Got Glutes? (Part 1 – assessment)

Glutes. They are key to lower body power. They are an essential component of stability. There is an injury waiting to happen when they aren’t working as they should. And let’s face it, we also all want ours to look nice.

About 1 week after I purchased my old URL, sportsmedforthemasses.com, I realized something. One could easily “misread” my web address in quite a humorous way.  It was at that point, I knew, I had to write this post at some point.  So here it is…

Here’s some “Sports Med For Them Asses!” (Part 1)

(*Cue Sir Mix-A-Lot*)

In my professional experience, when dealing with lower extremity sports injuries (especially those chronic in nature) and people with episodic, repeated low back pain, I can honestly say that the most common finding I attempt to address is some sort of dysfunction or weakness pertaining to the glutes. The problem could lie in a strength asymmetry (R vs L), general weakness bilaterally, malaligment (as a result of pelvis or sacral dysfunctions), trigger points/spasm, or just plain old dysfunctional glutes (i.e. “glute amnesia”). To clarify, I am referring to any or all of the following: gluteus maximus, gluteus medius, gluteus minimus, and the tensor fasciae latae.

Do your glutes work?  Try these three quick tests (worded especially for the “Joes”).  These should be performed with a partner who can provide feedback regarding your body position.

1. Single Leg Squat: Standing on your non-dominant leg, perform a single leg squat (while keeping your shoe flat on the floor) as low as you can while your other leg (knee extended) stays in front of your body.  Repeat three times on each leg.  A) Does your stance knee buckle inward (genu valgus)?  B)  Do you have trouble getting back up (especially if you can lower yourself >half way down)  C) Do you have trouble keeping your hips back and your shoe flat on the ground?  If any or all of the above occur, YOUR BUTT may not be working.
2. Single Leg Bridge: Lying on your back, with your knees flexed and your shoes flat on the floor directly underneath your knees (shoulder-width apart), lift your butt away from the floor until there is a straight line from your knees –>thighs –> torso to your shoulders.  Once up in position, extend your dominant knee  fully so that you are bridging on 1 leg.  Now hold for 10 seconds. A) Could you not hold for 10 seconds?  B) Do you feel cramping in your hamstrings, quads, calf, or low back?  C)  Does your unsupported hip drop towards the floor? If any or all of the above occur, YOUR BUTT may not be working.
3. Prone double leg raise:  Lying face down on a weight bench, with your hip bones (ASIS) right at the edge of the bench, hold on with an underhand grip. Keeping your knees straight and shoes together, lift both legs up to parallel to the floor and hold.  A) Do you have trouble keeping your knees straight (an indication your hamstrings are doing most of the work)?  B) Is one leg harder to hold parallel than the other? C) Unable to hold this position for >60 seconds? If any or all of the above occur, YOUR BUTT may not be working.

In addition to the findings of the above three tests, some other things I look for in my athletic training evaluation to determine any sort of problem directly or indirectly related to the glutes:

• Pelvic alignment (iliosacral or sacroilial dysfunctions): If your hip alignment is asymmetrical (i.e. one side of your pelvis is rotated anteriorly or posteriorly, or higher than the other), or if you have a sacral torsion or flare (tailbone), it changes the alignment of and muscle tension in your glutes.  This can lead to biomechanical changes and/or …
• Muscle spasm, adhesions, and/or trigger points: Any of these problems can affect the way your glutes function, getting in the way of proper muscle firing and lengthening. Adhesions can occur between the tissue layers of the glutes and the surrounding structures. A trigger point is when there is a stubborn hypersensitive bundle of muscle fibers that becomes painful, which can refer pain to other locations, as well as potentially weaken the muscle. Unfortunately these are far-to-often overlooked.
• Hip and lower extremity mobility/flexibility deficits:  Where (if any) is there restricted motion?
• Isolated weakness with manual muscle testing of isolated hip motions:  Looking for the weak link in the chain.
• Breakdowns in functional movement patterns (squat, lunge):  How pretty and symmetrical is the movement?

So what is the verdict?  Do you think you have buns of steel, or are they in need of some baking?

Now on to part 2:  How to address those dysfunctional glutes.

May the junk in your trunk be working properly,

RS

cATalyzingPodcast@gmail.com

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