As individual bodies age, the nerves and muscles begin to degenerate, especially in the lower spinal region. This can cause sciatic pain and muscle weakness. Elderly sciatica is very common as the nerves and muscles have gone through a lot. Bending, lifting, carrying, reaching, twisting, and natural wearing and tearing make the sciatic nerve and surrounding muscles prone to injury. For overweight seniors, the risk of developing sciatica is higher.
Elderly Sciatica
The main reason for elderly sciatica is that as the body ages, the discs/cartilage between the vertebrae/bones in the spine dry out, losing their cushioning ability, which can lead to the bones shifting out of place more easily, rubbing against each other, and compressing nerves. On average, the body loses about 1 centimeter in height every ten years after 40.
Risk Factors
Diabetes
Diabetes affects the entire body.
Not keeping blood sugar in check can cause widespread symptoms that affect the nerves and organs.
Individuals with diabetes have an increased risk of developing sciatica and other nerve-damaging disorders.
Genetics
If spinal conditions are part of family medical history, there is an increased risk of developing sciatica.
With chiropractic, elderly individuals can attain better quality sleep, improved mood, and increased energy levels.
A chiropractic physical therapy team can develop a specialized/customized treatment plan for preventive and palliative care.
Body Composition
Sarcopenia
Sarcopenia affects the elderly population’s mortality, cognitive function, and quality of life. As the elderly population is living longer, preservation of lean mass becomes an integral part of maintaining an individual’s independence. Loss of muscle in the arms and legs is linked to decreased mobility, increased risk of falls, and prolonged hospital stays. Falls and fractures often result in a cycle of muscle deterioration. InBody can help track body composition changes and help to minimize muscle wasting and risk of impaired mobility.
References
Aggarwal, Sameer, and Nityanand. “Calcium and vitamin D in postmenopausal women.” Indian journal of endocrinology and metabolism vol. 17,Suppl 3 (2013): S618-20. doi:10.4103/2230-8210.123549
Dougherty, Paul E et al. “The role of chiropractic care in older adults.” Chiropractic & manual therapies vol. 20,1 3. 21 Feb. 2012, doi:10.1186/2045-709X-20-3
Ferreira, Manuela L, and Andrew McLachlan. “The Challenges of Treating Sciatica Pain in Older Adults.” Drugs & aging vol. 33,11 (2016): 779-785. doi:10.1007/s40266-016-0404-z
Kherad, Mehrsa et al. “Risk factors for low back pain and sciatica in elderly men-the MrOS Sweden study.” Age and aging vol. 46,1 (2017): 64-71. doi:10.1093/ageing/afw152
Pregnant and Chiropractic: Many women experience back/pelvis/leg/feet swelling, soreness, achiness, and pain during pregnancy. A growing belly added weight and changes in connective tissue can cause a variety of musculoskeletal strains and misalignments. Chiropractic care provides health maintenance of the spinal column, discs, nerves, joints, muscles, and bones. It is an art and science of adjusting a misaligned body, reducing stress, and promoting health throughout the body.
Pregnant and Chiropractic
With a primary doctor’s clearance, chiropractic can provide safe adjustments. Chiropractors trained to work with pregnant women utilize techniques that avoid applying pressure on or around the abdomen. Benefits of chiropractic during pregnancy include:
Restores and maintains spinal alignment and balance.
Helps control symptoms of nausea.
Improves energy levels.
Relieves body pain.
Helps reduce labor time and delivery.
Restores pelvic positioning and balance, improving standing, sitting, and walking mechanics.
A chiropractor trained in the needs of pregnant women will also provide exercises and stretches that are safe during pregnancy. A chiropractor will discuss/recommend treatment options, patient concerns, and a complete medical history assessment. They will monitor symptoms to customize treatments to the individual’s specific needs to get the most relief.
Body Composition
Gestational Hypertension
Gestational hypertension develops during pregnancy. It is not preventable and returns to normal levels postpartum. However, there is an increased risk of developing chronic hypertension later if gestational hypertension begins to develop. According to Mayo Clinic, gestational hypertension is diagnosed by the following:
Blood pressure is higher than 140/90 on at least two occasions.
Must be more than four hours apart.
There is no other organ damage present.
