Is your buttock lazy, not weak?


Over the last few weeks, you all will have noticed that we have been posting about lower limb loading mechanics and keep mentioning the muscle Gluteus Medius. That is because it is a very important muscle to know how to find when you are trying to stand on 1 leg ie walking, going up and down stairs, running, kicking, etc. I can attest to just how important as it has played a vital role in helping me to learn how to walk again with good loading patterns following a foot accident I had.

What is gluteus medius and what does it do?
Gluteus medius is a muscle up the top of your group of buttock muscles which is responsible for controlling your whole lower leg. It is especially important to help with knee control and stop it from dropping inwards to touch your other knee. It also helps to keep your pelvis level whilst standing or doing tasks where you are required to stand on one leg. We believe that in many cases the muscle is not actually weak but rather your brain forgets how to recruit this muscle and use at the correct times.

Why do I need it?
If your gluteus medius is not working then it can lead to knee, achilles, hip, lower back, and many other injuries. Due to the damage to my lower leg in my accident, I had to learn how to walk again. I was in the hospital for a long time and then had to use crutches for another 8 months. As I had such a long time walking β€œabnormally” my glute med was not kicking in when I needed it to. So I ended up with a multitude of problems:

1) My left hip dropped significantly when I was walking which lead me getting acute lower back pain which I needed physio for (yes even physios need physio too sometimes!)
2) My left knee would deviate inwards if I was squatting which would also give me back pain again.
3) I had both back and knee pain which worsened if I had to jog on and off the rugby pitch.
Luckily, all these signs were spotted and I was given rehabilitation exercises which initially worked on me working out how to find this muscle. This was easier said than done! Once I found it and could teach my brain to recruit this muscle rather than all the other ones I had been using, we could really start the rehabilitation process.

I had a multitude of exercises from very basic unloaded work such as glute bridges and clam shells. Then I progressed to more functional exercises which had me in standing, such as standing wall pushes and single leg loading exercises focusing on pelvic and trunk positioning to help my brain to locate my glute med. It reinforced to me that just doing exercises lying down, which I could do well after a few weeks, did not mean that I could do them when I stood up and tried to walk. All my old patterns of activation kicked in again. I had to take it slowly and integrate the awareness of the right muscles into standing and then functional dynamic exercises.

Now, thanks to this rehab, I am much more aware of the best positions for me to be in so as not to kick in all my old compensatory patterns. I am now able to walk with a barely noticeable limp, I can single leg load without my pelvis tipping and I can jog on and off the rugby pitch at weekends with no lower back or knee pain!

We see this poor activation pattern most days in the clinic so if you are moving a different way after an injury, come in and see us to check your patterns and see if they might be causing some of your aches and pains.

Maddison Taylor

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