ANATOMY
There has been in recent times much more emphasis on the importance of the gluteal muscles and how they relate to a patient's pain presentation. The big muscles of the buttocks or ‘glutes’ are made up of three muscle groups: 1
1. Gluteus Maximus: the biggest and most superficial of the three. Primary functions: Hip extension and hip external rotation
2. Gluteus Medius: the muscle on the side of the hip. Primary Functions: Aids in stabilization of your pelvis, hip rotation, and hip abduction
3. Gluteus Minimus: the deepest of the three below the gluteus medius. Primary Functions: Hip joint stability
Weak glutes have been associated with several lower extremity dysfunctions and increased risk of injury such as: ACL tears, patellofemoral pain syndrome, iliotibial band syndrome, and knee collapse.2
PAIN PRESENTATION
A patient with weak glutes will usually present to a Back in Motion clinic with any or all of the following pain patterns:
· Tight and tender glutes
· Tight and spasming lower back muscles
· Tight and tender hamstrings
· Referral pain in and around the lower back and hips
· Referral pain down either leg mimicking traditional sciatica symptoms
ACTIVATION
In order to activate all the glute muscles appropriately a range of exercises should be employed to target each area separately and as a whole. A sample routine can look like:
· Cable Kickbacks.
· Banded monster walks.
· Clam shells.
· Stability wall squats.3
PREVENTION
Once a patient is able to activate their glutes much more effectively it is then a guided process of regularly building up the strength and endurance of the glutes so that no further flare ups or relapses occur. This will include steady progression of a gym/home based weights routine or a return to regular sport as well as regular maintenance treatments with your Back in Motion practitioner to ensure that everything is functioning correctly.
REFERENCES
1. Kirkpatrick, J., The Science Behind Glute Activation.
2. Cochrane, D.J., Harnett, M.C. and Pinfold, S.C., 2017. Does short-term gluteal activation enhance muscle performance?. Research in Sports Medicine, 25(2), pp.156-165.
3. Parr, M., Price, P.D. and Cleather, D.J., 2017. Effect of a gluteal activation warm-up on explosive exercise performance. BMJ Open Sport & Exercise Medicine, 3(1), p.e000245.