Effect Of Myofascial Release With Targeted Gluteus Maximus and Medius Activation on Lumbar Pain , Pelvic Stability and Functional Mobility

Abstract

Background: Mechanical low back pain (LBP) causes pain, disability, pelvic instability, and gait dysfunction. Myofascial release (MFR) may reduce soft tissue restriction, whereas gluteal strengthening may improve pelvic stability. Case Presentation: A 62-year-old female presented with severe LBP radiating to the left lower limb, waddling gait, pelvic asymmetry, functional scoliosis, positive Trendelenburg test, restricted hip ROM, and gluteal weakness (3/5). The NPRS was 10/10 and MODI was 48 %.Intervention: A six-week physiotherapy program that included MFR, hip ROM exercises, gluteal activation, strengthening, stretching, postural and gait training, electrotherapy, and patient education. Outcome Measures: Pain and disability were measured using the Numerical Rating Pain Scale (NPRS) and Modified Oswestry Disability Index (MODI), respectively . Hip range of motion (ROM) was measured using a goniometer, and muscle strength was assessed using manual muscle testing (MMT). Apparent leg length, gait pattern, and the ability to perform activities of daily living were also assessed.Results : The NPRS increased from 10/10 to 4/10 and MODI from 48% to 42%. The strength of the gluteals and iliopsoas in the patients improved from 3/5 to 4/5, and their hip range of motion, gait pattern, pelvic control and ability to perform activities of daily living improved.Conclusion: The six-week physiotherapy program led to decreased levels of pain and dysfunction, as well as increased strength, mobility, gait, and overall performance.