Tuesday, September 29, 2009

Chronic Pain and the often overlooked glut muscles

Chronic Pain and the Often Overlooked Glut Muscles

Most people look at the abdominal wall when they have chronic low back or pelvic problems. They do endless amounts of crunches and Pilates type movements to strengthen their core. While this does build strength, it doesn’t address an often overlooked group of muscles which includes the external rotators of the hip and the gluteus muscles. For ease, I’ll call them the butt muscles.
When the butt muscles are weak (inhibited) they can cause multiple problems for the musculoskeletal system. Let’s look at the gluteus maximus as an example. This muscle attaches to the outside of your upper leg to a thick band called the iliotibial band. Its other attachment is at the top of your pelvis and to the small pie shaped bone at the base of your spine that forms the foundation of your spine, called the sacrum. It crosses the sacroiliac joint and the hip joint. It’s nearly always involved in sacroiliac pain, lumbar spine pain and hip pain.
You can notice the gluteus maximus muscle working when you walk with a long stride. If you place your hands over the lower portion of your buttocks and walk with a short stride, you will feel very little muscle contraction. Now lengthen your stride and you will feel the muscle contract when you toe off and when your heel strikes the ground. This is actually a good way to keep the muscle strong. Walking in heels prevents long strides and contributes to inhibited butt muscles.
Getting out of a chair or car and climbing stairs are other common uses of the butt muscles. When they are weak, you have to lean forward to shift your weight more over your knees in order to get up.

Why is the strength in these muscles important?

When these muscles are weak there will be a slow lengthening of the sacroiliac ligaments which causes pain and pelvic imbalances that become chronic. If this occurs, there will usually be muscle tightness running up your back even up to the neck muscles.

What are the symptoms of weakness of the butt muscles?

1. Chronic pelvic problems
2. Chronic knee pain
3. Stiffness to the lower back
4. Restriction in neck rotation
5. Difficulty sitting for long periods of time
6. Difficulty getting out of a car or up from a low chair

What can you do about this?

First you have to have your pelvis, hip, foot and thoracic spine tested for any structural imbalance. Then the muscle needs to be tested for its proper function and corrected if it cannot contract properly. Once the muscle is able to function properly, simply walking with long strides may be enough to keep the muscle contracting properly. If this is not enough, then specific exercises can be prescribed to help allow for proper biomechanics of the butt muscles. Unfortunately, all of the machines at the gym don’t take into account the way the butt muscles actually function when walking and they often work the hamstring and low back muscles more than the buttock muscles which leads to further imbalance.

If you have chronic problems or know someone with this type of problem, please talk to me about it. Often treating this group of muscles helps with many problems at once, from the foot to the neck.

As always, your referral is my greatest compliment.

Kevin Colling, D.C. 503-808-9145

1 comment:

Courtney said...

I would appreciate any help on this matter. I came across your blog today when I researched extremely weak butt muscles. I've been dealing with a slew of symptoms since a shoveling injury at the end of January. I originally thought all my symptoms were coming from my pelvic floor, as I had delivered a baby just 10 weeks before the injury and felt very weak there. After weeks of therapy to treat muscle weakness, my symptoms still stood and I was tested with biofeedback to find out I had pelvic floor muscle tension this whole time. I also have had increased back pain and once therapy resolved my pelvic floor muscle tension, the back pain stood out very strongly. Just last week I had an MRI done and there was a slight disk bulge found. I am currently going to physically therapy again, but for this disk bulge. I am writing because this whole time (since the day I woke after shoveling) I have had this extremely weak feeling along my butt and lower back. I feel like I can't hold myself upright for very long without my butt muscles tensing on their own. Even sitting I struggle to relax them. Just today I'm feeling exhausted yet not a normal after workout exhausted... to the point of tears. I'm not sure if it's because I did some intense core strengthening last night at Physical Therapy, or because there is something else going on. I've been struggling to describe my symptoms and I don't know what to do. Any advice would be GREATLY appreciated.