Individuals on their feet all day regularly experience back problems and discomfort symptoms. Wearing unstable shoes that are flat with no arch support with little or no shock absorption or the wrong type of shoe for gait can cause biomechanical issues that can cause back discomfort and lead to chronic back pain. Athletic running shoes are recommended for lower back pain because they are well-cushioned and designed to help absorb the impact of walking or running. They also have proper arch and ankle support to maintain foot position for correct posture. What to look for in running shoes to help relieve back pain and keep the back injury free?
Athletic Running Shoes
Shoes that don’t have enough cushioning can cause inflammation in the back muscles from the lack of impact absorption. The best athletic running shoes for back pain relief are stiff, supportive, and well-cushioned. When selecting shoes for back pain, the most important factors to consider are:
Stiffness of the sole.
Quality support and cushioning.
Proper and comfortable fit.
Shoe Type
Athletic running shoes are available in various types of support for all foot types.
Consider foot structure and gait when selecting shoes.
Flat and high-arched feet can cause muscle imbalances, which increase pressure on the back, hips, legs, knees, ankles, and feet.
The grooves and patterns increase friction and provide grip to the person while walking or running.
Durability
Wearing worn-out shoes with inadequate cushioning and shock absorption can increase the risk of back problems.
Depending on the uses, shoes can wear out in three months or less.
It is important to replace shoes when the cushioning wears out.
Look for high-quality material that doesn’t wear down quickly.
Improve Whole-Body Wellness
References
Anderson, Jennifer, et al. “A narrative review of musculoskeletal problems of the lower extremity and back associated with the interface between occupational tasks, feet, footwear, and flooring.” Musculoskeletal care vol. 15,4 (2017): 304-315. doi:10.1002/msc.1174
American Podiatric Medical Association. Which Running Shoe is Right for You?
Hong, Wei-Hsien, et al. “Effect of shoe heel height and total-contact insert on muscle loading and foot stability while walking.” Foot & ankle international vol. 34,2 (2013): 273-81. doi:10.1177/1071100712465817
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Back Pain: Diagnosis, Treatment, and Steps to Take.
National Institute of Neurological Disorders and Stroke. Low Back Pain Fact Sheet.
Healthy posture and movement are essential for everyone, but especially for mothers-to-be. Practicing healthy posture is one of the most important contributions to a healthy pregnancy. Proper body alignment decreases low back and neck discomfort symptoms and muscle fatigue. A chiropractic therapy team can educate on maintaining a healthy posture when standing, sitting, and lying down throughout pregnancy, alleviate any subluxations, maintain optimal alignment, and keep the muscles relaxed through massage techniques.
Pregnancy Posture
Many changes occur in the musculoskeletal system during pregnancy for the growing fetus. This impacts posture, balance, and gait. Pregnancy posture can significantly influence the comfort and/or pain levels in the pregnant and postnatal body. This includes:
Sleeping in the best position while pregnant.
Sitting in the best position during pregnancy.
These little changes and adjustments impact the health of the mother and baby.
Postural Changes During Pregnancy
During pregnancy, several factors work against maintaining correct and healthy alignment. For one, the baby’s weight causes the lower back to sway as the center of gravity shifts forward.
Increased Lumbar Lordosis
The concave curvature in the spine can become more pronounced because of the forward pull of the growing fetus.
The normal slight forward curvature of the spine in the neck or cervical area is called cervical lordosis.
The growing fetus aggravates the forward pull on the neck.
During pregnancy, the breasts grow, adding more weight to the thoracic or mid back, causing the neck curvature to get pulled forward and down.
Both shoulders also move forward and inward.
These changes can lead to back problem symptoms/pain, sciatica, and other musculoskeletal disorders and conditions if left untreated.
Unhealthy Posture Happens Naturally
The abdominal muscles become stretched as the baby grows.
Hormone levels increase and cause joints and ligaments to loosen.
The muscles cannot contract fully and keep the lower back in alignment.
Healthy Posture Requires Practice
Standing
Proper posture when standing. From top to bottom:
Maintain a neutral gaze that looks straight ahead.
Don’t bend the head too much forward or backward.
Avoid twisting/bending movements whenever possible, or keep them to a minimum.
The chest should be up, the core braced, and the shoulders back.
The body weight is distributed evenly along the lower extremities.
