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Single Leg Squat Image
20 Oct 2015
20 Oct 2015
by Jay Anderson

Glutes - Part 1, An Introduction

Glutes - Part 1, An Introduction

A common misconception I regularly encounter on a day to day basis as a Physiotherapist, is athletes concept of which muscles are the primary drivers in running. The answer I usually receive is the quadriceps and the calves. Whilst this is partially correct, most forget or undervalue the role of the Gluteal muscles in forward momentum. Not only do our glutes drive us forward each step and they also play a huge role in keeping runners running, without developing overuse type injuries.

So what are the glutes and why should you know about them?

There are three different Gluteal muscles which all have a slightly different role. This is due to their difference in size, direction of orientation, as well as different attachment points to the hip and pelvis. Gluteus Maximus is the biggest muscle of the three and is primarily responsible for hip extension, that is the movement of bringing your thigh from in front of you - such as before you make contact with ground; to bringing the thigh behind you - the motion of striking the ground and bringing your body forward. Gluteus Medius is responsible for hip abduction - that is bringing your leg out to the side, whilst the smallest of the three, Gluteus Minimus is responsible for both hip extension and abduction however it also works to stabilize the hip within the pelvis.

Beneath the three Gluteals lie six other muscles which form the short external hip rotators. These are the forgotten hip stabilizers, these muscles work together to keep the thigh bone tracking straight.

Let's think about this in a single leg squat position. In the image below, we have a well controlled single leg squat a), and a single leg squat which lacks adequate control b) - a position I see all too often as a physiotherapist. In the poorly controlled squat, we can see that the knee rolls inwards (femoral internal rotation), moves across the midline (femoral adduction), the outside side of the pelvis has dropped (Trendelenberg Sign) and the arch of the foot has lowered (pronation). This can be attributed to a number of deficiencies in control and strength of the muscles at the hip. The hip drop and knee falling across midline are due to weakness of the gluteus medius and minimus, whilst the knee rolling in is due to a loss of control of the six short external hip rotators, foot pronation can be partially due to the centre of gravity being moved towards the inside edge of the foot.

Now imagine this type dysfunctional movement when we start to add the impact forces of running. This can equate to many multiples of your bodyweight impacting the foot, ankle, knee and hip joints - a recipe for many running based injuries, often classed as overuse injuries.

The term of 'overuse' injuries is a funny term and implies that we have simply used one area of the body too much. If 'use' was only related to how often we did a particular movement or exercise such as running, we would expect both sides of the body to experience the same injury, at the same time. Rarely does this occur. Most often we find that an athlete will develop an 'overuse' injury on one side of the body. Why is this so? The most common reason for this is that there is an issue with the control or coordination of a moment. It is not that we have used the leg too much it's that we have used the leg incorrectly. A lack of hip and gluteal control is a very common reason for this. Gluteal dysfunction and weakness has been linked to a whole host of lower limb injuries often experienced by runners.

 

Foot -

Plantarfascitis

Hallux Valgus

 

Ankle -

Achilles Tendinopathy

Tibialis posterior tendinopathy

 

Shin -

Medial tibial stress syndrome

Shin Splints

Calf Strains

 

Knee -

Patello-femoral pain syndrome

ITB friction syndrome

 

Hip -

Gluteal tendinopathy

Groin Pain

Hamstring Injuries

 

 

As the single leg squat image alerts to, a change in the position and the control of hip has consequences for the rest of the leg and changes the line of force around each joint. If the hip isn't contributing to its share of the workload, another area is likely to take up the slack, or be placed under a greater degree of load and force. It is in this situation when injuries start to occur.

Time after time we are told about how to reduce the symptoms of an injury. An example of this is using a foam roller to loosen up the tissue around the ITB (iliotibial band) to diminish the pain caused by ITB friction syndrome. Whilst this is ok for short-term pain relief, it fails to address the cause of the problem. In ITB friction syndrome, the most common cause is due to a lack of glute strength and control - who would have thought!

In this particular case, when the gluteals aren't functioning correctly, the body employs  other muscles to help stabilize the leg, such as the TFL (tensor fasciae latae) and the lateral quadricep muscle (vastus lateralis). As these muscles attach closely to the ITB, these muscles increase the tension of this band to the point where the ITB causes pressure on the outside of the knee - resulting in pain. This is an example where just treating a tight ITB won't cure your pain, but strengthening your gluteal muscles will.

Apart from injury risk, a lack of gluteal strength and control can directly influence performance. As discussed earlier one of the main roles of the gluteals is to contribute to straight line power and acceleration. If the gluteals lack strength, the ability to generate force in hip extension is lost, resulting in a less effective and efficient stride. By strengthening your gluteals, you can actually become a more efficient athlete!

Running is a strange sport. It is one of the only sports where most athletes don't train prior to performing. In ball sports, teams and athletes break down each skill into small components to work on, and train a few times a week  prior to putting the skills into a competitive situation or match. With running, we simply throw on a pair of shoes and run out the front door. By taking the view of needing to train well, to run well, we can easily incorporate a few exercises each day to strengthen key technical components before we push our running loads further. Gluteal strengthening and activation should be a focus of all keen runners.

This introduction to gluteal and hip mechanics is aimed to serve the function of educating runners and sports people alike about the importance the gluteal muscles. It does not serve to diagnosis and treat individual injuries. If you do experience pain whilst running, get it seen to early by a good sports physiotherapist. If they tell you to only use a foam roller question them about the role of your glutes!

 

For more information call Sportsmed Biologic on 1300 858 860

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Carlton Football Club Sydney Swans AFL Melbourne City Football Club Eastern Football League (EFL) Collingwood Football Club Box Hill Rugby Union Club Eastern Ranges Football Club Northern Blues Football Club
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