Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes...Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes. However, a functional integrative rehabilitative approach addressing lumbo-pelvic misalignment in the sagittal (anteriorly tilted pelvis) and frontal (Trendelenburg gait) planes has not been presented. The aforementioned patho-biomechanical conditions and their management are often discussed estranged from each other rather than functionally integrated. This paper serves as a short communication which discusses the lumbo-pelvic anatomy, identifies the anatomical and biomechanical associations between the anteriorly tilted pelvic and Trendelenburg gait. Through an analysis of relevant literature, recommendations were made on the improvement of flexibility of the hip flexors, taut iliofemoral and pubofemoral ligaments to resolve the primary abnormal force-couple, with improved flexibility of the erector spinae and quadratus lumborum to resolve the secondary abnormal force-couple. In addition, improved flexibility of the hip flexors should coincide with closed-kinetic chain concentric strengthening of the ipsi-lateral hip abductors and contralateral external obliques. Patient education is also needed for self-re-alignment of the lower extremity to a neutral position and neutral foot stance. Biokineticists/exercise therapists should also review the patient’s gait biomechanics to determine whether sartorius synergistic dominance is in play. In conclusion, the association between an anteriorly tilted pelvis and Trendelenburg gait, is in regard to taut anterior acetabulofemoral ligaments and femoral retroversion torsion angle that is both preceded and followed by the biomechanical influence of various anatomical structures. These anatomical and biomechanical factors must be evaluated by the biokineticists/exercise therapists before prescribing a rehabilitative programme to ensure successful rehabilitation of lumbo-pelvic hip complex.展开更多
文摘Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes. However, a functional integrative rehabilitative approach addressing lumbo-pelvic misalignment in the sagittal (anteriorly tilted pelvis) and frontal (Trendelenburg gait) planes has not been presented. The aforementioned patho-biomechanical conditions and their management are often discussed estranged from each other rather than functionally integrated. This paper serves as a short communication which discusses the lumbo-pelvic anatomy, identifies the anatomical and biomechanical associations between the anteriorly tilted pelvic and Trendelenburg gait. Through an analysis of relevant literature, recommendations were made on the improvement of flexibility of the hip flexors, taut iliofemoral and pubofemoral ligaments to resolve the primary abnormal force-couple, with improved flexibility of the erector spinae and quadratus lumborum to resolve the secondary abnormal force-couple. In addition, improved flexibility of the hip flexors should coincide with closed-kinetic chain concentric strengthening of the ipsi-lateral hip abductors and contralateral external obliques. Patient education is also needed for self-re-alignment of the lower extremity to a neutral position and neutral foot stance. Biokineticists/exercise therapists should also review the patient’s gait biomechanics to determine whether sartorius synergistic dominance is in play. In conclusion, the association between an anteriorly tilted pelvis and Trendelenburg gait, is in regard to taut anterior acetabulofemoral ligaments and femoral retroversion torsion angle that is both preceded and followed by the biomechanical influence of various anatomical structures. These anatomical and biomechanical factors must be evaluated by the biokineticists/exercise therapists before prescribing a rehabilitative programme to ensure successful rehabilitation of lumbo-pelvic hip complex.
