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.
In addition to the HIIT sessions, it’s always a good idea to go for a 30–60-minute walk as many days per week as you can. I recommend getting a minimum of 10,000 steps every day. Use a phone app to track them. If you’re into jogging, swimming, hiking, or some other form of long-duration, fairly low-intensity cardio, that is fine to do as well, and as often as you like.
Bodybuilders often split their food intake for the day into 5 to 7 meals of roughly equal nutritional content and attempt to eat at regular intervals (e.g. every 2 to 3 hours). This method can serve two purposes: to limit overindulging in the cutting phase, and to physically allow for the consumption of large volumes of food during the bulking phase. Contrary to popular belief, eating more frequently does not increase basal metabolic rate when compared to the traditional 3 meals a day. While food does have a metabolic cost to digest, absorb, and store, called the thermic effect of food, it depends on the quantity and type of food, not how the food is spread across the meals of the day. Well-controlled studies using whole-body calorimetry and doubly labeled water have demonstrated that there is no metabolic advantage to eating more frequently.
Too much sitting: You probably know it can contribute to serious health problems like obesity and osteoporosis. But did you know it also contributes significantly to back woes, including lower back pain in yoga poses? Fortunately, you can use your yoga practice to offset the effects of a sedentary lifestyle, relieve associated back pain, and set the stage for safe practice of intermediate poses like backbends.
The bulk of the gluteal muscle mass contributes only partially to shape of the buttocks. The other major contributing factor is that of the panniculus adiposus of the buttocks, which is very well developed in this area, and gives the buttock its characteristic rounded shape. The gluteal muscle bulk and tone can be improved with exercise. However, it is predominantly the disposition of the overlying panniculus adiposus which may cause sagging in this region of the body. Exercise in general (not only of the gluteal muscles but of the body in general) which can contribute to fat loss can lead to reduction of mass in subcutaneal fat storage locations on the body which includes the panniculus, so for leaner and more active individuals, the glutes will more predominantly contribute to the shape than someone less active with a fattier composition. The degree of body fat stored in various locations such as the panniculus is dictated by genetic and hormonal profiles.
Simply put, glute activation is waking up your glutes. It makes the connection from your brain to your muscle and gets the muscle fired up and ready to do some work. Glute activation should be done prior to your workout, but it can also be done as an active rest between sets. And trust me when I say that doing some glute activation prior to your squats, lunges, and deadlifts will result in an excellent glute workout!
Firstly, let’s establish where your glutes are and what they actually refer to! Your ‘glutes’ — or your gluteal muscles, as they are more formally known — refer to the muscles in your butt. Specifically, there are three major muscles in this area: your gluteus maximus (the main, large muscle that shapes your backside), your gluteus medius and your gluteus minimus (two smaller muscles that assist the gluteus maximus in moving your body).