Contract abdominal and pelvic floor muscles during movements, as they support the stability of the pelvis and the trunk.
When standing and having to hold the position for an extended period, use a box or stool to prop up one foot.
For example, when washing dishes, the cabinet under the sink can rest the foot on the ledge.
Switch position every 20 to 30 minutes.
Chiropractic
Whether in the planning stages or the second or third trimester, it’s essential to keep postural health in mind. A chiropractor trained in the needs of pregnant women will use tables that adjust for a pregnant woman’s body, and they will use techniques that avoid unneeded pressure on the abdomen and provide safe exercises and stretches. Benefits of chiropractic include:
Helps maintain a healthier pregnancy.
Helps regulate symptoms of nausea.
Relieves back, neck, discomfort symptoms, and pain.
Relieves and reduces excess strain on muscles, ligaments, and joints.
Spinal curvature exaggeration is corrected.
The normal spine curvatures are restored and maintained.
As more women seek the benefits of chiropractic for pregnancy, more healthcare providers seek trained doctors of chiropractic to refer their pregnant patients. Discuss these options with your healthcare provider, and schedule a visit to Injury Medical Chiropractic and Functional Medicine Clinic to check posture and biomechanics.
Chiropractic Pregnancy Treatment
References
Bauer, A W. “NEUE GESICHTSPUNKTE UEBER HALTUNG UND ERNAEHRUNG WAEHREND DER SCHWANGERSCHAFT” [NEW VIEWPOINTS ON POSTURE AND NUTRITION DURING PREGNANCY]. Wiener medizinische Wochenschrift (1946) vol. 113 (1963): 875-6.
Fitzhugh, M L, and M NEWTON. “Posture in pregnancy.” American Journal of Obstetrics and Gynecology vol. 85 (1963): 1091-5. doi:10.1016/s0002-9378(16)35644-7
Gutke A, Ostgaard HC, Oberg B Spine (Phila Pa 1976). 2006 Mar 1; 31(5):E149-55. Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning.
Schröder, Guido et al. “Impact of pregnancy on back pain and body posture in women.” Journal of physical therapy science vol. 28,4 (2016): 1199-207. doi:10.1589/jpts.28.1199
Yoo, Hyunju, et al. “Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women.” Journal of physical therapy science vol. 27,1 (2015): 279-84. doi:10.1589/jpts.27.279
How a person walks or their gait performance can determine how their body’s balance and stability are functioning. Since the body has many muscles, ligaments, and tissues in the musculoskeletal system protecting the spine and the vital organs that work together to maintain proper functionality when a person is in motion; however, the body can succumb to numerous issues that can affect a person’s gait performance and cause the upper and lower extremities to develop myofascial trigger points in the muscle fibers. When these issues begin to cause dysfunction in the body, it can lead to many disorders associated with gait disturbances. Today we will focus on how to approach gait disturbances, how trigger points affect gait performances, and how treatment techniques like MET can help. We provide information about our patients to certified medical providers that offer available therapy techniques like MET (muscle energy techniques) for individuals dealing with gait disturbances associated with trigger points that correlate to how a person walks. We encourage each patient appropriately by referring them to our associated medical providers based on their diagnosis results. We accept that education is a spectacular way when asking our providers the most crucial questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., assesses this information as an educational service. Disclaimer
How To Approach Gait Disturbances?
Have you been dealing with mobility issues when walking? How about feeling stiffness in your hips or lower body extremities? Or have you experienced headaches or neck pain? Many of these issues are associated with gait disturbances that can affect your ability to walk. When it comes to gait disturbances, studies reveal that underlying systemic disorders or other environmental factors could trigger the prevalence of gait disturbances. Regarding gait disturbances, it is important to know that as the body ages, it can cause issues to the musculoskeletal system naturally, and environmental factors can further affect the central nervous system to cause gait disturbances. Additional studies have mentioned that gait disorders in the elderly could potentially lead to various issues that affect a person’s quality of life. When approaching gait disturbances, many doctors will examine to see the causes of these gait disturbances that correlate with the musculoskeletal system. It could be:
Orthopedic problems
Neurological conditions
Musculoskeletal disturbances
Metabolic disturbances
Many of these issues can cause the lower half of the body to shift the skeletal joints, leading to tight, stiff muscles and developing tiny hard nodules in the muscle fibers that can further affect gait performance.
