The patient generally presents with leg stiffness, weakness in the hip flexors, and impaired foot dorsiflexion in the second through fourth decades, although symptoms may be apparent in infancy or not until late adulthood. The gait disturbance progresses insidiously and continuously. Patients may also have paresthesia and mildly decreased vibratory sense below the knees and urinary urgency and incontinence late in the disease. On neurological examination, generally there are no abnormalities of the corticobulbar tracts or upper extremities, except possibly brisk deep tendon reflexes. In the lower extremities, deep tendon reflexes are pathologically increased and there is decreased hip flexion and ankle dorsiflexion. Crossed adductor reflexes, ankle clonus (Video 82, Cross‐Adductor Reflex; Video 84, Sustained Clonus), and extensor plantar responses are present. Hoffman's and Tromner's signs, as well as pes cavus, may be present. Occasionally, slight dysmetria may be seen on finger‐to‐nose testing in patients with long‐standing disease.

This test measures a participant's ability to stand up from a seated position as many times as possible in a thirty-second period of time.[2] Testing the number of times a person can stand up in a thirty-second period helps assess strength, flexibility, pain, and endurance,[2] which can help determine how far along a person is in rehabilitation, or how much work is still to be done.

Often people try to correct a forward tilt of the pelvis by gripping with the abdominal muscles. But besides limiting your breathing and being counterproductive in backbends, gripping the abdominals won't control the anterior pelvic tilt if you have tight hip flexors—not even in simple standing postures. That's why it's so important to make hip flexor stretches part of your daily practice, especially after a long day of sitting. These poses will let you enjoy a new sense of space in your pelvis—and help protect you from compression and pain in your lower back.
Working in the pelvic region is not easy for many therapists and clients. There are cautions and borders that need to be addressed and talked through before addressing these muscles. There are emotional and comfort aspects about working in the lower pelvic region. Some clients find this area too personal or private to allow the therapist's hands in this area. Other considerations are the internal organs such as the intestines, uterus, kidneys, and bladder. As the iliacus and psoas travel under the inguinal ligament and insert into the lesser trochanter of the femur, there is also the femoral triangle, which needs to be worked around. Body positioning can be useful to help access these muscles in a less invasive way while protecting the comfort of the client.
Your standard lunge does a nice job of making your derriere stronger, but to get glutes that function at their best, you need to start moving sideways, too. You see, when you do a side lunge or skaters, for example, you strengthen muscles in your outer hips. And strong outer hips can help you steer clear knee injuries. Plus, the sideways moves engage glute muscles so they can reap all the benefits of lower-body exercises. Not sure where to start? These exercises will help inspire you to work your glutes at a new angle. 

(10) Exercising - you talk about building muscle - this comes from breaking down the muscle and building it back up with protein. A surplus is not needed for muscle growth, protein is. I always say stick with 100g minimum so you’re consistent. 100g is 400 calories. Muscles need glucose to perform, so I would eat enough carbs to fill your glycogen levels to prepare for your next training. Then eat fats to cover the rest of the calories whether it’s a surplus or deficit. You can build muscle and lose weight in the same day, just not at the same time (I’ll explain in point 10). Building muscle = breaking down the muscle and rebuilding it with protein. Losing weight = a deficit. Tell me why this can’t happen? Some fear muscle loss during deficits. No. Eat protein. Eat a little more. Some think surpluses are needed to build muscle. No. A surplus leads to fat gain. Even if the excess calories come from protein. Everything has a number. Figure out what fits for you. This is why point 9 is important.

