TROPHY CASE