Mobility Physiotherapy Limited

Mobility Physiotherapy Limited Mobility Physiotherapy Ltd based in York or home visits in North Yorkshire

Mobility Physiotherapy Limited offers Physiotherapy in a location to suit you, whether that is home, work or clinic. Treating musculoskeletal injuries, orthopaedics,Pilates (including pre and post natal) POTS, hypermobility and long covid.

Physiotherapy for Elderly Care & Rehabilitation ๐Ÿ’šSupporting independence, confidence and quality of life at every stage....
16/02/2026

Physiotherapy for Elderly Care & Rehabilitation ๐Ÿ’š

Supporting independence, confidence and quality of life at every stage.

We specialise in evidence-based rehabilitation for older adults, including:

โ€ข Vestibular rehabilitation (dizziness & balance)
โ€ข Neurological conditions โ€“ including stroke & Parkinsonโ€™s
โ€ข Rheumatology conditions
โ€ข Cardiac rehabilitation (pre & post surgery)
โ€ข Balance training & functional strengthening
โ€ข Building lung capacity after COPD
โ€ข Respiratory conditions, including COPD

Our goal is simple: help you move better, breathe easier and live more confidently.

Get in touch to book an assessment or learn how we can support you or your loved one.

๐Ÿ“ž 01904936076
๐Ÿ“ž 07954327405
๐Ÿ“ง info@mobilityphysiotherapy.co.uk
๐ŸŒ www.mobilityphysiotherapy.co.uk

15/02/2026

๐—ง๐—ต๐—ถ๐—ด๐—ต ๐— ๐˜‚๐˜€๐—ฐ๐—น๐—ฒ ๐—–๐—ต๐—ฎ๐—ป๐—ด๐—ฒ๐˜€ ๐—ถ๐—ป ๐˜๐—ต๐—ฒ ๐—”๐—–๐—Ÿ-๐——๐—ฒ๐—ณ๐—ถ๐—ฐ๐—ถ๐—ฒ๐—ป๐˜ ๐—ž๐—ป๐—ฒ๐—ฒ: ๐—” 4-๐—ฌ๐—ฒ๐—ฎ๐—ฟ ๐—Ÿ๐—ผ๐—ป๐—ด๐—ถ๐˜๐˜‚๐—ฑ๐—ถ๐—ป๐—ฎ๐—น ๐— ๐—ฅ๐—œ ๐—ฆ๐˜๐˜‚๐—ฑ๐˜† ๐—ผ๐—ณ 1,207 ๐—ฃ๐—ฎ๐˜๐—ถ๐—ฒ๐—ป๐˜๐˜€

๐Ÿฆต The anterior cruciate ligament (ACL) serves as a fundamental mechanical and sensory stabilizer of the knee. ACL tears are among the most prevalent ligamentous injuries, with an annual U.S. incidence of 68.6 per 100,000 (https://pubmed.ncbi.nlm.nih.gov/26920430/). While much of clinical orthopaedics has traditionally focused on acute quadriceps weakness following injury, emerging evidence suggests that the long-term neuromuscular landscape is far more complex. Systematic reviews, such as those by Birchmeier et al. (2020, https://pubmed.ncbi.nlm.nih.gov/31608490/) and Schwartz et al. (2025, https://pubmed.ncbi.nlm.nih.gov/39800896/), have highlighted persistent strength deficits and muscle size alterations that remain even years after the initial trauma. This suggests that an ACL tear is not merely a structural failure but a catalyst for chronic, systemic adaptations in the lower limb.

๐Ÿ“˜ A brand-new longitudinal matched-cohort study by Alzobi and colleagues (https://pubmed.ncbi.nlm.nih.gov/41370366/), utilizing data from the Osteoarthritis Initiative (OAI), tracked 1,207 participants over a four-year period to observe how an unreconstructed ACL tear influences thigh muscle morphology and function. The researchers employed a deep-learning U-Net model to segment MRI data, allowing for precise quantification of muscle cross-sectional area (CSA) and intramuscular adipose tissue (IMAT).

