abdominal problem - need opinions pls

[etvin]

hello alophysio,
why can't it be this sway back posture due to Paralysis of gleutius maximus?
As i know Gleutius maximus provide stability in normal standing posture, and it helps to counteract the flexiom movement of hip. when this G.m paralysed the trunk will be pulled backward.

[etvin]

see this image here the sway back posture is due to problem at hip complex.

[alophysio]

Hi etvin,

1. Do you mean "paralysed"? Perhaps a better word would be inhibited? Paralysed would imply that the muscle has no neural input and the patient is unable to use it wouldn't it? I will assume this is not what you meant.

2. From the photo, it looks like he has normal enough muscle tone in his gluts. It is not the perfect picture and we only have one view but his gluts didn't strike me as being the problem. It looks like he hinges in the low L/S with a long kyphosis. As i explained above, i think the hinging is there because he cannot tell where he is in space in neutral posture.

3. I don't think glut max has a large role to play in normal standing stability. It actually should be quite toned down in relaxed standing because it's main function is to act in a phasic way. Standing is simply a sustained loading position which requires fine tuning from your slow twitch muscles (soleus, TrAb, pelvic floor, multifidus, etc etc). If you actually use your glut max when you are standing (try it), you will get tired and sore quite quickly.

I hope this helps. if it is still unclear, i am more than willing to try put it another way...

[Packard]

hi,thanks for your replies.

Ive found another physiotherapist and started this week,he started me on Hidrotherapy (exercises in the pool) and something called Kynesis,its like exercices with medicine balls and some machines.

what are your opinions on this? is this the recomended procedures?

thanks