How Do Trigger Points Affect Gait Performances
So how can these tiny hard nodules affect gait performance in the body? These small hard nodules are trigger points and often correlate with overlapping risk profiles associated with musculoskeletal disorders. “Clinical Application of Neuromuscular Techniques,” written by Leon Chaitow, N.D., D.O, and Judith Walker DeLany, L.M.T., mentioned that various additional causes and maintaining factors may be associated with dysfunctional patterns that correlate with trigger point involvement. The book also says that different influences affecting the muscles can increase trigger point activity while inducing influences from acute or chronic soft tissue dysfunction. Research studies reveal that myofascial pain syndrome is a collection of sensory, motor, and autonomic symptoms that correlate with musculoskeletal symptoms like local/referred pain, decreased range of motion, and muscle weakness. When trigger points are causing problems in the muscle fibers, it can affect a person’s gait performance and cause them to lose function when walking.
Balance Issues Associated With Myofascial Trigger Points-Video
Have you been dealing with balancing issues when walking? Do your muscles feel tight in certain areas? Or do constant headaches or neck pain affect your day? The video above explains what can cause balancing issues that affect gait performance and cause numerous symptoms like headaches and neck pain. Many balance issues are associated with myofascial trigger points affecting your gait performance. Myofascial trigger points can overlap risk profiles that can affect the muscle fibers in the body. Many correlating factors can affect a person’s gait performance, leading to musculoskeletal disorders related to trigger points. When musculoskeletal disorders are correlated with myofascial trigger points, it can decrease a person’s health and wellness if not treated early on. Fortunately, some treatments incorporate techniques to reduce muscle and joint pain while alleviating symptoms associated with myofascial trigger points.
How The MET Technques Helps With Gait Performance & Trigger Points
When a person is dealing with imbalances affecting their gait performance and having overlapping risk profiles associated with trigger points, treatment techniques can help improve their gait while reducing pain-like symptoms. Many pain specialists will use the MET technique (muscle energy technique) to help stretch affected muscles that are stiff and help regain mobility back to the body. Therapies like chiropractic care utilize this technique combined with spinal manipulation to help realign the body while loosening up stiff muscles affecting gait performance. When a person continues treatment care to regain mobility, it allows them to be aware of how they walk and carry themselves without pain.
Conclusion
How a person walks is how their balance and stability function in different environments. A person’s gait performance has to maintain the functionality that allows the various muscles, ligaments, and tissues in the musculoskeletal system to move. When environmental factors or musculoskeletal disorders affect the different muscles, it can cause overlapping issues that affect gait performance. To that point, it leads to stiffness and pain associated with trigger points. Luckily techniques like the MET combined with chiropractic care can help realign the body and loosen up stiff muscles and joints to regain mobility back to the body and help improve overall gait performance.
References
Chaitow, Leon, and Judith Walker DeLany. Clinical Application of Neuromuscular Techniques. Churchill Livingstone, 2002.
Marshall, Frederick J. “Approach to the Elderly Patient with Gait Disturbance.” Neurology. Clinical Practice, U.S. National Library of Medicine, June 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3613197/.
Pirker, Walter, and Regina Katzenschlager. “Gait Disorders in Adults and the Elderly : A Clinical Guide.” Wiener Klinische Wochenschrift, U.S. National Library of Medicine, Feb. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5318488/.
When it comes to the body, the various muscles, tissues, joints, and organs provide functionality and movement when it is in motion. Everyone worldwide cares for their bodies by resting them when needed, eating numerous foods to provide energy, and staying active to live longer. However, over time, many factors can contribute to the body by causing many individuals to develop musculoskeletal issues that can affect a person’s posture and the sensory-motor functions that the body provides to maintain motion and stability. In today’s article, we examine muscle imbalances, how it affects the body’s gait pattern, and how the MET technique can help with muscle imbalances. We provide information about our patients to certified medical providers that offer available therapy techniques like MET (muscle energy techniques) for individuals dealing with chronic conditions associated with muscle imbalances that could affect a person’s gait pattern and lead to pain in the muscles and joints. We encourage each patient appropriately by referring them to our associated medical providers based on their diagnosis results. We accept that education is a spectacular way when asking our providers the most crucial questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., assesses this information as an educational service. Disclaimer
What Are Muscle Imbalances?