๐Ÿ”‘ ๐—ž๐—ฒ๐˜† ๐—™๐—ถ๐—ป๐—ฑ๐—ถ๐—ป๐—ด๐˜€

Contrary to the common clinical emphasis on the quadriceps, this study revealed that the most significant long-term deterioration occurs in the posterior thigh:

1๏ธโƒฃ ๐—ฆ๐—ฒ๐—น๐—ฒ๐—ฐ๐˜๐—ถ๐˜ƒ๐—ฒ ๐—”๐˜๐—ฟ๐—ผ๐—ฝ๐—ต๐˜†: ACL-deficient thighs experienced progressive atrophy in the hamstrings (-28.18 mm/year) and the sartorius (-3.02 mm/year).

2๏ธโƒฃ ๐—ค๐˜‚๐—ฎ๐—ฑ๐—ฟ๐—ถ๐—ฐ๐—ฒ๐—ฝ๐˜€ ๐—–๐—ฆ๐—” ๐—ฆ๐˜๐—ฎ๐—ฏ๐—ถ๐—น๐—ถ๐˜๐˜†: Surprisingly, no significant longitudinal changes were observed in quadriceps or adductor CSA over the four-year window.

3๏ธโƒฃ ๐—™๐˜‚๐—ป๐—ฐ๐˜๐—ถ๐—ผ๐—ป๐—ฎ๐—น ๐——๐—ฒ๐—ฐ๐—น๐—ถ๐—ป๐—ฒ: Corresponding with the physical atrophy, hamstring strength decreased significantly (-3.49 N/year), while quadriceps force remained relatively stable.

4๏ธโƒฃ ๐— ๐˜‚๐˜€๐—ฐ๐—น๐—ฒ ๐—ค๐˜‚๐—ฎ๐—น๐—ถ๐˜๐˜†: There were no significant differences in fat infiltration (IMAT) or contractile percentage between ACL-deficient and ACL-intact groups, suggesting the primary issue is muscle volume rather than "marbling" of the tissue.

๐Ÿ’ก ๐—–๐—น๐—ถ๐—ป๐—ถ๐—ฐ๐—ฎ๐—น ๐—œ๐—บ๐—ฝ๐—น๐—ถ๐—ฐ๐—ฎ๐˜๐—ถ๐—ผ๐—ป๐˜€

The results suggest that the loss of the ACL-hamstring reflex arcโ€”a feedback loop where ACL mechanoreceptors trigger hamstring activation (https://pubmed.ncbi.nlm.nih.gov/3618871/, https://pubmed.ncbi.nlm.nih.gov/11206261/)โ€”may lead to chronic disuse and subsequent wasting of the posterior muscles. This "quadriceps dominance" can further destabilize the knee by increasing anterior tibial shear. These findings challenge the traditional "quad-centric" view of ACL recovery. To protect the long-term health of the knee, rehabilitation must evolve to include rigorous, targeted strategies for hamstring preservation.

14/02/2026

๐—ฃ๐—ผ๐˜€๐˜-๐—ฒ๐˜…๐—ฒ๐—ฟ๐˜๐—ถ๐—ผ๐—ป๐—ฎ๐—น ๐—บ๐—ฎ๐—น๐—ฎ๐—ถ๐˜€๐—ฒ (๐—ฃ๐—˜๐— ) ๐—ฎ๐—ป๐—ฑ ๐˜๐—ต๐—ฒ ๐—บ๐˜†๐˜๐—ต ๐—ผ๐—ณ ๐—ฐ๐—ฎ๐—ฟ๐—ฑ๐—ถ๐—ฎ๐—ฐ ๐—ฑ๐—ฒ๐—ฐ๐—ผ๐—ป๐—ฑ๐—ถ๐˜๐—ถ๐—ผ๐—ป๐—ถ๐—ป๐—ด: ๐—ฟ๐—ฒ๐˜๐—ต๐—ถ๐—ป๐—ธ๐—ถ๐—ป๐—ด ๐˜๐—ต๐—ฒ ๐—ฝ๐—ฎ๐˜๐—ต๐—ผ๐—ฝ๐—ต๐˜†๐˜€๐—ถ๐—ผ๐—น๐—ผ๐—ด๐˜† ๐—ผ๐—ณ ๐—น๐—ผ๐—ป๐—ด ๐—ฐ๐—ผ๐˜ƒ๐—ถ๐—ฑ

PEM is a hallmark feature of long COVID, affecting approximately 80% of patients (https://pubmed.ncbi.nlm.nih.gov/39694730/ ). It is characterized by a delayed exacerbation of symptoms following physical or cognitive activity that exceeds a patient's specific, often narrow, threshold. Crucially, these "crashes" are not merely temporary fatigue; they can persist for weeks or even result in a permanent decline in the patient's baseline health. Because of this risk, major health authorities like the WHO have cautioned against traditional graded exercise therapies for these individuals (https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2023.2).