References
Gutke, Annelie et al. “Treatments for pregnancy-related lumbopelvic pain: a systematic review of physiotherapy modalities.” Acta Obstetricia et Gynecologica Scandinavica vol. 94,11 (2015): 1156-67. doi:10.1111/aogs.12681
Poděbradská, R et al. “The effect of physiotherapy intervention on the load of the foot and low back pain in pregnancy.” “Vliv fyzioterapeutických postupů na zatížení plosky a bolesti zad v těhotenství.” Ceska gynekologie vol. 84,6 (2019): 450-457.
Schreiner, Lucas et al. “Systematic review of pelvic floor interventions during pregnancy.” International journal of gynecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics vol. 143,1 (2018): 10-18. doi:10.1002/ijgo.12513
For older individuals, experiencing frequent low back pain could turn out to be a sacral fracture. They tend to occur in individuals over the age of 60 often because there has been a degree of bone loss. Sacral fractures tend not to be the first thing doctors think of when low back pain symptoms are presenting. They are often not picked up on X-rays and are either not diagnosed early enough to take steps or not diagnosed at all. However, they are common.
Sacrum
The sacrum is shaped like a triangle and comprises five segments fused into one large bone. It sits at the base of the spine, between the two halves of the pelvis, connecting the spine to the lower half of the body. It stabilizes the body when walking, sitting, or standing. The nerves in the lower spine control the bowels bladder and provide sensation to the region.
The two dimples that can be seen on individuals’ backs are where the sacrum joins the hipbones or the sacroiliac joint.
The point where the low back joins the sacrum can develop discomfort, soreness, and pain.
This area experiences stress from bending, twisting, reaching, lifting, carrying during physical activities or sitting for long periods.
Sacral Fracture
Most sacral fractures result from trauma, like slips, falls, and automobile accidents. Stress fractures that happen without a specific injury are also called insufficiency fractures.
Types of Sacral Fractures
Low-energy fractures usually happen to older individuals with weak bones due to osteoporosis.
An individual trips on something, lands hard on their butt, lifts a heavy object awkwardly, or over-exerts themselves from some physical activity.
Then persistent back or buttock pain begins to present.
The pain is often centered in the lower back, the hips, and butt.
It is more than just back achiness.
The individual goes to the doctor, and X-rays are ordered.
A lot of the time, these fractures are missed on X-rays.
The doctor may diagnose a sprain, but the pain symptoms do not improve.
Sometimes there is no apparent cause for the pain.
It can be misdiagnosed as a lower back compression fracture or urinary tract infection.
High-energy fractures are due to trauma and are more common among the young.
The individual sustains injuries from an auto accident, has fallen from a significant height, or suffers a sports injury.
It results in severe pain.
A woman who has just had a baby and gone through some bone loss because of the pregnancy can experience a sacral stress fracture.
For individuals that have been to a doctor and had an X-ray that reveals no fracture, and there is no improvement after 5 to 7 days, it is recommended to schedule another appointment and ask for a CAT scan or MRI, which is highly effective at finding a sacral fracture.
Treatment
Treatment consists of resting the bone but still being safely active in most cases.
Medication is prescribed for pain relief.
Many individuals have been found to do well with anti-inflammatory medications, topical medications, and lidocaine patches.
Older individuals may be recommended to use a walker during the treatment/healing process.
Depending on the severity, crutches may be recommended.
Engaging in regular exercise is not recommended, but too much bed rest is also not recommended.
Too much rest may not allow the injury to heal correctly, worsen the injury, and/or cause new injuries.
Chiropractic and physical therapy are not recommended to let the sacrum naturally heal.
After the pain subsides, chiropractic and physical therapy can be implemented to maintain agility and flexibility and strengthen the pelvic and core muscles.
In some cases, if the bone does not heal correctly or some other issue, sacroplasty could be recommended. This is a minimally invasive procedure that injects bone cement into the fracture. It offers quick and long-lasting pain relief with a low percentage of complications. It is considered low risk and can be done by an interventional radiologist or spine surgeon.
Prevention
To minimize the risk of a sacral fracture, it is highly recommended to maintain bone strength. This consists of:
Try to keep moving with different exercise stretches, or take a lap around the building.
