- Dr. Brian Abelson DC
Strong Glutes Your Functional Advantage!
Updated: Nov 1, 2022
Did you ever think about why our gluteal muscles, especially our gluteus maximus muscle, evolved into such a large strong muscle as compared to other animals? The answer is quite simple, and it has to do with our bipedal locomotive system. We stand on two legs!
Because we walk on two legs instead of four we need strong, power gluteal muscles for optimum function. Without strong activated gluteal muscles we lose a lot of our core stability and run the risk of multiple injuries. Injuries related to weak gluteal muscles involve the back, hips and the entire lower extremity (knees, ankles and feet).
For example, weak gluteal muscles (gluteal atrophy) cause an increased incidence of osteoarthritis in the hips (7). The weaker and more atrophied gluteal muscles the higher the level of osteoarthritic changes.
GLUTEAL ANATOMY & GENERAL FUNCTION
Your gluteal muscles are made up of three muscles: the gluteus maximus, gluteus medius, and gluteus minimus.
Want some in depth gluteal anatomy? Check out our video “Anatomy & Palpation of the Gluteal Group”. Just Click on the image "Anatomy - The Gluteal Region".
Your gluteal muscles are multi-functional, consider some of the actions these muscles perform. The gluteal muscles (1,2):
Act as primary hip extensors, external rotators, and shock absorbers (absorbing shock by eccentrically dissipating force).
Stabilizes the hip by offsetting what is known as gravity’s hip adduction torque.
Stabilizes the sacroiliac joint.
Preserves proper leg position by eccentrically controlling internal rotation and adduction of the leg.
Play an important role in both pelvic and spinal stabilization.
Help keep you in an upright position, balancing the pelvis on the femoral heads, which has a huge influence on posture.
The gluteal muscles help provide stability to the knees, ankle and feet. Think of your glutes as playing a critical role in a kinetic chain from your feet to your core.
GLUTEAL AMNESIA
In today’s increasingly sedentary world, bio-mechanical specialists talk about ‘gluteal amnesia’! Gluteal amnesia is what occurs when we spend too much time sitting.
Excessive sitting causes our hip flexors (iliopsoas) to become short and contracted. Since these hip flexors are the antagonists to the glutes (gluteus maximus), when they tighten, they neurologically inhibit gluteal function.
This also occurs with the muscles on the inside of the thighs, the adductors. When the adductor muscles become short and contracted they inhibit the gluteus medius muscle.
Inhibition of gluteal muscle function decreases both core and lower body stability. For example:
Weak gluteal muscles will cause increased internal rotation of the leg (femur), which then causes the knee to move inward (knee valgus), and the foot to pronate excessively. This increased inward movement of the knee, greatly increases the incidence of ACL (Anterior Cruciate Ligament) injury. Excessive pronation can be a major factor in knee, ankle and foot problems. In fact, research has also shown that there is a relationship between hip muscle strength and chronic ankle sprains (8). Plantar Fasciitis is also another condition related to excessive pronation.
If you would like to learn more about common conditions that the Gluteal Muscles are involved in just read some these articles by Dr. Abelson:
Sciatica – 4 Part Series - Diagnosis to Treatment
GLUTEAL FUNCTION & RUNNING
Strong, flexible, engaged gluteal muscles are critical to optimum running performance. The gluteal muscles play an important role in our gait patterns. Just take a look at some of the primary functions that the Gluteus Maximus and Gluteus Medius play in a runners gait.
THE GLUTEUS MAXIMUS MUSCLE
Lets start with the Gluteus Maximus (G-Max) muscle (to the right in red). The gluteus maximus muscle (1,2):
Is very active at the beginning of the stance phase and at the end of the swing phase of running gait. This means that the GM is very important in both stabilization and propulsion.
Is involved in the initiation of hip extension and the deceleration of hip flexion.
This is very interesting because we usually think of the gluteus maximus as having a primary role in hip extension. Yet, the glutes are most active during flexion of the thigh (EMG analysis). In other words, an important role of the G Max is to control hip flexion. Let that sink in for minute, this is the opposite of what we usually think of when we think about gluteal function.
Helps control stability of the hip and knee during the foot contact and mid-stance phases of gait.
Helps limit subtalar joint pronation. Excessive subtalar joint pronation has been cited as a contributor to knee problems (patellofemoral dysfunction).
Clinical Tip: Weakness of the gluteus maximus produces a backward lurch of the trunk on heel strike. This can be observed during gait analysis (with practice).
THE GLUTEUS MEDIUS MUSCLE
The Gluteus Medius muscle (G-Med): (3,4):
The G-Med is very active at the beginning of the stance phase and at the end of the swing phase of a runners gate. This means that the gluteus medius plays an important role as a frontal plane stabilizer.
The G-Med distributes force throughout the hip joint during the stance phase of running. A strong gluteus medius helps to protect the hips through force distribution and stabilization.
