The gluteus medius is not as popular as it’s big brother the gluteus maximus (being a little brother myself I can empathise), never the less the gluteus medius is as important in terms of stability of the pelvis and movement at the hip. Because the gluteus medius doesn’t directly influence the sacroiliac joint like the gluteus maximus does, the gluteus medius stabilises the pelvis in a different way to the gluteus maximus.
This blog is part 2 of my blog last week How Your Gluteus Maximus Affects Your Lower Back so after reading this you should go back and read that blog too. Reading both will give you a well rounded understanding on how these muscles influence pelvis and lower back mechanics.
The Little Brother
The gluteus medius originates on the outer surface of the ilium (pelvis) in-between the posterior and anterior gluteal lines and inserts onto the lateral superior surface of the greater trochanter of the femur (top of the thigh).
The gluteus medius abducts the thigh (away from the midline), the anterior muscle fibres medially rotate the thigh and the posterior muscle fibres laterally rotate the thigh.
During gait the gluteus medius helps with the alignment of the legs, making sure they don’t adduct (towards the midline) too much. If the gluteus medius isn’t working properly it could manifest as the leg(s) going in too much when walking. The gluteus medius also helps with stabilising the pelvis when you’re balancing on one leg, very important for yoga and most sports!
So if the gluteus medius for what ever reason isn’t functioning properly, this can result in an unstable pelvis, especially when trying to balance one leg or when moving from one leg to the other. The foundation of the lower back is the pelvis (specifically the sacrum), if foundation is unstable, it’s very reasonable to assume that the structures (lower back discs / vertebrae) on top will be negatively influenced due to compensations up and down the kinetic chains.
Unstable Pelvis – Unstable Lower Back
A test you can do on yourself to assess your ability to stabilise your pelvis is the double to single leg stance test. Find a mirror and take one leg of the floor, what you’re looking for is if your pelvis is able to stay parallel to the mirror with one leg or if you have to shift or rotate your pelvis to balance. If you can’t maintain a parallel pelvis then you would score positive for a ‘weak’ gluteus medius.
Now of course there is much more going on in the body during this test that can prevent the pelvis from being parallel as we are not isolating the gluteus meduis (not that you can isolate a muscle) but for purpose of this blog we will continue as if the gluteus medius is the cause for not passing this test. If you would like more information on what else could be causing the pelvis to be unstable other than the gluteal muscles please private message me or comment below and we can continue this discussion.
Improving Gluteus Medius Function
The gluteus medius might be in spasm or fibrotic (tight) so using a massage ball or tennis ball to massage the muscle fibres is a good place to start. Seeing a Sports Therapist is a great idea if you can’t bare a tennis ball. The advantage of having a massage by a health professional is they can be more intentional and deliberate with their hands (or elbow!) than a ball. This is because a tennis ball doesn’t have a brain (that sentence sounded more profound in my head).
Like in last week’s blog with the gluteus maximus, you now want to improve the neuromuscular feedback and strength of the gluteus medius. There are a lot of fun and effective ways of doing this so here is just an example of what you can do the strengthen the gluteus medius.
- Leg abductions with cable.
- Single leg lifts – Pilates.
- Hip hitching
As well as strength work, proprioceptive centred exercises will also be good practice. This is basically anything that requires balance and co-ordination.
Your Deepest Lower Back Muscle – Quadratus Lumborum
The human body is an integrated system, so the story doesn’t start and end with the gluteus medius. There is a direct functional pattern between the gluteus medius and the quadratus lumborum (QL) on the other side.
As you can see in the picture to the side if the right gluteus medius is ‘weak’ the left QL (contralateral side) will be ‘tight’ or in spasm. Potentially the reason why the gluteus medius is not working optimally in the first place is because the QL is ‘tight’ (maybe due to lifestyle or a past injury). Not addressing the QL can prevent the pelvis from being stable. The inner thigh muscles on the side (ipsilateral side) of the ‘weak’ gluteus medius is also another area to check for strength and function as the adductors of the hip are the antagonists to the gluteus medius.
I’m just highlighting an example of how a ‘weakeness’ in the body can actually be a compensation due to a biomechanical issue somewhere else in the body.
Don’t treat symptoms and finish there. Treat symptoms and work on the rest of the body to help maintain that change. You can’t produce a long term change in the nervous system with a single input.
If you want to continue this discussion please comment or message me.
As always thanks for reading guys and have a great day 🙂
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