References
Gibbs, Wende Nocton, and Amish Doshi. “Sacral Fractures and Sacroplasty.” Neuroimaging clinics of North America vol. 29,4 (2019): 515-527. doi:10.1016/j.nic.2019.07.003
Holmes, Michael W R, et al. “Evaluating Abdominal and Lower-Back Muscle Activity While Performing Core Exercises on a Stability Ball and a Dynamic Office Chair.” Human factors vol. 57,7 (2015): 1149-61. doi:10.1177/0018720815593184
Santolini, Emmanuele et al. “Sacral fractures: issues, challenges, solutions.” EFORT open reviews vol. 5,5 299-311. 5 May. 2020, doi:10.1302/2058-5241.5.190064
Squat exercises are highly effective, as they strengthen the back and core muscles, helping the prevention of injury. They can be done anywhere with or without equipment like weights and resistance bands and can be part of an aerobic workout. Squatting requires following proper form and posture. Using the improper form, adding too much weight too soon, overdoing it without enough recovery time can cause soreness, back pain, and injury. Having muscle soreness after performing squats is expected; however, if symptoms like chronic soreness, tingling, numbness, or sharp aches that come and go, begin to appear, it is recommended to consult a medical trainer, chiropractor, doctor, or spine specialist to evaluate the symptoms, and if necessary develop a treatment plan, as well as a prevention plan to continue exercising safely.
Squat Exercises
Squatting is a highly beneficial form of exercise. Athletes, trainers, coaches, and individuals just staying healthy use the technique as a part of their training and workouts. This is because squatting increases core muscle strength, increasing body power. Squat exercises benefits include:
Increased Flexibility
Improved strength and a range of motion allow the body to move flawlessly in various directions with minimal effort.
Increased Core Strength
All major muscles work together during a squat.
This increases muscle stabilization, maintains body balance, increasing core strength.
Injury Prevention
Squats work all leg muscles simultaneously, synchronizing the body.
This increases body stability decreasing the risk of injury.
Back Pain and Potential Injury
The spine is exposed and unprotected during a squat. This is where back pain and injury can happen. Potential causes include:
Priming each muscle is recommended. This could be:
Starting with glute work.
Then planks to activate the core.
Finish off with stretching and range of motion exercises.
A personal trainer can assist in creating a customized workout routine.
Starting Position
The feet should always face forward to protect the hips and knees when beginning a squat.
If the feet face at an angle, the form can be impacted, leading to back pain or collapsing arches.
Spinal Alignment
Maintaining a straight-ahead or upward gaze, which increases center awareness during squat exercises, can prevent the body from leaning forward and placing stress on the spine.
Only squat as far as possible, making sure to feel in control and maintain the form.
Squatting too deep can cause muscle strain leading to pain.
Focus on form, as it is more important than depth.
Joint mobility
Ankle mobility and stability are essential to balance and control.
If the ankle is compromised, the feet could lift off the floor, forcing the body to compensate, leading to strain and potential injuries.
Barbell back squats are more advanced and, if done incorrectly, can cause injury.
A chiropractor or physical therapist will be able to evaluate spinal health, exercise form, and advise if there is an issue.
Body Composition
Achieve Health and Fitness Goals By Doing What You Enjoy
Don’t engage in workouts or fitness programs that make you miserable. Do workouts/activities that you enjoy and have fun doing. Exercise for the love of the body, keeping it healthy and in shape, not because there is a feeling of obligation.
Individuals who don’t like lifting weights try using resistance bands or bodyweight exercises.
The same goes for nutrition. Don’t base diet and supplement choices on misperceptions about health.
References
Calatayud, Joaquín et al. “Tolerability and Muscle Activity of Core Muscle Exercises in Chronic Low-back Pain.” International journal of environmental research and public health vol. 16,19 3509. 20 Sep. 2019, doi:10.3390/ijerph16193509
Clark, Dave R et al. “Muscle activation in the loaded free barbell squat: a brief review.” Journal of strength and conditioning research vol. 26,4 (2012): 1169-78. doi:10.1519/JSC.0b013e31822d533d
Cortell-Tormo, Juan M et al. “Effects of functional resistance training on fitness and quality of life in females with chronic nonspecific low-back pain.” Journal of back and musculoskeletal rehabilitation vol. 31,1 (2018): 95-105. doi:10.3233/BMR-169684
Donnelly, David V et al. “The effect of the direction of gaze on the kinematics of the squat exercise.” Journal of strength and conditioning research vol. 20,1 (2006): 145-50. doi:10.1519/R-16434.1
Zawadka, Magdalena et al. “Altered squat movement pattern in patients with chronic low back pain.” Annals of agricultural and environmental medicine: AAEM vol. 28,1 (2021): 158-162. doi:10.26444/aaem/117708
Improving posture can be challenging. Poor posture is often the source of various musculoskeletal issues like chronic pain throughout the body. Poor posture can be so ingrained in the brain that it becomes an unconscious positioning reflex that feels right but could be worsening spinal, hip, and leg problems. The Alexander Technique could be a treatment option that could help long-term.