This muscle is the largest of the gluteal group. Its origin is the posterior line of the upper ilium, the posterior surface of the lower sacrum, and the side of the coccyx. Its insertion is two-fold: First, the lower and larger portion of the gluteus maximus end with a thick tendon that passes through the greater trochanter (hip) into the iliotibial band. And there is also the gluteal tuberosity between the vastus lateralis (a quadriceps muscle) and adductor magnus.
When it comes to finding the right meal plan, you have to start somewhere. Start with writing down what you eat in a food diary, calculate the calories you’re consuming daily (ex: 3,000 without protein shakes), and break those up into six meals (ex: 500 calories each), says Heath. Then, choose a macronutrient ratio. For example, the 40% protein, 40% carbs, 20% fat ratio is what Heath used to get bigger when he first started bodybuilding. “Buy a food scale, learn how to use it, and you may even have to learn to use the metric system, like grams instead of ounces,” Heath says. “You need to train your body to process food quickly, so eat every three hours.”
^ Mangano, Kelsey M.; Sahni, Shivani; Kiel, Douglas P.; Tucker, Katherine L.; Dufour, Alyssa B.; Hannan, Marian T. (February 8, 2017). "Dietary protein is associated with musculoskeletal health independently of dietary pattern: the Framingham Third Generation Study". The American Journal of Clinical Nutrition. 105 (3): 714–722. doi:10.3945/ajcn.116.136762. PMC 5320406. PMID 28179224 – via ajcn.nutrition.org.
In addition to the proper amount of sleep, do not overdo your training regimen. While you might be tempted to think that "more is better," in fact the opposite is true. You can reach a point known as "over-training", in which you'll lose the ability to "pump" (engorge the muscles with oxygen-rich blood) your muscles, and this can even lead to muscle wasting—exactly the opposite of what you are trying to achieve. Here are some symptoms to be aware of if you think you may be falling into the over-training zone:
Below (in no particular order) are the top glute exercises to incorporate into your fitness regimen. You can mix and match these in multiple combinations for awesome glute and overall lower body work. Sets and reps for each exercise depends on your particular needs, goals, and current abilities. But, 2-5 sets of 8-15 reps is Reames’ general recommendation. 
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Information is the best approach. This makes me think of another question I recently answered: “how do I motivate myself to get in shape”. My answer simply was to read. I feel reading helps motivate us. Which can lead into a habit. It can be tough to become motivated to learn and read, but we need to take this action. I’m motivated to write this because I enjoy explaining things so it helps people understand better. One can practice turning motivation into habits by “waking up”. It can be tough to wake up in the morning (even worse at a certain/different time than one is use to). If one can accomplish waking up when tired, this to me, seems to help accomplishments by that energy being rolled onto other “goals”. It’s hard again because one is use to waking up when they have been usually waking up. Since they “usually” wake up at a certain time, this means they have repeatedly did something over and over. It’s time to try and do some else over and over.

(4) Insulin is a fat storage hormone - this isn’t true, okay kinda. Like I mentioned, both insulin and protein trigger insulin. If insulin was the issue than high protein intakes should has a worse reputation beyond what it currently has. Insulin has a job of transporting nutrients into cells. Carbs have a more direct connection to insulin than protein, so when carbs are consumed, insulin is spiked higher. Insulin will take the carbs (sugars) and transport them into cells for energy and then the rest into glycogen to save for later. If glycogen is full, then insulin still has a job to do. It doesn’t just float around dumb founded. It takes the carbs (sugars) and stores then into fat. It’s smart like that. But, we abuse that system by eating too many carbs and being in a surplus. The body doesn’t want to convert carbs into fat, that’s what fats are for, yet we abuse and do it anyways.
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Grade III (severe): A complete tear in your muscle that causes severe pain and swelling and you can't bear weight on that leg, making it difficult to walk. You've also lost more than 50 percent of your muscle function. These injuries are less common and may need surgery to repair the torn muscle. They can take several months or more to completely heal.
The first thing you need is a weight training program that signals the muscle building process to begin. Research has shown that a well designed program will generate this “signal” via a combination of progressive tension overload (as in, getting stronger over time), metabolic stress (as in, fatiguing the muscle and getting “the pump”), and muscular damage (as in, actual damage to the muscle tissue itself).
I get it. Bodybuilding is a subjective sport with judges that determine who wins based on the judges opinions. In the other resistance training sports you win objectively by outperforming your competitors. Bodybuilders also tend to work out differently with little concern for the weight being lifted, so long as the end result is a better-looking body. This can make bodybuilding type training seem narcissistic and shallow. That’s too bad because hard core resistance training athletes can learn a LOT from bodybuilders and how they train.
Just because your hip flexor region feels sore doesn’t necessarily mean the muscles there are tight — in fact, they might need strengthening. This is where that sports science debate we mentioned earlier comes into play. It’s important to identify whether you’re tight or if the muscles are weak. Again, the Thomas Test will help you identify if you’re maybe stretching something that actually needs strengthening.