Have you been dealing with tight back, shoulders, and hip muscles? Do you feel one side of your body is weaker than the other? Or do you feel unstable when walking? Many people who are experiencing these issues are associated with muscle imbalances that are affecting their bodies. So what are muscle imbalances, and how does it affect the body? Well, according to “Clinical Applications of Neuromuscular Techniques,” written by Leon Chaitow, N.D, D.O, and Judith Walker DeLany, L.M.T., stated that the soft tissues in our bodies are often changed from their normal elastic, pliable, and toned functional status to short, fibrous and weak function in the different muscle groups. Since the body compensates (without any chronic symptoms) to everyday activities, when the body’s muscles and tissues are exhausted, it can cause the symptoms to develop over time, causing pain, muscle restriction, and limited range of motion to the body. Thus, these symptoms often correlate to musculoskeletal disorders, leading to muscle imbalances.
Other issues that can cause muscle imbalances in the body could result from muscle injuries from traumatic forces. Research studies have revealed that repetitive motions from traumatic injuries could result in microtrauma tears to the muscles and tendons, which can develop into muscle-referred pain and increase the risk of chronic joint inflammation. To that point, it can lead to referred pain in different body areas and affect a person’s stability. When the body is dealing with traumatic injuries that affect the muscles over time, many people shift how they walk or change their postures to compensate for the pain, which can change their gait patterns.
How Does It Affect The Body’s Gait Pattern?
When a person is walking, their entire body is in motion, and over time their posture will change depending on the upper body’s weight bearing down to the hips and lower extremities. Studies reveal that loss of muscle strength can be characterized by musculoskeletal disorders like osteoarthritis that can cause pain symptoms, reduce physical function, decrease range of motion, and muscle/joint instability. So how would muscle imbalances affect the body’s gait pattern? First, we must look at the influences that the neurological and metabolic functions of the central nervous system provide on the musculoskeletal system. The central nervous system sends neuron signals to each muscle group from the upper and lower extremities to allow the individual to walk, run, and do other motor functions. When muscle imbalances are associated with traumatic injuries, it can cause the body to be hunched over over time, causing the short muscles to be tight and the long muscles to be weak. To that point, it can lead to a chain of dysfunctional phases of the gait cycle and its associated symptoms. Some of the signs that can affect a person’s gait pattern include:
Associated joint restriction on the hips
Muscle tension on the pelvis and lower extremities
Muscle tightness in the cervical-thoracic region of the back
Trigger points on the lower extremities causing referred pain
How Muscle Imbalances Associate With Low Back Pain- Video
Have you been dealing with pain in your joints or muscles? Do you find it difficult to walk or carry heavy objects? Or have you been experiencing tight hips and shoulders? Many of these issues are due to muscle imbalances associated with traumatic injuries. The video above explains how muscle imbalances could be related to low back pain. When environmental factors or traumatic forces begin to affect the muscles and joints in the body, it can change a person’s gait pattern (how they walk) and develop into chronic issues affecting the body. When the muscles are imbalanced and cause gait problems, it can lead to muscle and joint pain associated with poor posture and other chronic conditions. When this happens, it can lead to dysfunctional phases of the gait pattern. Luckily there are many treatments and techniques to reduce pain and restore gait function to the body.
How The MET Technique Help With Muscle Imbalances
Going to therapy treatments to restore muscle functionality, enable the body to recover naturally, and reduce the chances of future injuries to come back. When the body is dealing with muscle imbalances, there are many treatments and techniques that many pain specialists, like chiropractic care that are utilized to restore the body and prevent injuries from re-occurring. One of the techniques is called the MET technique (muscle energy technique). The MET technique is a form of manual therapy that uses isometric stretches to reduce pain in the soft tissues and lengthen weak muscles. Studies reveal that when pain specialists use the MET technique combined with other treatments like physical therapy and spinal manipulation, it can help reduce the pain affecting the muscle fibers while restoring the body to normalcy and lengthening tight muscles. When the MET technique is combined with other forms of therapy, it can help stretch and strengthen the weak muscles and allows the individual to be aware of how their posture is being corrected.
