​Greater than normal lumbar curvature during lifting and lowering, is a sign that the dancer relies disproportionately on the lower back and anterior hip muscles for trunk stability and less able to recruit the lower abdominals (transverse abdominus) and gluteals for lifting. Inability to initiate a balanced trunk stabilizing strategy, or retain dynamic hip centering, result in inefficient and laborious lifting and predisposes the structures of the lower back to risks of wear-and-tear and overuse injury. (Lower Crossed Syndrome - Janda)

As the upper body works against resistance, the lower back arches and knees migrate forward. The sudden back-arching reflex and forward shifting of the knees indicates tighter than normal, and or hypertonic rectus femoris (RF), in need of release, and weak/inhibited hip extensors that require strengthening.

Self-initiated pressure release with foam roller, decreases the tightness/tonicity present in this two-joint muscle, and allows the dancer to realize the influence RF has on adopted hip positions. It also makes the dancer more aware how the muscles around the hip should feel when the RF is released and the pelvis is in neutral alignment – the ASIS and PSIS remain in level position through balanced muscle effort - which is an important learning step in hip centering. (Note – The hand placed on the ankle provides a stable base against which the dancer performs resisted, full-range knee extension to loosen fascial adhesions and reach greater elongation of the RF muscle - sometimes up to 8 inches - with just a few takes, and without over-stretching structures - Autogenic Inhibition) Following this PNF procedure for trigger point release, the hip should feel "looser" and more responsive to abdominal bracing.

This positional release exercise helps to actively evaluate whether the dancer can maintain abdominal bracing and neutral pelvis against the passive resistance of RF, as the muscle is lengthened eccentrically in a rhythmical fashion. From a muscle imbalance perspective, I am interested in the dancer's ability to maintain hip alignment while stretch is put on the anterior structures of the hip, including the RF.

When the dancer lifts the right leg, the thighs rotate internally and the feet turn externally in response to forces of gravity. He also has a hard time maintaining the femur horizontally. According to kinesiologic studies, when Psoas cannot support the weight of the limb in flexion, the TFL/ITB and other muscles proximal/anterior to the hip tend to pick-up the workload and become overactive.

In contrast, when the left leg is lifted and held horizontally, the left thigh and knee remains aligned in Sagittal plane. Sagittal hip flexion without TFL/ITB coupling action, and neutral pelvis  indicates optimal Psoas recruitment and holding capacity on the left.

Gravity induced pressure on the muscle belly,  combined with movements that consider the kinesiologic function, fiber direction and attachment sites of TFL, quickly lowers muscle spindle activity, and releases the hip from the grip of TFL. (Note – No pressure is ever applied to the leg. The hand only provides passive resistance against the dancer’s effort, as he internally rotates the femur and activates posterior Glute-medius. Antagonist stimulation exercises as part of his home-practice, allows him to reciprocally inhibit and reduce the contractile capacity of TFL, anytime tightness develops in the IT band or as need arises)

After just one application of TFL self-release, followed by bilateral Psoas activation routine, the dancer is able to sustain neutral left knee/ankle position when re-tested. Multiple studies, and anecdotal feedback show that changes to automatic patterns of movement at the hips can be achieved with getting the right muscles involved, and the produced effects may be sustained with a simple conditioning routine.  Side note – When TFL muscle is overactive, even if this only occurs on the side of the non-weigh bearing leg, it can still tilt the hip anteriorly and send the lower back into hyperextension during weight bearing. This promotes poor dynamic trunk alignment, and decreases the weight acceptance capacity of hip extensors. Therefore the dynamic behavior of TFL should be tested on each side periodically, and released when signs of over activity is present.

Once the hip flexor muscles are released, the legs are lifted with the hips positioned neutral in supine laying. This position is suitable for practicing isometric trunk control via abdominal bracing, in combination with bilateral hip and knee flexion/extension, without pelvic motion. Hip flexion against resistance improves the holding capacity of Psoas, ankle dorsi-flexion enhances TRA activity, while resisted knee extension targets the hard to isolate, but generally weak VMO (Vastus Medialis Oblique) in the quad group. Reducing the irritability threshold of VLO (Vastus Lateralis Oblique) what makes VMO isolation possible.

As the hip and knee are held under tension on one side, the leg on the other is gradually lowered with knees held in bent position. When the descending leg nears horizontal, the lower abdominals are further tightened to maintain neutral hip and low-back position, which activates the gluteals. (This modified Thomas's test position  has been a reliable and repeatable measure of RF and TFL after activity)  ​Versions of this open chain endurance routine helps the dancer develop an internalized sense, that its possible to move the involved limb into flexion/extension against a stable trunk, without tilting the pelvis and or arching of the lower back. (Co-activation of the quads with deep lumbar stabilizers, prevents the early activation of hamstrings, especially biceps femoris (BF), and lumbar erectors and improves the dynamic behavior of Core/Gluteals during hip extension.)

To progress this exercise, the dancer is instructed to raise the lower part of the trunk of the platform only about a quarter to half-an-inch, and without loosing lower-back alignment, which is only possible through the co-contraction of the TRA/Lumbar Multifidus without substitution. This combination helps the dancer develop the strength and coordination necessary to maintain dynamic control over hip position/movements, even with the trunk and upper extremity muscles  engaged. Once this pelvic stabilizing pattern is learned, and becomes fine tuned through repeated practice, the nervous system will increasingly automate this new proximal/distal muscle alliance, and readies the body for closed-chain conditioning sequences.

Leaning forward at the hips with neutral positioned lumbar spine, and heels supported, further challenges the holding capacity of lower abdominals/gluteals against reflexively tight lumbar erectors/hamstrings. Bracing of the lower abdominals puts the lumbar muscles into an elongated position, while leaning forward from the hips eccentrically lengthens the hamstrings. Eccentric hamstring lengthening and maintaining tight erectors in a lengthened position, reduces the contractile strength of these tissues (Flexion Relaxation Phenomenon) and impels the nervous system to increasingly couple the gluteals/ abdominals for hip extension. With repetition and practice, this newly learned muscle dynamic becomes part of the dancer's muscle-memory and further advances lower abdominal and gluteal muscle co-activation in preparation to closed-chain flexions/extensions, including bi/unilateral lowering or lifting. (Reduction of lumbar erector muscle tone opens up the local capillary, improving blood flow, oxygen and nutrition exchange in the working tissue. Over time, this can permanently resolve localized trigger point action and ischemic episodes that frequently follow improper lifting)

Once the dancer is able to do isolated hip tilting, with abdominal and gluteal co-activation in closed chain kneeling, he is introduced to standing weight-bearing exercises, where he has to control the kinetic interplay between back/hamstring muscles versus abdominals/gluteals at a functional level. Kettlebell swing, especially asymmetric moves with light weight, is a perfect medium for introducing dynamic lumbar stabilization in an up-and-down motion. Recruitment of the lower abdominals during lifting, particularly during the initial phase of the lift when the stress on the lower back is greatest, helps to minimize strain on the inert lumbar structures and teaches the mechanics of lifting with good form and gluteal focused strategy.

As a final demonstration of effectiveness, the dancer is able to perform up-and-down motion without tilting the pelvis and arching the lower back, and relies solely on muscle memory to execute lifting task. ​He is much less dependent on the coupled behavior of the hamstrings, hip flexors and back muscles for lifting and has learned to rely on intra-abdominal pressure and thoracolumbar fascia to reduce potentially harmful forces at the lumbar region.