Alexander Technique
The approach focuses on learning mind-body awareness. It is an educational process to teach individuals to become aware of their body positioning and change unhealthy posture/movement habits into healthy ones. The objective is learning to utilize sufficient levels of muscle tension for everyday activities, like sitting, standing up, and walking in a healthy way to maintain optimal health of the musculoskeletal system.
The theory is that less tension minimizes wear and tear on the muscles and structures of the spine vulnerable to compression.
The fundamental goal of the Alexander Technique is to undo all the unhealthy tension habits to decompress the spine and retrain the mind and body to approach movement and body positioning in a new and healthy way.
Teachings
The technique can be done in a class setting or one-on-one teaching because everyone’s postural and movement habits are unique. A teacher helps identify the tension-inducing postures and educates the individual on how to correct them. Human touch is an integral part of the Alexander Technique. Using their hands gently to adjust the individual to a proper upright position, a teacher helps release pressure from the head, neck, shoulders, and upper back. The individual learns to release the tension throughout their body. The Alexander Technique is a type of hands-on therapy; it is not manipulation or massage. It uses a light touch with no risk of injury to the spine, allowing anyone to participate. However, individuals must be willing to participate/engage in the process to get the benefits. Most individuals can tell if it’s right for them during the first lesson.A typical program teaches:
Staying alert to the body’s warning of tension and compression.
Tension Build Up
Individuals usually don’t even realize they’re constantly placing pressure on their spine from unhealthy postural habits, building up muscular tension they never knew they created. For example, unhealthy neck position habits include:
Pushing the head forward
Slumping over
Pinning the shoulders back
These postures generate/build pressure and tension that radiates outward and down to the large muscles of the spine.
Habitual downward pressure can pull and change the spine’s shape, leading to degenerative forms of spinal deformity in severe cases.
When the tension is released, the neck and body begin to stand upright comfortably, without pulling down or pulling back.
Frederick Matthias Alexander
Developed the technique in the 1890s to help his muscle tension problems affecting his acting career. When performing, he would stiffen his neck and pull his head back and up, building tension that caused him to tighten his throat and lose his voice. He did not know he was doing this until he performed in front of a mirror and saw his awkward positioning. He realized this and retrained himself to pose naturally, stay relaxed, and be aware of any tension building in the muscles to release it immediately. Alexander Technique educators/practitioners practice all over the world. The American Society for the Alexander Technique or AmSAT website has a Find A Teacher Tool that connects individuals to AmSAT-approved teachers.
Body Composition
Practicing Mindfulness
Developing a mindfulness practice can help identify triggers of negative behavior or thoughts. Just like diet and exercise, practicing mindfulness is unique to everyone. It is recommended to try different things like:
Journaling is another way to tune into oneself. Grab a pen and paper, a computer, tablet, or phone, and take a few minutes to write every day.
Write one thing that makes you happy.
One thing you want to improve.
One goal you want to accomplish that day or that week.
Mindful music listening can help reduce stress by allowing the individual to focus their attention when their mind is going in all directions.
Instead of turning to the news or email when waking up, grab a cup of coffee or tea and listen to a favorite podcast or music.
Put the phone away and listen to your mind and self.
Try to meditate in the morning when waking up. This helps set the day’s goals/plans. Goal-setting mindfulness has been shown to reduce stress levels and anxiety. However, if the morning is not possible then at night before bed can be used to reflect on the day’s activities, what went well, what didn’t, how to improve something, whatever the case, the point is to make time for yourself to reflect, set goals, and develop a plan to achieve those goals.
References
Becker, Jordan J et al. “Preliminary evidence for feasibility, efficacy, and mechanisms of Alexander technique group classes for chronic neck pain.” Complementary therapies in medicine vol. 39 (2018): 80-86. doi:10.1016/j.ctim.2018.05.012
Cacciatore et al., Improvement in automatic postural coordination following Alexander technique lessons in a person with low back pain. Physical Therapy Journal, 2005; 85:565-578. Accessed January 5, 2011
Chin, Brian et al. “Psychological mechanisms driving stress resilience in mindfulness training: A randomized controlled trial.” Health psychology: official journal of the Division of Health Psychology, American Psychological Association vol. 38,8 (2019): 759-768. doi:10.1037/hea0000763
Little P, Lewith G, Webley F, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. The BMJ. 2008;337:a884. doi: https://doi.org/10.1136/bmj.a884.