Conclusion
It is important to everyone that different factors and injuries could result from muscle imbalances that can affect your posture. Muscle imbalances in the body can lead to unwanted symptoms of muscle weakness, pain, and dysfunctional gait patterns that correlate with musculoskeletal disorders. Going to therapy treatments and incorporating techniques like MET, physical activities, and chiropractic care can help the body be restored and prevent future injuries from returning and affecting a person’s health and wellness.
References
Chaitow, Leon, and Judith Walker DeLany. Clinical Applications of Neuromuscular Techniques. Churchill Livingstone, 2003.
Joshi, Reema, and Nishita Poojary. “The Effect of Muscle Energy Technique and Posture Correction Exercises on Pain and Function in Patients with Non-Specific Chronic Neck Pain Having Forward Head Posture-a Randomized Controlled Trail.” International Journal of Therapeutic Massage & Bodywork, U.S. National Library of Medicine, 1 June 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC9134480/.
Neme, Jamil R. “Balancing Act: Muscle Imbalance Effects on Musculoskeletal Injuries.” Missouri Medicine, U.S. National Library of Medicine, 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC9324710/.
Vodička, Tomáš, et al. “Could the Evaluation of Muscle Strength Imbalances Be Used as a Predictor of Total Hip Arthroplasty?” International Journal of Environmental Research and Public Health, U.S. National Library of Medicine, 11 May 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8150769/.
Many people don’t often realize that stability and balance are two of the most reliable abilities to keep the body from falling, and it is often taken for granted from the earlier stages, where infants and toddlers are learning to stand upright, to adulthood where we are walking, running or performing any physical activities. Our bodies are complex machines comprised of upper and lower portions that provide balance and stability. The lower half of our bodies helps stabilize and balance the upper half weight and allows us to move around. This is known as gait. However, when the body begins to age naturally or chronic issues begin to affect the muscles and cause an imbalance in the lower half, it can lead to many disorders associated with these imbalances. Today’s articles examine what gait is, how gait disturbances are associated with the body, and how the MET technique improves gait. We provide information about our patients to certified medical providers that offer available therapy techniques like MET (muscle energy techniques) for individuals dealing with chronic conditions associated with gait disturbances that could affect a person’s ability to walk. We encourage each patient appropriately by referring them to our associated medical providers based on their diagnosis results. We accept that education is a spectacular way when asking our providers the most crucial questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., assesses this information as an educational service. Disclaimer
What Is Gait?
Have you been dealing with issues when walking for a short or long distance? Do your feet or ankles seem to feel tired or ache when stepping? Or have you been dealing with mobility issues in your hips? Many of these issues are associated with gait and can cause balance disturbances in the body. So what is gait? In the book by Leon Chaitow, N.D, D.O., and Judith Walker DeLany, L.M.T, titled “Clinical Applications of Neuromuscular Techniques,” gait is defined as how you walk and how each lower body section contributes to how you walk. This includes:
Feet
Ankles
Knees
Hips
Spine
The book also mentions how a person progresses from one location to another using muscular action and gravity to make them walk. Two functional units are in a casual relationship contributing to gait: the passenger and locomotor units. The passenger unit consists of the upper extremities, like the head, neck, arms, trunk, and pelvis, to be the center of gravity when moving forward. At the same time, the locomotor unit comprises the pelvis and lower extremities, like the legs, knees, feet, and ankles, to support the weight of the upper extremities and perform structural stability and mobility to make the body move forward.
Gait Disturbances Associated With The Body
So what happens when traumatic factors or natural aging begins to affect the body and causes gait disturbances. Research studies reveal that since gait depends on the interplay of the nervous, musculoskeletal, and cardiorespiratory system which can be influenced by age and other factors that can lead to issues in the lower extremities causing falls and injuries. Many factors can lead to gait disturbances that can affect how a person walks and how it can affect the joints and muscles, which can lead to pain-like symptoms. Additional studies mentioned that gait disorder affects elderly adults, increasing their fall risk and leading to mobility issues in their hips. Muscle shortening and joint health are other issues that can cause gait disturbances in the lower extremities. When the muscles in the lower extremities are tight and weak, it can cause them to be short and be accompanied by joint dysfunction. The health of the joints in the lower extremities depends on the balancing strength of the opposing flexor muscles. When the flexor muscles lose part or all of their function, it can cause the joint to be hyperextended. To that point, it causes abnormal joint stress, corresponding to lower back pain associated with gait disorders affecting a person’s ability to walk and keep their body balanced.