๐Ÿ“˜In a brand-new publication, Charlton and colleagues (https://bjsm.bmj.com/content/early/2026/02/09/bjsports-2025-111387) debunk the deconditioning myth of long covid. While physical inactivity (deconditioning) can occur in chronically ill patients, the authors present evidence that it cannot explain the specific cardiac alterations seen in long COVID:

โœ… Preload Failure: Many patients suffer from "preload failure," where the heart does not fill with enough bloodโ€”a phenomenon not typical of simple deconditioning.

โœ… Structural and Inflammatory Changes: Research has identified myocardial scarring, inflammation, and "leaky" blood vessels in long COVID cohorts.

โœ… Mitochondrial Dysfunction: There is significant evidence of deranged mitochondria and impaired oxygen extraction at the cellular level, suggesting an energy production failure rather than just a lack of fitness.

๐Ÿ‘ซ A Human-Centered Approach to Rehabilitation

The authors emphasize that because long COVID is highly heterogeneous, treatment must be personalized and data-driven. They advocate for several specific strategies:

โ–ถ๏ธ Systematic Screening: Healthcare providers should use tools like the DePaul Symptom Questionnaire to identify PEM early and distinguish it from other pathologies.

โ–ถ๏ธ Heart Rate Pacing: Utilizing wearable monitors to stay within the "first ventilatory threshold" allows patients to remain within their "energy envelope," preventing the repetitive exposure to PEM events that can worsen their health.

โ–ถ๏ธ Postural Management: For those with POTS or severe PEM, gentle upright postures, supported sitting, and compression garments are recommended to prevent skeletal muscle decline without triggering a crash.

โ–ถ๏ธ Targeted Pharmacotherapy: The use of low-dose naltrexone, beta-blockers, or pyridostigmine may be necessary to reduce the symptom burden of PEM and autonomic dysfunction.

๐Ÿ’กUltimately, the paper concludes that cardiac alterations in long COVID are largely independent of deconditioning, and safe recovery requires moving away from historical exercise guidelines toward an individually tailored management strategy.

09/02/2026

Hot off the Press ๐Ÿ”ฅ

๐—›๐˜†๐—ฝ๐—ฒ๐—ฟ๐˜๐—ฟ๐—ผ๐—ฝ๐—ต๐—ถ๐—ฐ ๐—˜๐—ณ๐—ณ๐—ฒ๐—ฐ๐˜๐˜€ ๐—ผ๐—ณ ๐—ฆ๐—ถ๐—ป๐—ด๐—น๐—ฒ- ๐˜ƒ๐—ฒ๐—ฟ๐˜€๐˜‚๐˜€ ๐— ๐˜‚๐—น๐˜๐—ถ-๐—๐—ผ๐—ถ๐—ป๐˜ ๐—˜๐˜…๐—ฒ๐—ฟ๐—ฐ๐—ถ๐˜€๐—ฒ: ๐—” ๐——๐—ถ๐—ฟ๐—ฒ๐—ฐ๐˜ ๐—–๐—ผ๐—บ๐—ฝ๐—ฎ๐—ฟ๐—ถ๐˜€๐—ผ๐—ป ๐—•๐—ฒ๐˜๐˜„๐—ฒ๐—ฒ๐—ป ๐—ž๐—ป๐—ฒ๐—ฒ ๐—˜๐˜…๐˜๐—ฒ๐—ป๐˜€๐—ถ๐—ผ๐—ป ๐—ฎ๐—ป๐—ฑ ๐—Ÿ๐—ฒ๐—ด ๐—ฃ๐—ฟ๐—ฒ๐˜€๐˜€

๐Ÿฆต Single-joint knee extension (KE) and multi-joint leg press (LP) are commonly used exercises to train the quadriceps femoris (QF), the largest muscle group in humans. However, their comparative effectiveness for inducing QF hypertrophy remains unclear. Furthermore, the specific muscles hypertrophied by LP are not well characterized.