Paolucci, Teresa et al. “Chronic low back pain and postural rehabilitation exercise: a literature review.” Journal of pain research vol. 12 95-107. December 20 2018, doi:10.2147/JPR.S171729
Sciatica motor vehicle crash. After an automobile crash/accident, symptoms of pain and discomfort can immediately follow the force of impact, indicating an injury. Many injuries and symptoms appear right away, like:
Pain from high-impact trauma and cuts.
Bone fractures.
Dislocations.
Neck whiplash.
Back pain.
The sciatic nerve is the largest in the body, and any damage can cause pain in one or both sides of the body. Pressure and compression on the nerves, ligaments, and muscles accompanied by weakness or numbness in the lower back, legs, or feet could cause delayed sciatica symptoms hours, days, even weeks later. It is critical to meet with a doctor and auto accident chiropractor after any type of accident, large or small, to develop a thorough personalized treatment plan.
Sciatica Motor Vehicle Crash
Sciatica can be brought on by a pinched nerve, which is often the result of the spine shifting out of place, causing herniation and compression on the sciatic nerve. The trauma from a motor vehicle accident can cause the spinal discs to be knocked out of place, rupture, and leak out, irritating the surrounding tissue and nerve endings. Back injuries are among the most common forms of damage/injury resulting from a motor vehicle accident/crash that can lead to sciatica. Broken and/or fractured vertebral, hip, or pelvis bone fragments can compress the sciatic nerve. Even when the initial result of the impact does not result in sciatica, over time, an untreated back injury could lead to sciatica symptoms.
Symptoms
Motor vehicle crashes often activate or aggravate pre-existing conditions like asymptomatic degenerative disc disease, affecting the sciatic nerve causing discomfort and pain. Common symptoms include:
Mild discomfort or achiness.
Tingling sensations from the lower back and down the back of the leg.
Weakness, numbness, or difficulty moving the leg and foot.
Inability to bend the foot upward at the ankle- known as foot drop.
Constant pain in one side of the buttocks or leg.
Sharp pain that makes it difficult to stand up and walk
Difficulty sitting.
Burning or tingling in one leg can worsen when sitting.
Intense pain.
Sharp burning and/or what feels like shooting electricity pain.
Diagnosis
A spine doctor and chiropractor will use diagnostic imaging tools like X-rays, and CT scans to see the scope of the injured area.
An X-ray will show a detailed image of the spine and affected bones in the area.
A CT scan will include a 3D image that shows the surrounding musculature, tissues, and nerves that could be damaged/injured.
Treatment
The doctor and chiropractor will then develop an appropriate and personalized treatment plan that could utilize various methods and techniques.
Chiropractic is commonly the first treatment to realign the spine and relieve pressure on the nerve.
A pain management specialist or physical therapist will be brought in for rehabilitation/recovery as adjustments progress.
Orthopedists and neurologists may be brought in for less conservative treatment in more severe cases, including surgical options.
Other treatments can include steroid injections or anti-inflammatory medicines to relieve nerve pressure.
Body Composition
Injury Rehabilitation Phase
Current in-clinic methods of measuring the composition of an injured body are indirect, while medically advanced techniques limit the frequency of testing. InBody provides cost-effective, comprehensive, and timely measurements that identify areas of weakness from damage, injury, or recent surgery and develop a customized rehabilitation program to improve functional status.
During the rehabilitation phase, increased sedentary behavior and/or immobilization causes muscle loss in the injured or operated region. By independently evaluating lean mass in each segment of the arms, legs, and torso, a chiropractor or physical therapist gathers baseline information on the body segments with restricted mobility.
InBody can help provide further insight into an individual’s body composition to analyze long-term health risks and develop a personalized exercise intervention to improve overall health and reduce health risks. This provides beneficial information for identifying potential imbalances related to muscle loss post-injury/surgery that can be targeted and improved. Identifying these imbalances allows the therapists to increase functional fitness and mobility, helping the individual reduce the risk of re-injury or new injuries.
References
Defouilloux, B et al. “A propos de trois observations chez des polytraumatisées de la route présentag une fracture du bassin associée à des signes neurologiques” [Apropos of 3 cases of multiple traffic injuries presenting pelvic fractures associated with neurologic signs]. Journal de radiologie, d’electrologie, et de medecine nucleaire vol. 48,8 (1967): 505-6.
