Flat back syndrome is the reduction of the curve in the lumbar area. Due to neuroplasticity and myofascial adaptation, a flat back syndrome patient will present with deconditioned glutes and hamstring dominance.
Hamstrings are mobilisers, whereas glutes are stabilisers, but when the glutes are deconditioned and the hamstrings are restricted, the body adapts by recruiting synergistic muscles, to mobilise and stabilise the hip joint.
Hip Abductor Insufficiency
Hip abductor insufficiency presents itself during gait as a hip hike, which is called Trendelenburg gait.
Lumbopelvic stability in motion is maintained by force closure of the sacroiliac joint.
Gluteus medius is a stabiliser of the hip joint in abduction, so a lateral hip tilt will force the quadratus lumborum, a synergistic muscle on the other side of the hip tilt, to contract and pull up to stabilise the hip, and cause the hip to hike.
Treatment Strategy
Apply myofascial tension technique (MFTT).
Apply neuromuscular facilitation (NMF) to gluteus medius and minimus.
Mobilise the joint.
Prescribe functional movements and plyometrics appropriately.
Jnana Myotherapy 