Rest your hip. Sore hip flexor muscles can benefit from rest. Avoid the activities that caused your pain. Ice your affected hip for 20 minutes at a time, several times a day. Keep the leg of your affected hip elevated as much as possible 48 hours from the first onset of pain. You can also take over-the-counter pain medications to help control pain.
Below is a workout that you can use to get you going while you're travelling for the few days of Eid: Warm-up 10 Jumping Jacks 10 High Knees 10 sit-ups OR 5-10 Minute Light Jog (If you have outdoors access) Workout: 15 Squats 15 Push-ups 15 Glute Bridges 15 Lunges X 4 sets How to do the workout: Squat: Stand with your feet shoulder width apart and your toes turned outwards 15 -- 30 degrees.
First off, every single resistance-training athlete in the world should be very thankful for bodybuilding training. It was bodybuilding that brought weight training to the mainstream. The bottom line is that the average gym goer is MORE interested in how they look vs. how they perform. 99% of every client I ever trained had an aesthetic goal as their primary goal. In my 20 plus years as a trainer I can count maybe 10 clients who said, “My goal is to be able to bench press or squat or lift more weight.” It was the aesthetic focus of bodybuilding that opened the doors for all other resistance training pursuits to enter into the mainstream.
Are you tired of stretching or rolling out tight hip flexors with no improvements? If you are a runner, weight lifter, or team sport athlete, chances are you have heard a teammate or friend complain about having “tight hip flexors”. Either that or you yourself have had to deal with the problem. The problem with these tight hip flexors is that people will stretch, stretch, and ……..stretch some more (until the cows come home) and get NO RELIEF. This keeps people in a perpetual cycle of ALWAYS stretching their tight hip flexor with no real permanent relief.  The cycle looks something like this:
Work on strengthening all of your core muscles and glutes. These muscles work together to give you balance and stability and to help you move through the activities involved in daily living, as well as exercise and sports. When one set of these muscles is weak or tight, it can cause injury or pain in another, so make sure you pay equal attention to all of them.
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The iliopsoas is another powerful hip flexor that begins in two distinct regions proximally. The iliacus has a broad origin, arising from the inner table of the iliac wing, the sacral alae, and the iliolumbar and sacroiliac ligaments. The psoas originates at the lumbar transverse processes, the intervertebral discs, and the adjacent bodies from T12 to L5, in addition to the tendinous arches between these points. Distally, the two large muscular bodies converge to become one distinct structure—the iliopsoas—and subsequently jointly insert at the lesser trochanter of the proximal femur. The nerve to the iliopsoas (i.e., the anterior division of L1 to L3) supplies the iliopsoas muscle.


This muscle is the largest of the gluteal group. Its origin is the posterior line of the upper ilium, the posterior surface of the lower sacrum, and the side of the coccyx. Its insertion is two-fold: First, the lower and larger portion of the gluteus maximus end with a thick tendon that passes through the greater trochanter (hip) into the iliotibial band. And there is also the gluteal tuberosity between the vastus lateralis (a quadriceps muscle) and adductor magnus.
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These muscles are all involved in the action of flexing the hip which is required during squatting, running, and playing sports. Something important to take note of here is that the psoas muscle (part of the iliopsoas) actually starts at the spine and runs down to the hip. It is considered to play a role in spinal stabilization. Common complaints include a pinch/sharp/tight sensation when getting down into a squat, pain in the front of the hip/thigh during running, or sensation of tightness when sitting for long periods of time.

To do dips, place your hands at shoulder-width apart on a bench, with your body and feet stretched out in front of the bench. Slowly bend your elbows and lower your body down so that your butt nearly touches the floor. Lift back up with your arms to starting position; repeat, doing 3 x 8. If this isn't a high-intensity set for you, increase the resistance by lifting one foot off the floor.


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Bodybuilders spend years and years of their lives focused on perfecting the human body through proper training and nutrition. You, on the other hand, might not have an interest in the sport of bodybuilding, but do want to know the secrets to six-pack abs, a wide back, and rounded shoulders. And what better place to score the tricks of the trade than from 3-time Mr. Olympia Phil Heath. 
Most people require around 20 calories per pound (or 44 kcal / kg) of bodyweight to gain muscle mass. Using a 180-pound (82kg) male as an example, the required daily calorie intake is 3600 calories (20 kcal x 180 lb = 3600 kcal). When it comes to gaining weight, it is likely that you may put on a few pounds of fat along the way, but if you do find your body fat increasing, either increase the amount of aerobic exercise (moderate intensity) you are doing or slightly reduce the total number of calories you are consuming. Remember you can’t force feed muscle gain!
Other things would be….the main reasons “diets” work like keto, is because you are eating less food. Eating less will help always if you have been eating too much. Each diet has a specific way of doing things. Keto is cool because it drops the carbs. Dropping carbs is dropping calories. Dropping calories is eating less. Also, as we drop carbs we lower our glycogen levels which means we lower the risk of carbs turning into fats. If we just have fats being stored as fat, then we are doing better than bother carbs and fats being stored. This doesn’t mean carbs are bad because they are being dropped. This just means carbs are being dropped to get your glycogen levels back to “normal”. Also, with dropping carbs we drop the amount of work insulin has to do. Insulin does a lot during a surplus, so by dropping carbs, you drop calories and increase insulin sensitivity. Even if you don’t drop carbs, you still are improving insulin as you aren’t making it work in a surplus any more. Even though protein still spikes insulin, we are still improving it by letting ONLY protein spike insulin rather BOTH carbs and protein.
The hip flexors are a group of muscles in the front of the hip that act to lift the knee and bring the thigh towards the abdomen. The major muscles making up the hip flexors that we will focus on are the iliacus and the psoas, or the iliopsoas and the rectus femoris. The rectus femoris  is a “two joint muscle” because it crosses both the hip and knee joints. As a group, the hip flexors have attachments on the lumbar spine, the pelvis, and the femur. In addition to their major function of flexing the hip, their attachment on the spine makes them an important part of the core muscles and spinal stabilizers.
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