๐Ÿ“˜ A brand-new study by Kinosh*ta and colleagues compared the hypertrophic effects of KE and LP on the QF and other lower-limb muscles (https://pubmed.ncbi.nlm.nih.gov/41630124/)

๐Ÿ“‹ Methods

๐Ÿ‹๏ธโ€โ™‚๏ธ Seventeen untrained adults performed KE with one leg and LP with the contralateral leg at 70% of one-repetition maximum, 10 reps/set, 5 sets/session, 2 sessions/week for 12 weeks. MRI was used to assess pre- and post-training muscle volumes of 17 individual muscles, including the four QF heads, gluteus muscles, hamstrings, and adductors.

๐Ÿ“Š Results (s. infographic)

Muscle volumes of the individual and whole QF significantly increased in both conditions ( P โ‰ค 0.026), except for the re**us femoris in the LP condition ( P = 0.379).

โœ… Re**us femoris volume gains were greater for KE than LP (+13.2% vs. +1.1%, P โ‰ค 0.001), but gains in the vasti muscles (+5.0-7.2% vs. +4.4-6.2%) and whole QF (+7.1% vs. +4.9%) were comparable between conditions ( P โ‰ฅ 0.319).

โœ… LP, but not KE, increased volumes of the gluteus maximus (+15.4%) and the adductor magnus (+6.2%) ( P โ‰ค 0.001).

โœ… A follow-up experiment using surface electromyography showed that muscle excitation patterns during KE and LP generally mirrored the between-condition hypertrophic differences and similarities observed after the training intervention.

๐Ÿ’กConclusions

LP induces significant hypertrophy in the gluteus maximus and adductor magnus while producing similar vasti and overall QF growth as KE, indicating that LP is a highly time-efficient exercise.

However, KE is essential for effectively targeting the re**us femoris, which may have clinical relevance given its high susceptibility to strain injuries and marked re**us atrophy after anterior cruciate ligament reconstruction.

We love celebrating your wins!Every journey is unique and hearing how physiotherapy has helped you move easier, feel str...
09/02/2026

We love celebrating your wins!

Every journey is unique and hearing how physiotherapy has helped you move easier, feel stronger and get back to what you love truly inspires us.

Ready for your own success story? Letโ€™s get you started ๐Ÿ—“๏ธ

We can do home visits in
โ–ช๏ธ York
โ–ช๏ธ Harrogate
โ–ช๏ธ Leeds
โ–ช๏ธ North Yorkshire
โ–ช๏ธ & Surrounding areas

Also, Clinic visits are available in Bishopthorpe, York๐Ÿ“

Book your session today by booking online here
๐ŸŒhttps://mobility-physiotherapy-ltd.uk1.cliniko.com/bookings

Encephalitis is a condition whereby a virus or autoimmune response causes inflammation to brain tissue. This often resul...
02/02/2026

Encephalitis is a condition whereby a virus or autoimmune response causes inflammation to brain tissue. This often results in swelling, disruption to neural functioning and if left untreated, neuronal death. It is often diagnosed with brain scans (normally MRI) and lumbar punctures can also be done to test cerebrospinal fluid for signs of encephalitis. It is a fairly rare condition, typically affecting around 10-15 people per 100,000 per year which equates to around 4000-6000 people annually. If left untreated, the condition is very serious and globally around 10% of patients with encephalitis pass away, however this is likely a lot lower in the UK where healthcare is very good.

Acute phase:

Treatment will be started depending on the type of encephalitis, normally strong antivirals if they suspect a viral cause, antibiotics if bacterial, steroids, immunoglobulin (IVIG) and plasma exchange is autoimmune.

Encephalitis is a condition whereby a virus or autoimmune response causes inflammation to brain tissue. This often results in swelling, disruption to neural functioning and if left untreated, neuronal death. It is often diagnosed with brain scans (normally MRI) and lumbar punctures can also be done....

๐Ÿ’š The power of physiotherapy, resilience and determination ๐Ÿ’šWeโ€™re incredibly inspired by Lucie Maguire, who is taking on...
02/02/2026

๐Ÿ’š The power of physiotherapy, resilience and determination ๐Ÿ’š

Weโ€™re incredibly inspired by Lucie Maguire, who is taking on an extraordinary challenge to mark five years since a life-changing accident.