Clinical Tip: The Trendelenburg Gait – If a runner has a weak gluteus medius you will observe a hip drop during the stance phase of gait. This hip drop will be on the opposite hip to the foot touching the ground (5,6). This can be observed during gait analysis (again with practice).
RECOMMENDED REFERENCE BOOKS
Netter Atlas of Human Anatomy https://amzn.to/3SQYWgx
Functional Atlas of the Human Fascial System - Carla Stecco https://amzn.to/3TE1EqP Functional Anatomy: Anatomy, Kinesiology, and Palpation https://amzn.to/3f49Xgn
The Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns and Stretching Joseph E. Muscolino – https://amzn.to/3SAh5Pl
Anatomy Trains: Myofascial Meridians for Manual Therapists https://amzn.to/3SCkhtZ
THE GAIT CYCLE
Gait Cycle: When runners who have weak gluteal muscles become fatigued abnormal (sub-optimal) gait patterns start to appear. Often the runners' quadriceps and hamstrings start to become more activated to compensate. These abnormal patterns often contribute to injuries (such as ACL injuries). This not only shows the importance of gluteal strengthening but the importance of rest between training or racing events.
Besides gait observation, I also like to take runners through a series of functional tests such as the one leg split squat test, or box jump test. Video taping these tests can provide us with great information. The "Over Head Deep Squat Test" is an example of a functional test we use to observe for weaknesses or muscle imbalances. Click this link to view a video of this test. Over Head Deep Squat Test.
Want to learn more about the different phases of the gait cycle? Read Dr. Abelson's blog "Designed to Run - The Human Gait Cycle".
ADDRESSING GLUTEAL RESTRICTIONS - MSR
There are multiple ways to address restrictions in the gluteal muscles. Each case of gluteal restriction must be assessed and treated as a unique dysfunction specific to that individual. Certain cases will only involve local structures (Gluteus medius, maximus, or minimus muscles) while other cases will involve a much larger kinetic chain (psoas, hamstrings, or adductor muscles).
Below is a video of demonstrating some of the procedures we could use release restrictions in the Gluteus Maximus muscle. We would often combine treating the Gmax with other structures in a larger kinetic chain, including osseous joints.
The Gluteus Maximus Release - Motion Specific 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
It is incredibly important that you activate your gluteal muscles. This will have a huge effect on injury prevention, and your athletic performance.
Below are some of the exercises that we prescribe to patients. Before embarking on strengthening exercises we recommend spending a few weeks on flexibility and myofascial release exercises. Then introduce strengthening exercises into your routines. After that start working on your balance and proprioception to recruit more of your nervous system.
Some of the best exercises for gluteal activation are single leg squats and single leg dead-lifts.
Flexibility & Myofascial Release Exercises
Strengthening Exercises
Balance Exercises
DR. BRIAN ABELSON DC.
Best selling author, Dr. Brian Abelson is the developer of Motion Specific Release (MSR) Treatment Systems. His clinical practice in is located in Calgary, Alberta (Kinetic Health). He has recently authored his 10th publication which will be available later this year.
Dr. Abelson (Brian) believes in running an Evidence-based, Patient-centered, Inter-professional and Collaborative clinical practice.
Make Your Appointment Today!
Make an appointment with our incredible team at Kinetic Health in NW Calgary, Alberta. Call Kinetic Health at 403-241-3772 to make an appointment today, or just click the MSR logo to right. We look forward to seeing you!
REFERENCES
Anderson T. Biomechanics and running economy. Sports Med. 1996;22:76–89.
Williams K.R, Cavanagh P.R. Relationship between distance running mechanics, running economy, and performance. J. Appl. Physiol. 1987;63:1236–1245.
Cavanagh, P., & Kram, R. (1990). Stride Length in Distance Running: Velocity, body dimensions, and added mass effects. In P.R. Cavanagh (Ed.), (pp. 35-63). Champaign, IL: Human Kinetics.
Billat VL, Demarle A, Slawinski J, et al. Physical and training characteristics of top-class marathon runners. Med Sci Sports Exerc. 2001;33:2089–2097. doi: 10.1097/00005768-200112000-00018.
Basmajian JV, Deluca CJ. Muscles Alive: Their Functions Revealed by Electromyography. Ed 5. Baltimore:Williams & Wilkins, 1985:377.
Dalstra M. Biomechanics of the Human Pelvic Bone. In: Vleeming A, Mooney V, Dorman T, et al. (eds). Movement, Stability and Low Back Pain: the Essential Role of the Pelvis. New York:Churchill Livingstone 1999:91-102.
Arokoski MH1, Arokoski JP, Haara M, Kankaanpää M, Vesterinen M, Niemitukia LH, Helminen HJ. Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis. J Rheumatol. 2002 Oct;29 (10):2185-95.
Karen Friel, Nancy McLean, Christine Myers, and Maria Caceres, Ipsilateral Hip Abductor Weakness After Inversion Ankle Sprain, J Athl Train. 2006; 41(1): 74–78.
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