Baby got Back!

Unless you have been living under a rock you have probably noticed there is a cultural obsession with big bums and curvaceous figures thanks to celebrities like Beyoncé, Nicki Minaj and Kim Kardashian to name a few. If your social media is anything like mine, you may have noticed an increase in workout videos and posed pictures of women emphasising their large gluteal muscles accompanied by the peach emoji. I think it’s awesome that women are proud to be strong and fit and are squatting, deadlifting and hip thrusting their way to their goals. Aesthetics aside though, gluteal function is important in lower back and lower limb injury prevention and rehabilitation, let’s look at this further.

The gluteal complex is a group of three muscles that make up the buttock and include the gluteus maximus, gluteus medius, gluteus minimus, all pictured below.

The gluteus maximus is the biggest muscle of the hip and the most superficial, it is powerful hip extensor and lateral rotator. The gluteus maximus is used is in activities like climbing stairs, sprinting, or squatting where the body is accelerated upwards and forwards from a position of hip flexion.

The gluteus medius is broad fan shaped muscle lying deeper than the gluteus maximus, anatomically it is divided into three parts, anterior, middle and posterior. The main function of the gluteus medius is to stabilise the femur and pelvis during single leg stance in activities such as walking, running and jumping. The gluteus medius is also a hip abductor generating a large amount of force for its size, it also contributes somewhat to hip flexion.

The gluteus minimus is the smallest and deepest of the three muscles, it is the primary internal rotator of the hip joint, it acts to assist the gluteus medius with hip abduction and pelvis stability when the opposite leg is off the ground.

So, why are the gluteals so important in the rehabilitation setting? Hip dysfunction including weakness and limited range of motion has a strong correlation with injury. As mentioned above the gluteal muscles have a big role in maintaining a level pelvis and preventing hip adduction and internal rotation during single limb support. A number of pathologies are related to the inability to maintain proper alignment of the pelvis and the femur, including: tibial stress fracture, low back pain, iliotibial band friction syndrome, anterior cruciate ligament injury, and patellofemoral pathology (Reiman, Bolgla, & Loudon., 2012).

So, what are the best exercises to prevent or correct hip dysfunction? This really depends on the pathology, how the individual presents and what their goals are, this is something an Accredited Exercise Physiologist can assist with. Most of us know that compound movements such as squats, deadlifts and lunges produce a high level of gluteal activation. However, there are many other exercises used in the rehabilitation setting that are effectively used to correct hip dysfunction such as clams, hip hitches, side plank with hip abduction and single leg squat to name a few. A comprehensive gluteal programme will be specific to the individual and target different muscle fibres of the gluteal complex, include both unilateral and bilateral exercises and use a variety of repetition ranges, set ranges and tempos. It will also consider things like changes in trunk position, movement direction and base of support as these can all affect gluteal muscular activation. For more information contact an Absolute Balance today.

 

Lisa Wallbutton (BSR, MClinicalExPhysiol(Rehab))

Accredited Exercise Physiologist (AEP) (ESSAM)

 

Reference

Reiman, M. P., Bolgla, L. A., & Loudon., J. K. (2012). A literature review of studies evaluating gluteus. Physiotherapy Theory and Practice, 257–268.

 

Boren, K., Conrey, C., Le Coguic, J., Paprocki, L., Voight, M., & Robinson, T. K. (2011). ELECTROMYOGRAPHIC ANALYSIS OF GLUTEUS MEDIUS AND GLUTEUS MAXIMUS DURING REHABILITATION EXERCISES. International Journal of Sports Physical Therapy, 6(3), 206–223.