At just 19, Lucie suffered devastating injuries after being run over by a tractor, resulting in the amputation of her right leg and pelvis, alongside multiple serious injuries. After spending 518 days in hospital and years of ongoing rehabilitation, Lucie continues to push boundaries in her recovery.

Now aged 24, Lucie is preparing to โ€˜hopโ€™ up Whitbyโ€™s famous 199 Steps on one leg to raise funds for Day One Trauma Support, the charity that supported her throughout her recovery journey.

Lucieโ€™s story highlights the vital role rehabilitation and physiotherapy play in helping individuals regain independence, rebuild strength and achieve goals that once felt impossible. With the support of her physiotherapy team, Lucie has progressed from standing with support, to walking with aids, to now taking on full staircases. An incredible achievement.

We wish Lucie the very best of luck with her challenge and applaud her determination to turn trauma into triumph while raising awareness for others living with serious injuries.

If you would like to support Lucieโ€™s fundraising challenge, you can donate here:
๐Ÿ‘‰ www.justgiving.com/page/lucie-maguire-1

01/02/2026

Just published ๐Ÿ”ฅ

๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ฎ๐—ป๐—ฑ ๐˜๐—ต๐—ฒ ๐—ถ๐—บ๐—บ๐˜‚๐—ป๐—ฒ ๐˜€๐˜†๐˜€๐˜๐—ฒ๐—บ

โš–๏ธ Pain is increasingly understood as a multidimensional phenomenon arising from dynamic interactions between the nervous and immune systems. Early conceptual frameworks framed pain largely as a neurocentric process; however, seminal work in neuroimmunology demonstrated that immune signaling plays a critical role in both the initiation and persistence of pain (https://pubmed.ncbi.nlm.nih.gov/36775098/, https://pubmed.ncbi.nlm.nih.gov/12270950/). Building on this paradigm, recent research has highlighted the importance of neuroinflammation across nociceptive, neuropathic, and nociplastic pain states (https://pubmed.ncbi.nlm.nih.gov/36775098).

๐Ÿ“˜ A brand-new narrative review by Hodges et al. (2026, https://www.sciencedirect.com/science/article/pii/S2468781225002322) synthesizes current evidence on neuro-immune mechanisms underlying chronic pain and discusses implications for mechanism-based treatment approaches. The authors present a comprehensive narrative review examining how interactions between immune cells and the nervous system contribute to the development and maintenance of chronic pain. Pain should not be viewed solely as a neuronal output but rather as the product of continuous bidirectional signaling between neurons and immune cells across the peripheral and central nervous systems.

๐Ÿ“Š Immune mediatorsโ€”such as cytokines, chemokines, prostaglandins, reactive oxygen species, and autoantibodiesโ€”modulate nociceptor excitability at multiple anatomical levels, including peripheral tissues, peripheral nerves, dorsal root ganglia, the spinal cord, and supraspinal brain regions. These neuro-immune interactions differ across pain phenotypes. In neuropathic pain, nerve injury triggers local immune activation that expands along the neuraxis, creating self-sustaining feed-forward loops between immune cells, glia, and hyperexcitable neurons. In nociceptive inflammatory conditions such as rheumatoid arthritis and osteoarthritis, tissue-driven inflammation initially dominates but may progressively transition toward central neuroinflammatory and nociplastic mechanisms.

โŽ A key contribution on pain chronicity seems to be a failure of inflammatory resolution rather than mere persistence of inflammation. Immune and glial cells are shown to play dual roles: while early pro-inflammatory responses are essential for tissue repair, insufficient engagement of anti-inflammatory and pro-resolving pathways promotes maladaptive plasticity and long-term pain. Specialized pro-resolving mediators, regulatory immune cells, and anti-inflammatory cytokines (e.g., IL-10) are critical modulators of pain resolution. Pain chronification may be viewed as a failure of anti-inflammatory processes to bring proinflammation to resolution.

๐ŸThe review further discusses translational challenges, noting that much mechanistic knowledge derives from animal models that incompletely capture the complexity of human chronic pain. Nonetheless, emerging human evidenceโ€”from tissue studies, transcriptomics, and neuroimaging using PET markers of glial activation โ€”supports a meaningful role of neuroinflammation in clinical pain conditions, particularly nociplastic pain.