An Overview Of Gait Analysis-Video
Have you been dealing with mobility issues in your joints? Do you find yourself becoming unstable every time you walk? Or do your leg muscles feel tight? If you have been dealing with these issues, it could be due to a gait problem. Many people have different ways of walking; if there are issues, they can be pointed out in an examination. When there is an issue with gait, it can indicate pain and other revealing problems that can affect the entire body. The video above explains the gait cycle and gait analysis of a person’s walk. Gait analysis is often used in a normal examination to evaluate how a person walks, their body mechanics, and muscle activity to provide insight into the issue. A person’s gait can offer many important clues that doctors and pain specialists can see and identify the problem by developing a treatment plan to improve a person’s gait and reduce pain-like symptoms.
How The MET Technique Improves Gait
So many treatment plans can effectively improve balance and gait disorders in the body. Many pain specialists like chiropractors use manual spinal manipulation to re-align the spine to loosen stiff joints that may have contributed to imbalances in the lower extremities. MET (muscle energy technique) and physical therapy can help stretch the tight muscles and strengthen the muscle groups affected. MET and other approaches to improve gait allow many individuals to regain their stamina and adopt new strategies for their posture and movement. These therapy treatments will enable a person to feel more confident and more aware of how they walk while providing muscle strength to the affected muscles to prevent fatigue and decrease the chances of injuries in the future, as studies reveal.
Conclusion
Walking is determined by a person’s gait and how they move in different scenarios. Our bodies are comprised of upper and lower portions that correspond with gait and allow us stability and balance when we are in motion. When various issues like traumatic factors or just normal aging affect the body, the joints and muscles can cause problems with a person’s gait, leading to balance issues and fall injuries. Incorporating treatment plans to improve gait can help prevent future chances of injuries and help stretch and strengthen the affected muscles while loosening up stiff joints. This allows a person to regain their balance and improve stability in their bodies.
References
Baker, Jessica M. “Gait Disorders.” The American Journal of Medicine, U.S. National Library of Medicine, 27 Dec. 2017, pubmed.ncbi.nlm.nih.gov/29288631/.
Chaitow, Leon, and Judith Walker DeLany. Clinical Applications of Neuromuscular Techniques. Churchill Livingstone, 2003.
Pirker, Walter, and Regina Katzenschlager. “Gait Disorders in Adults and the Elderly : A Clinical Guide.” Wiener Klinische Wochenschrift, U.S. National Library of Medicine, Feb. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5318488/.
Van Abbema, Renske, et al. “What Type, or Combination of Exercise Can Improve Preferred Gait Speed in Older Adults? A Meta-Analysis.” BMC Geriatrics, U.S. National Library of Medicine, 1 July 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4488060/.
Uneven hips can throw the back out of natural alignment and cause back stiffness, tightness, discomfort, and pain. Hips that are off-balance unhealthily affect standing, sitting, sleeping posture, walking gait, and overall movements. Biomechanics issues cause the core and spine stabilizing muscles to become weakened and fatigued from overcompensating to keep the body up and moving. Over time this can lead to chronic pain in the back, hips, knees, and feet. Chiropractic care can restore proper hip and spinal alignment and wellness.
Uneven Hips
Misaligned hips can be caused by work or sports injury, exercise, vehicle collision, and/or general wear and tear. When hips are out of alignment, they have shifted from their centered position. They could be rotated forward or backward, forcing the spine and the lower limbs to compensate, resulting in the spine tilting that can make the legs appear uneven. Discomfort may be one-sided low back pain near the sacroiliac joint, causing a stiff/tight back, limited motion, and/or pain symptoms. Because the spine and lower limbs have to compensate for the unevenness, the shoulders and upper back, connected to the pelvis through the spine, are also affected and result in:
Back pain.
Hip and gluteal muscle pain.
Uneven leg length.
Knee, ankle, and foot issues and pain.
Uneven shoulders.
The shoulder blades can stick out on the side of the lower hip.
Rib discomfort and pain.
The rib cage could protrude out on one side. However, this could be due to advanced scoliosis.
Therapy
Staying active is recommended and includes stretching and core strengthening. General stretches recommended to optimize hip equity include:
Hamstring stretch
For this stretch, lie on a flat surface with your legs extended straight out.
