TITLE:
What Is the Association between an Anteriorly Tilted Pelvis and Trendelenburg Gait?
AUTHORS:
Yvonne Paul, Mariette Swanepoel, Terry J. Ellapen, Marco Barnard, Henriette V. Hammill, Reino W. Müller, Juandré Williams
KEYWORDS:
Anteriorly Tilted Pelvis, Trendelenburg Gait, Interactive Functional Rehabilitation
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.8 No.12,
December
19,
2018
ABSTRACT: 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.