Have you ever been told your glutes don’t work? I have! When I started my posture therapy program, I couldn’t activate my left glutes at all. It’s like they had amnesia, which they did. My muscles had forgotten how to work. Dr. Stuart McGill often finds what he terms “gluteal amnesia” in his back pain patients. When the glutes don’t fire during hip extension, the back compensates, and the spine is compressed. Ouch!
Glutes shut off due to three main factors:
- Lack of use
“Any pain that lasts more than 48 hours begins to alter function. That means trigger points begin to develop, the pain spreads up and down the chain, and key stability muscles shut down,” explains Marc Heller, DC in his article, Changing Inhibition Patterns: Breaking The Pain - Inhibition - Instability Cycle. Looking at his image to the right, you can see the cyclical relationship between pain, inhibition and instability. Pain inhibits muscles, which leaves joints unstable and leads to greater pain.
I had pain in my left hip, which caused my glutes to turn off, creating greater instability in my hip and more pain. Fabulous!
This cycle describes a neurological imbalance between the brain and the muscles. The Feldenkrais Method referred to as a somatic educational system increases your awareness of movement. Slow, gentle exercises are used to rewire correct movement patterns. When I attended my first Feldenkrais class a couple years ago, I was astounded by the differences in my right and left sides. Clearly, I could not move my left side in the same fluid, easy manner as the right. I felt oh-so-uncoordinated on my left. Before taking the class, I never would have guessed the pain in my hip had such a profound effect on my body communication systems and movement abilities. Shocking!
The gluteal complex of muscles - gluteus maximus, medius and minimus - span from the pelvis to the femur (thigh bone). The alignment of the pelvis and femur, therefore, affects the position, length and tension of your gluteal muscles. If these muscles are not in an ideal posture, their function will be compromised--sometimes to the point that the muscles are not able to contract.
An anterior pelvic tilt, shown left, is an example of such a postural misalignment. In this position the pelvis tilts too far forward, over stretching the gluteal muscles and rendering them weak. Dr. Vladimir Janda discovered a connection between this posture and muscle function called the Lower Crossed Syndrome, shown right. The hip flexors and back extensors are short and tight, while the abdominals and glutes are lengthened and weak.
The glutes on the back of the body extend the hip and work in opposition to the hip flexors located on the front of the body. These actions cannot be performed simultaneously. When the body wants to flex the hip, an excitatory signal is sent to the hip flexors to contract, while an inhibitory signal is sent to the glutes to relax and lengthen. This is called reciprocal inhibition. A problem can occur when the excitatory signal is sent to the glutes and an inhibitory signal is sent to the hip flexors. If the hip flexors are excessively tight, they may block the message from ever reaching the glutes leaving them inactive.
My clients often struggle with gluteal activation, especially when the hip is in a flexed position. Doing a hip flexor lengthening exercise prior to the glute squeeze usually increases their ability to find and fire these muscles.
Lack of use
If you have pain or are in a poor position as described above, your glutes may shut down. And if you sit for long periods where your glutes are being overly stretched and underutilized, they may stop working. Additionally, glutes aren’t activated to the same extent as other muscles during daily activities. This leads to muscle substitutions.
When going to do a gluteal function like hip extension, the body is going to recruit the strongest muscle for the job, which may be the hamstring if the glute is weak. I have seen many clients with hamstring tears and strains resulting from amnesic glutes. Alternatively, the lower back may be substituted for the glutes to create hip extension, leading to many cases of back pain. Not good!
Since we still have to move and play even if we have flakey glutes, the body will find another way. Since the quads, on the front of the leg, are engaged in daily activities - standing from a chair and climbing stairs - they tend to be recruited. Many people are quad dominant, using these muscles primarily when doing strengthening exercises like squats, step-ups and lunges. Hence, trying to rehab your glutes with these exercises will be ineffective. Isolation of the glutes is required to retrain them and correct your faulty movement patterns.
Watch for my next blog on glute activation exercises.