Bend the right leg at the knee, placing the right foot on the ground.
Use a towel, belt, or band to grab and wrap around the left foot.
Keep the hip/buttock on the left side planted on the floor.
Slowly raise the left leg upward as far as possible until you feel the stretch.
Once you feel a stretch or restriction in the hamstring, hold the position for 30 seconds.
Repeat on the other side.
Perform 2 to3 times.
Hip flexor stretch
Kneel on the affected leg and bend the healthy leg out in front with the foot flat on the floor.
Back straight.
Slowly push the hips forward until you feel the stretch in the upper thigh and hip.
Hold the stretch for around 15 to 30 seconds.
Chiropractic Care
Chiropractic treatment is a highly recommended non-surgical option for uneven hips and pelvic tilt. Depending on the severity of the misalignment, underlying issues, and body scanning images, hip alignment treatment could include:
Soft tissue therapeutic massage
Chiropractic muscle release for tight hip flexors, quadriceps, hamstrings, and glutes.
Kiapour, Ali et al. “Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain.” International journal of spine surgery vol. 14, Suppl 1 3-13. 10 Feb. 2020, doi:10.14444/6077
Lee, Jeong-Hoon, et al. “The effect of Graston technique on the pain and range of motion in patients with chronic low back pain.” Journal of physical therapy science vol. 28,6 (2016): 1852-5. doi:10.1589/jpts.28.1852
Patel, Rikin V et al. “Pelvic Tilt and Range of Motion in Hips With Femoroacetabular Impingement Syndrome.” The Journal of the American Academy of Orthopaedic Surgeons vol. 28,10 (2020): e427-e432. doi:10.5435/JAAOS-D-19-00155
Rivière, C et al. “Spine-hip relations add understandings to the pathophysiology of femoro-acetabular impingement: A systematic review.” Orthopaedics & traumatology, surgery & research : OTSR vol. 103,4 (2017): 549-557. doi:10.1016/j.otsr.2017.03.010
Suits, William H. “Clinical Measures of Pelvic Tilt in Physical Therapy.” International journal of sports physical therapy vol. 16,5 1366-1375. 1 Oct. 2021, doi:10.26603/001c.27978
A Trendelenburg gait is an abnormal walking gait resulting from a defective or weakened hip abductor.The gluteal musculature is the primary musculature that includes the gluteus medius and gluteus minimus muscles. Weakness in these muscles causes sagging/dropping of the pelvis on the opposite side while walking. There will be a noticeable side-to-side motion if the glutes are too weak to support the body’s weight when walking. It can look as though the individual is limping or missing a step. Individuals can minimize the effects with foot orthotics, core strengthening, chiropractic, and physical therapy.
Trendelenburg Gait Causes
This gait often results from straining the hip abductor muscles during physical activity. Exercises specifically for the glutes done improperly are a common cause. When improper exercise form is the cause, the abnormal gait usually goes away as muscle inflammation fades. The gait can also present after total hip replacement surgery, as the procedure requires incisions in the gluteus medius muscle. This can weaken the muscle causing an abnormal gait. Weakness in these muscles can also be caused by:
Nerve damage or dysfunction in the nerves that run through the gluteal minimus and medius muscles.
Osteoarthritis is a type of arthritis that occurs when joint cartilage starts to wear down.
Muscular dystrophy is a condition that causes the muscles and bones to become weak over time.
Poliomyelitisis a condition associated with polio that weakens the muscles.
Cleidocranial dysostosis is a condition present from birth that can cause your bones to develop improperly.
Symptoms
The walking gait is made up of two phases:
Swing – When one leg moves forward.
Stance – The other leg stays still and maintains balance.
The main symptom of Trendelenburg gait can be seen when one leg swings forward and the hip drops down and move outward. This is because the hip abductor of the other leg is too weak to support the weight. Individuals may lean back or to the side slightly when walking to maintain balance, or they may lift the foot higher off the ground with each step to avoid losing balance or tripping as the pelvis shifts unevenly.
