Have you ever wondered why our gluteal muscles, particularly the gluteus maximus, are so large and powerful compared to those in other animals? The reason is quite straightforward and lies in our unique bipedal locomotion system: we stand and move on two legs!
The fact that we walk on two legs instead of four necessitates strong and powerful gluteal muscles for optimal functionality. When our gluteal muscles aren't adequately activated, we lose much of our core stability, increasing the risk of various injuries. These injuries can affect the back, hips, and the entire lower extremity, including knees, ankles, and feet.
Article Index:
Conclusion
References
Gluteal Anatomy & General Function
The gluteal region consists of three key muscles: gluteus maximus, gluteus medius, and gluteus minimus.
Gluteal muscles serve various essential functions:
Act as primary hip extensors, external rotators, and shock absorbers by eccentrically dissipating force.
Stabilize the hip by counteracting gravity's hip adduction torque.
Stabilize the sacroiliac joint.
Maintain proper leg positioning by eccentrically controlling internal rotation and adduction of the leg.
Play a significant role in pelvic and spinal stabilization.
Assist in maintaining an upright posture by balancing the pelvis on the femoral heads, greatly influencing overall posture.
Provide stability to the knees, ankles, and feet, acting as a crucial component in the kinetic chain from your feet to your core.
Gluteal Amnesia
In a world where sedentary lifestyles prevail, biomechanical experts are drawing attention to 'gluteal amnesia,' a condition stemming from excessive sitting.
Extended periods of sitting result in shortened, tightened hip flexors (iliopsoas). Given that hip flexors act as antagonists to the glutes (gluteus maximus), their contraction neurologically hinders gluteal functionality. Similarly, tightened adductor muscles on the inner thighs impede the gluteus medius muscle.
This impaired gluteal function compromises core and lower body stability, manifesting in several ways. Weakened glutes lead to increased internal rotation of the leg (femur), which in turn causes inward knee movement (knee valgus) and excessive foot pronation. The inward knee movement notably heightens the risk of ACL (Anterior Cruciate Ligament) injuries. Furthermore, excessive pronation is linked to knee, ankle, and foot problems. Research also highlights a correlation between hip muscle strength and chronic ankle sprains (8). Plantar fasciitis is yet another issue associated with excessive pronation.
Gluteal Function & Running
Optimal running performance relies on strong, flexible, and engaged gluteal muscles. These muscles significantly influence our gait patterns. Let's explore the primary roles that the Gluteus Maximus and Gluteus Medius play in a runner's gait.
The Gluteus Maximus Muscle
Let's discuss the Gluteus Maximus (G-Max) muscle (shown in red). The Gluteus Maximus muscle (1,2):
Is highly active at the beginning of the stance phase and the end of the swing phase in running gait. This indicates its crucial role in both stabilization and propulsion.
Initiates hip extension and decelerates hip flexion. It's interesting to note that we typically associate the Gluteus Maximus with hip extension, yet it's most active during thigh flexion (as shown by EMG analysis). This means one of the G-Max's key functions is controlling hip flexion, which might be counterintuitive at first.
Contributes to hip and knee stability during foot contact and mid-stance phases of gait.
Helps limit subtalar joint pronation. Excessive subtalar joint pronation has been linked to knee issues, such as patellofemoral dysfunction.
Clinical Tip: A weak Gluteus Maximus results in a backward trunk lurch upon heel strike. This can be observed during gait analysis with practice.
The Gluteus Medius Muscle
The Gluteus Medius muscle (G-Med) (3,4):
Is highly active at the beginning of the stance phase and the end of the swing phase in a runner's gait. This indicates the gluteus medius plays a crucial role as a frontal plane stabilizer.
Distributes force throughout the hip joint during the stance phase of running. A strong gluteus medius helps protect the hips by ensuring proper force distribution and stabilization.
Clinical Tip: The Trendelenburg Gait – If a runner has a weak gluteus medius, you'll notice a hip drop during the stance phase of their gait. This hip drop will occur on the opposite hip of the foot touching the ground (5,6). This can be observed during gait analysis with practice.
Addressing Gluteal Restrictions
A wide range of approaches can be used to address restrictions in the gluteal muscles. Each case of gluteal restriction should be assessed and treated as a unique dysfunction specific to the individual. Some cases may only involve local structures (gluteus medius, maximus, or minimus muscles), while others may involve a more extensive kinetic chain (psoas, hamstrings, or adductor muscles).
The video below demonstrates some procedures that can be used to release restrictions in the Gluteus Maximus muscle. Often, treating the Gmax is combined with addressing other structures in a larger kinetic chain, including osseous joints.
Gluteus Maximus Release - (MSR):
In this video Dr. Abelson demonstrates how to use Motion Specific Release (MSR) to release restrictions in the Gluteus Maximus muscle. Strong, flexible, engaged gluteal muscles are critical to optimum performance and injury prevention.
Mobilizing the Hip Joint - Motion Specific Release
Hip mobility is a key aspect of your bodies Kinetic Chain. Since no joint operates in isolation, a lack of hip mobility will affect your: knees, ankles, low back, and even your upper extremity. The hip joint is a ball-and-socket synovial joint designed to allow for multiaxial motion while transferring load between the upper and lower extremities.
