Saturday, April 28, 2012

Gluteus Medius: The Forgotten Muscle

On my last blog I related how I had discovered that my right gluteus medius (GM) wasn't firing while snow-shoeing up a mountain. Since then I've made it my mission to figure out why and to fix it.  I think I've succeeded and thought I would share, since so many injuries seem to have this muscle imbalance as a root cause.  In fact I would say that out of the past ten new injured runners I've seen, eight of them had a weak or 'turned-off' GM as a causative factor.  These injuries range from ITBand Syndrome, other knee injuries, Piriformis Syndrome, recurring calf pulls, and low back and hip pain.  The common theme here is that when the GM turns off other muscles over-compensate  and sooner or later an injury manifests.

I've had a right hip issue on and off for at least 15 years.  Early on I realized that keeping my hip abductors strong (including GM) kept the pain at bay.  I mainly did side steps with a resistance band around the ankles, but tried various other things as well.  It wasn't until snowshoeing however, that it dawned on me that my right GM still wasn't working.  This would explain why my hip pain had been worsening in recent years.

After I got over feeling sorry for myself, the phrase 'Physician, Health Thyself' came to mind, and I went back to the drawing board.  Basically I resurrected an old simple GM exercise: the lowly Clamshell.  However I now do (and teach) it with a new intent, specifically holding onto the GM and willing it to fire.  In the beginning this was quite frustrating because it just wasn't there.  What I've observed is that for people like myself, with long-standing weakness, the body becomes so skilled at over-compensating that the GM becomes neurologically by-passed.  Other neighboring muscles, like the gluteus minimus, TFL, piriformis, and/ or quadratus lumborum take up the slack.  It takes a deliberately simple exercise to find it and get it reconnected to the brain.  Any exercise that's the least bit complicated will only perpetuate the imbalance.

It took at least 2-3 weeks of this before I could reliable get the GM to respond.  However I was downright stoked when, after the 3rd week, I went out for a longer-than-expected long run and had virtually no hip pain for probably the first time in a year (beware when a friend says, "I want to try linking up some of the newer Portland trails I've found- shouldn't take more than two hours.")  Interestingly, the next week I wasn't quite as diligent with the clamshells, and when I went to do a warm up set before that weekend's long run I could tell the GM wasn't quite there, and correspondingly had more pain on that run even though it was shorter.

Thus confirmed, I've been working on it since with good results so far.  I've also been doing Kettle-bell swings, and I swear my but has gotten about an inch bigger (which, when you have 'white-guy' butt isn't a bad thing.)

I'll post my full "Glut Rehabilitation Program" shortly.