Get Your Glutes On!!

by Anna DiMarco, Senior Physiotherapist

You do not have to travel to Thunder Bay or to Hawaii to visit a Sleeping Giant. You may have "Sleeping Giants" right in your own back yard, or rather, right in your own back-side. If you suffer or have ever suffered from low back pain, nagging hip pain, knee pain or foot and ankle pain, it is possible that you may have lazy gluteal muscles to blame for your suffering. Conversely, your lazy gluteal muscles may not be the cause of your suffering, but rather the result of your suffering. It is a long and complicated story, but gluteal inhibition and weakness are surprisingly common findings in both the athletic population and the sedentary population. Surprisingly, even when the muscles appear to be well-developed, it is possible to find some functional weakness and inhibition. It is without question one of the most common things I see in my patient population. Often times the Glutes are often not firing effectively during simple activities of daily living (like rising from a chair) and more athletic endeavours like stair climbing, running or squatting. It is a natural consequence of daily living and hand dominance that we will have an asymmetrical strength finding with testing of the left and right gluteal muscles, but anything beyond a 15% difference in strength is considered problematic and should be targeted for correction.

Gluteal Amnesia

The Gluteal muscles work together to keep us upright and well aligned. Although these muscles work to extend (move backwards), abduct (move outwards) and rotate the hip, their most significant role is in spinal, pelvic and hip stabilization. Unfortunately, these powerful muscles are easily inhibited or weakened by a variety of causes. Inhibition and delayed activation of the Glutes compromises stability at the lumbar-pelvic-hip complex and therefore puts the whole lower kinematic chain at risk of pain and injury. Once these muscles become inhibited, the brain and the body choose the path of least resistance to create the desired movement, and in doing so, they often recruit other muscles who have the capacity to do similar work but with much less efficiency and accuracy. Unfortunately, these altered movement patterns become ingrained and automatic and the gluteal muscles continue to weaken and become even further inhibited by their relative disuse. Dr. Stuart McGill (physiotherapist extraordinaire and spinal research specialist) refers to this phenomenon as "gluteal amnesia".

On the Path to Gluteal Amnesia

Pain

Specifically, pain anywhere in the back or lower body, potentially even a simple stubbing of the big toe, produces a neurological inhibition of theses strong muscles. It is as though the "breaker" gets shut down so that the brain cannot properly activate these muscles in the presence of lower body pain. Some researchers believe this may be a survival defence mechanism intended to keep us from attempting to run or do highly demanding activities when it would serve us better to rest and recover.

Prolonged Seated Posture

It is believed that sitting on our bottoms for hours on end has an inhibitory effect on the gluteal muscles as well. This phenomenon is believed to be linked to both neural inhibition (breaker is off, possibly due to disuse, possibly due to reduced blood flow) and to mechanical inhibition (suboptimal muscle length issues). The hip flexors shorten/tighten as we sit for prolonged periods of time while the gluteal muscles lengthen, gradually beyond a healthy parameter. This altered muscle length scenario contributes to altered muscle recruitment patterns. For example, the Quadriceps muscle group may become more easily recruited for lifting and squatting movements, even though these are ideally Gluteal dominant movements.

Daily habits and postures

Many of us have developed daily habits and manners of living in our bodies that produce biomechanical and structural changes to muscle length and tension and to the resting positions of the spinal and extremity joints. For example, we may stand lop-sided while waiting in line ups or giving a presentation. We may sit off balance, with one hip higher than the other as we do our work or eat our meals. We may cross our legs in an automatic fashion as we sit at our desks and we may carry our babies around on our left hip to leave our right side free to multi-task. We may always sleep on our right side with our left knee flexed up high toward our chest, etc. All of these seemingly innocuous habits have the potential to negatively affect our postural alignment and our Gluteal and synergistic (partner) muscle length. As we have learned, this may affect how our brain recruits our muscles to achieve desired movements.

Sports

As most of us are not ambidextrous, we engage in sporting activities with a one-sided dominance. If the sports we primarily engage in are one-sided in nature (tennis, soccer, squash, hockey, golf, etc), we are training our bodies asymmetrically. This will naturally lead to a strength discrepancy between our left and our right sides. For example, a soccer player who is a right sided kicker will spend more time standing and balancing on her left leg. This will invariably lead to a stronger Glute and improved dynamic balance on her left side. Over time, she will almost certainly possess a strength and endurance differential of greater than 15% between her left and right side.

Test your Glutes

There are a couple of simple self-assessment strategies to test your Glutes’ firing capacity or willingness and ability to engage. In the first test, simply sit in a firm chair with your back straight and your feet flat on the floor, shoulder width apart. Place one hand under each cheek and tighten each side independently. Assess whether you have an easier time tightening one side. Try tightening both sides together and see if your brain - body connection improves for the lazier cheek. Next, tighten both sides together and gently lift up and off of your hands, as though you might rise from the chair. Do your Glutes stay activated as you transition into this mock lift-off? If not, you may have weak or inhibited Glutes.

The second test looks at how your Glutes are activating in a single leg stance test. Stand in front of a mirror, shoulders relaxed and hands on your hips. Gently engage your core (gentle belly bracing) as you shift all your weight to one leg and lift the other leg up into a "march" position. Did your non-stance hip drop down ? Did your standing hip hike up ? If you can not maintain a level pelvis, you may have a weak or inhibited Glute.

Fire them Up!

These simple tests can be used to start waking up those lazy muscles, but they are only the tip of the iceberg. Even if you possess adequate gluteal connection in these simple tests, you may suffer from delayed activation or preferential defaults to other muscles when carrying out more complex or demanding movements. It is also possible that you can "fire" your Glutes well enough but that you do not possess adequate endurance in your Glute strength or motor pattern connection. In order to further assess your Gluteal function, and to progress your Gluteal restoration program properly, you would have to seek out a consultation with a health care professional who has the capacity to test your functional movement patterns.

Move Well!

Live Well!

Anna