The Posterior Layer of the Thoracolumbar Fascia|Its Function in Load Transfer From Spine to Legs

Guidelines and pitfalls for the rehabilitation following hip arthroscopy

“…Iliopsoas isometrics with simultaneous core activation and trunk extensor activation should also be performed in this position and will help to reestablish the hip flexor and lumbar extensor force couple during open chain hip flexion [19,25]. Global trunk musculature including the oblique externus and internus, rectus abdominus, and erector spinae causes movement of the trunk and controls load transfer from the lower extremities to the pelvis and spine [26,27]. Muscle activation of these groups is also important during this phase to reestablish appropriate load transfer during weight bearing and as the patient becomes more independent with activity of daily living.…”

“…During this phase of rehabilitation neuromuscular control of the lower extremity should be reestablished while maintaining trunk and pelvic stability to prevent compensations leading to irritation or injury [26,38,39]. Exercises should consist of single leg multi plane movements focusing on proximal stability with distal mobility.…”

Gluteus maximus and semitendinosus activation during active prone hip extension exercises

“…semitendinosus activity, indicating that it might be employed to activate the semitendinosus muscle. The integrity of the gluteus maximus is important for the stability of the sacroiliac joint 2,6,8,14 , however, the effectiveness of neuromuscular training with exercises has been based on subjective perceptions 21,22 . Many studies have shown reduced activity of the gluteus maximus in low back pain patients 4,16,23 , but there is no consensus regarding the best exercises to stimulate this muscle.…”

“…The gluteus maximus, due to its perpendicular aligned fibers, is important for providing effective load transmission through the sacroiliac joint, contributing to the force closure 6,8,9,12 . This function leads to effective compression of the sacroiliac joints and avoids shearing forces through its attachments with the lumbar paraspinal muscles, thoracolumbar fascia and biceps femoris muscle via the sacrotuberal ligament 6,13,14 .…”

“…Previous studies have identified that the gluteus maximus can significantly influence sacroiliac joint stability and its weakness has been found to be associated with low back pain 5,12,14 . This has a major functional importance in the early stance of gait by compressing the sacroiliac joint to provide stability 8 .…”