Gluteal Exercises
Activating your gluteal muscles is crucial for injury prevention and enhancing athletic performance.
We recommend the following sequence of exercises for patients. Begin by focusing on flexibility and myofascial release exercises for a few weeks. Then, introduce strengthening exercises into your routine. Finally, work on balance and proprioception to engage more of your nervous system.
Some of the most effective exercises for gluteal activation include single-leg squats and single-leg deadlifts.
Flexibility & Myofascial Release Exercises
Strengthening Exercises
Balance Exercises
Conclusion
This article highlights the pivotal role of gluteal muscles, stemming from our distinctive bipedal locomotion. It navigates through the anatomy, the challenges of gluteal amnesia, and its impact on gait and running. The narrative unveils the complex biomechanical interactions at play, emphasizing the necessity of addressing gluteal restrictions for optimal function and injury prevention.
Delving into Motion Specific Release (MSR) and targeted exercises, the article offers a practical roadmap to mobilize and strengthen the gluteal region. These insights aim to mitigate injury risks, enhance athletic performance, and contribute to improved musculoskeletal health, paving the way for a better quality of life.
DR. BRIAN ABELSON DC. - The Author
Dr. Abelson's approach in musculoskeletal health care reflects a deep commitment to evidence-based practices and continuous learning. In his work at Kinetic Health in Calgary, Alberta, he focuses on integrating the latest research with a compassionate understanding of each patient's unique needs. As the developer of the Motion Specific Release (MSR) Treatment Systems, he views his role as both a practitioner and an educator, dedicated to sharing knowledge and techniques that can benefit the wider healthcare community. His ongoing efforts in teaching and practice aim to contribute positively to the field of musculoskeletal health, with a constant emphasis on patient-centered care and the collective advancement of treatment methods.
Revolutionize Your Practice with Motion Specific Release (MSR)!
MSR, a cutting-edge treatment system, uniquely fuses varied therapeutic perspectives to resolve musculoskeletal conditions effectively.
Attend our courses to equip yourself with innovative soft-tissue and osseous techniques that seamlessly integrate into your clinical practice and empower your patients by relieving their pain and restoring function. Our curriculum marries medical science with creative therapeutic approaches and provides a comprehensive understanding of musculoskeletal diagnosis and treatment methods.
Our system offers a blend of orthopedic and neurological assessments, myofascial interventions, osseous manipulations, acupressure techniques, kinetic chain explorations, and functional exercise plans.
With MSR, your practice will flourish, achieve remarkable clinical outcomes, and see patient referrals skyrocket. Step into the future of treatment with MSR courses and membership!
References
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Semciw, A. I., Pizzari, T., & Murley, G. S. (2013). Gluteus medius: an intramuscular EMG investigation of anterior, middle and posterior segments during gait. Journal of Electromyography and Kinesiology, 23(4), 858-864.
Neumann, D. A. (2010). Kinesiology of the hip: A focus on muscular actions. Journal of Orthopaedic & Sports Physical Therapy, 40(2), 82-94.
Wilson, N. A., Press, J. M., Koh, J. L., Hendrix, R. W., & Zhang, L. Q. (2009). In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain. Journal of Bone and Joint Surgery, 91(3), 558-566.
Nadler, S. F., Malanga, G. A., DePrince, M., Stitik, T. P., & Feinberg, J. H. (2000). The relationship between lower extremity injury, low back pain, and hip muscle strength in male and female collegiate athletes. Clinical Journal of Sport Medicine, 10(2), 89-97.
Delp, S. L., Hess, W. E., Hungerford, D. S., & Jones, L. C. (1999). Variation of rotation moment arms with hip flexion. Journal of Biomechanics, 32(5), 493-501.
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Friel, K., McLean, N., Myers, C., & Caceres, M. (2006). Ipsilateral hip abductor weakness after inversion ankle sprain. Journal of Athletic Training, 41(1), 74-78.
Neumann, D. A. (2012). Kinesiology of the musculoskeletal system: foundations for rehabilitation. Elsevier Health Sciences.
Janda, V. (1987). Muscles and motor control in low back pain: Assessment and management. In Physical Therapy of the Low Back (pp. 253-278). Churchill Livingstone.
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Grimaldi, A., Richardson, C., Stanton, W., Durbridge, G., Donnelly, W., & Hides, J. (2009). The association between degenerative hip joint pathology and size of the gluteus maximus and tensor fascia lata muscles. Manual Therapy, 14(6), 611-617.
Distefano, L. J., Blackburn, J. T., Marshall, S. W., & Padua, D. A. (2009). Gluteal muscle activation during common therapeutic exercises. Journal of Orthopaedic & Sports Physical Therapy, 39(7), 532-540.
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Willson, J. D., & Davis, I. S. (2008). Lower extremity mechanics of females with and without patellofemoral pain across activities with progressively greater task demands. Clinical Biomechanics, 23(2), 203-211.
Ireland, M. L., Willson, J. D., Ballantyne, B. T., & Davis, I. M. (2003). Hip strength in females with and without patellofemoral pain. Journal of Orthopaedic & Sports Physical Therapy, 33(11), 671-676.
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Worrell, T. W. (1994). Factors associated with hamstring injuries. An approach to treatment and preventative measures. Sports Medicine, 17(5), 338-345.
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