Diagnosis
Abnormal hip movement during a swing of one or both legs can give a doctor enough evidence to diagnose a Trendelenburg gait. A doctor will observe the individual’s walk in front and behind to get a detailed view. A doctor will also use the Trendelenburg test to diagnose the condition. The doctor will instruct the individual to lift one leg for 30 seconds. If the individual cannot keep the hips parallel with the ground while lifting, it could indicate Trendelenburg gait. X-rays of the hip will be used to identify any causes of weakness in the gluteus minimus or medius.
Treatment Options
Treatment options will depend on the severity and cause of the gait.
Medication
If the gait is causing pain, over-the-counter nonsteroidal anti-inflammatory NSAIDs, like ibuprofen or acetaminophen, will help ease symptoms.
In severe cases, a doctor may prescribe cortisone injections to help reduce pain.
Foot Orthotics
A doctor could also recommend using a foot orthotic in one or both shoes to compensate the hip abductor muscle weakness.
Chiropractic, Physical Therapy, and Exercise
Chiropractic and physical therapy can help adjust, realign, and strengthen the muscles to regain control of the Trendelenburg gait. The chiropractor or physical therapist will move the legs in various directions to help the joints become more accustomed to moving in certain directions and increase muscle strength and resistance. Exercises that can strengthen the hip abductor muscles include:
Lie on the side and extend the leg straight out.
Lie on the floor and move one leg up, over the other, and back in the opposite direction.
Step sideways and onto an elevated surface, then back down again.
Talk with a doctor or chiropractor before beginning any new exercise routine so they can recommend specific exercises and educate on proper form.
Complications
If left untreated, moderate-to-severe cases of Trendelenburg gait can become debilitating, leading to severe complications. These include:
Pinched nerves.
Sciatica.
Pain, stiffness, or grinding in the hips.
Loss of range of motion in the hips and gait.
Losing the ability to walk, which could require the use of a walker or wheelchair.
Trendelenburg gait is treatable with special shoes, orthotics, and exercises designed to strengthen the hip abductor muscles. Chiropractic and physical therapy can help limit the condition’s impact on the body’s health, the ability to walk, and reduce the risk of complications.
Body Composition
Heart-Healthy Foods
Citrus
The bright and tangy fruits are packed with vitamins and unique plant compounds known as polyphenols that can help lower blood pressure naturally.
However, it’s important to note that grapefruit and grapefruit juice could interact with certain prescription medications.
Beans and Lentils
Foods high in magnesium, potassium, and fiber can help maintain healthy blood pressure.
This is where beans and legumes come in, as they are high in fiber, potassium, and magnesium.
Individuals that swapped beans and lentils noticed a lower blood pressure, whether or not they had been diagnosed with hypertension.
Pumpkin Seeds
These seeds are packed with potassium, magnesium, and arginine.
Arginine is an amino acid used to make nitric oxide, which helps the blood vessels relax and dilate, allowing lower blood pressure.
A study found that postmenopausal women who took 3 grams of pumpkin seed oil daily for six weeks saw a significant decrease in their systolic blood pressure.
Garlic
Garlic contains nitric oxide, which has been shown to relax blood vessels.
Kyolic garlic, in particular, has been shown to help with arterial stiffness and can improve cholesterol levels.
References
Feyh, Andrew et al. “Role of Dietary Components in Modulating Hypertension.” Journal of Clinical & experimental cardiology vol. 7,4 (2016): 433. doi:10.4172/2155-9880.1000433
Gandbhir, Viraj N., et al. “Trendelenburg Gait.” StatPearls, StatPearls Publishing, 19 August 2021.
Giangarra CE, et al. (2018). Clinical orthopedic rehabilitation: A team approach.sciencedirect.com/science/book/9780323393706
Gilliss AC, et al. (2010). Use of osteopathic manipulative treatment to manage compensated Trendelenburg gait caused by sacroiliac somatic dysfunction.
jaoa.org/article.aspx?articleid=2093879
Maricelli JW, et al. (2016). Trendelenburg-like gait, instability and altered step patterns in a mouse model for limb-girdle muscular dystrophy 2i. DOI:
10.1371/journal.pone.0161984
Mayo Clinic Staff. (2017). Osteoarthritis.mayoclinic.org/diseases-conditions/osteoarthritis/home/ovc-20198248
Michalopolous N, et al. (2016). A personalized monitoring and recommendation framework for kinetic dysfunctions: The Trendelenburg gait. DOI: 10.1145/3003733.3003786
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