Noble, J et al. “Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries.” The Journal of trauma vol. 45,1 (1998): 116-22. doi:10.1097/00005373-199807000-00025
Walsh, K et al. “Risk of low back pain in people admitted to hospital for traffic accidents and falls.” Journal of epidemiology and community health vol. 46,3 (1992): 231-3. doi:10.1136/jech.46.3.231
Today, more than ever, individuals are less physically active and sitting down for more extended periods causing the gluteus muscles to be used less and weaken. Weak, inactive, or tightening glutes can cause instability in the lower spine, the hips, and the pelvis to shift out of alignment. This leads to low back and buttock pain. The pain is constantly dull, aching, pulsating, then when moving, getting up, it throbs and stings. Gluteal strengthening exercises can strengthen the muscles and alleviate the pain.
Gluteal Strengthening
Every individual has a unique physiology. The body develops asymmetrically as the individual favors one side or area of the body over another. This can cause imbalances in the muscular system, leading to awkward positioning that causes pain. The muscle groups that support the lower back consist of the:
Core muscles
The gluteal muscle group includes:
Gluteus Maximus
Gluteus medius
Gluteus minimus
Pelvis muscles
Hamstrings
Quadriceps
In some cases, the development or lack of level of an individual’s upper back strength can also affect the amount of strain on the lower back.
Gluteal Strengthening Difference
Many joints connect in this area that can have functional problems. The muscles within the lower back need:
Stretching allows the body to enhance the limits of its flexibility and mobility. Most of the stretches are involve the hip joint, as this is one of the most effective ways to loosen the gluteal regions. It’s essential to warm the muscles slightly with a light activity while stretching them to elongate naturally.
Seated Figure 4 Stretch
Sitting in a chair.
Cross the right leg over the left.
With the right ankle resting on the left knee.
It should resemble the number 4.
Bend forward at the hip, placing slight pressure onto the left leg.
Hold this stretch for ten-twenty seconds.
Stretch the other side.
Placing the left foot on the right knee.
Repeat this three times.
Downward Dog
This yoga pose engages all the muscles along the back. With the glutes at the top in this position, it forces them to activate, allowing them to stretch fully.
Hold this pose and focus the attention on the glutes.
Squats naturally engage the glutes. This is a variation on a squat that focuses on developing gluteal strength.
Stand with the back facing the wall.
Place a Swiss stability ball between the wall and the back.
Lean back into the ball for balance.
Lower the torso until the knees reach 90 degrees.
Return to standing.
Repeat for ten reps.
Do three sets.
Body Composition
Analysis An Effective Tool
Opportunities to increase physical activity lead individuals in a positive direction. The most common reason for reducing and stopping healthy changes is a lack of motivation and feedback. Strategies that provide immediate feedback are essential to:
Monitor progress for establishing a baseline.
Set appropriate and attainable goals.
Track changes over time.
Ensure success.
Monitoring changes with a simple weight scale or Body Mass Index calculator provides limited ability to accurately track changes that only highlight weight changes and not track progress in muscle gain or fat loss. In less than 45 seconds, the InBody Test provides doctors, trainers, and physical therapists with easy-to-understand, accurate and objective measurements to evaluate body composition that includes:
Assessing muscle distribution.
Target areas weakened by condition or injury.
Identify muscle and fat imbalances in each area of the body.
Monitor changes to determine the efficacy of the treatment plan, exercise program, and diet plan to ensure long-term success.
References
Akuthota, Venu et al. “Core stability exercise principles.” Current sports medicine reports vol. 7,1 (2008): 39-44. doi:10.1097/01.CSMR.0000308663.13278.69
Distefano, Lindsay J et al. “Gluteal muscle activation during common therapeutic exercises.” The Journal of orthopedic and sports physical therapy vol. 39,7 (2009): 532-40. doi:10.2519/jospt.2009.2796
Glaviano, Neal R et al. “Gluteal muscle inhibition: Consequences of patellofemoral pain?.” Medical hypotheses vol. 126 (2019): 9-14. doi:10.1016/j.mehy.2019.02.046
Jeong, Ui-Cheol et al. “The effects of gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients.” Journal of physical therapy science vol. 27,12 (2015): 3813-6. doi:10.1589/jpts.27.3813
Macadam, Paul et al. “AN EXAMINATION OF THE GLUTEAL MUSCLE ACTIVITY ASSOCIATED WITH DYNAMIC HIP ABDUCTION AND HIP EXTERNAL ROTATION EXERCISE: A SYSTEMATIC REVIEW.” International Journal of sports physical therapy vol. 10,5 (2015): 573-91.
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