๐Ÿ’Š Finally, precision pain management strategies that align treatments with dominant neuro-immune mechanisms are needed. Both pharmacological and non-pharmacological interventions (including exercise, diet, and behavioral therapies) are proposed to exert their effects partly through modulation of immune activity. An improved mechanistic classification of pain is essential to matching the right treatment to the right patient and advancing personalized pain care.

๐Ÿ“ท Figure: Overview of key neuroimmune processes at the level of the tissues, and the peripheral and central nervous systems.

01/02/2026
31/01/2026

๐Ÿ”— Kinetic Chain โ€“ The Alternating Pattern of Stability and Mobility

The kinetic chain describes how the human body functions as an interconnected system rather than isolated joints. Every joint influences the one above and below it, meaning dysfunction in a single region can create compensations throughout the entire body. This image highlights a fundamental biomechanical principle: the body alternates between joints designed primarily for stability and joints designed primarily for mobility.

At the top of the chain, the cervical spine requires stability to support the head and protect neural structures while allowing controlled movement. Excessive mobility here often develops as compensation for restrictions elsewhere, commonly presenting as neck pain, headaches, or muscle tension. Proper cervical stability depends on deep neck flexors and postural control rather than large, force-producing muscles.

Moving downward, the thoracic spine is designed for mobility, especially rotation and extension. Adequate thoracic movement allows efficient arm swing, overhead reach, and trunk rotation. When thoracic mobility is restrictedโ€”often due to prolonged sitting or poor postureโ€”the cervical and lumbar regions are forced to move excessively, increasing injury risk.

The lumbar spine is primarily a stability segment. Its role is to transfer forces between the upper and lower body while maintaining a neutral alignment. When lumbar stability is compromised, excessive motion appears in the lower back, often leading to disc stress, muscle overuse, and chronic pain. Many cases of low back pain are not due to stiffness, but rather a lack of segmental control.

Below the lumbar spine, the hip joints are built for mobility. They allow large ranges of motion in all planes and act as major force generators during walking, running, and lifting. Restricted hip mobility commonly shifts movement demand to the lumbar spine or knees, explaining why hip stiffness is frequently linked to back and knee problems.

The knee joint functions primarily as a stability joint. While it allows flexion and extension, it relies heavily on surrounding structures for alignment and load distribution. Poor hip or ankle mobility increases rotational and shear forces at the knee, often contributing to ligament strain, patellofemoral pain, or meniscal stress.

At the base of the chain, the ankle and foot complex require mobility, particularly dorsiflexion and controlled pronationโ€“supination. This mobility allows shock absorption and adaptation to the ground. When ankle mobility is limited, compensations occur at the knee and hip, altering gait mechanics and increasing overall load through the system.

The alternating pattern of stability and mobility is not randomโ€”it is essential for efficient movement. When a joint fails to meet its primary role, the body adapts by borrowing motion or stability from neighboring joints. Over time, these compensations reduce efficiency, increase energy cost, and elevate injury risk.

Understanding the kinetic chain shifts the focus of assessment and rehabilitation. Pain at one joint often originates from dysfunction elsewhere in the chain. Restoring the correct balance of stability and mobility at each level allows forces to flow smoothly through the body, improving performance and reducing strain.

The body moves best when each link in the chain does its job. Stability where control is needed, mobility where motion is required, and coordination everywhere in between.

Love these
30/01/2026

Love these

๐Ÿง˜โ€โ™€๏ธ Yoga Poses for a Healthy Spine ๐Ÿง˜โ€โ™‚๏ธ

Your spine needs gentle movement and proper support to stay strong and pain-free. These supported backbend variations help release stiffness and improve mobility in different areas of the back:

๐Ÿ”น Upper Back (Between Shoulder Blades)
Relieves tightness, improves posture, and opens the chest.

๐Ÿ”น Middle Back (Below Shoulder Blades)
Increases spinal flexibility and reduces mid-back tension.

๐Ÿ”น Lower Back (On the Sacrum)
Soothes lower back discomfort and supports spinal alignment.

โœจ Use blocks or cushions for support and relax into each pose with slow, deep breathing. Hold each position for 30โ€“60 seconds, staying comfortable and pain-free.

โš ๏ธ Practice mindfully. Avoid if you have recent injuries or severe back pain.

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