Gluteal Muscles

What are the Gluteal Muscles?

The Gluteal Muscles comprise three muscles which make up the buttocks: Gluteus Maximus, Gluteus Medius and Gluteus Minimus.

Gluteus

Tortora et al. (1990)^[1] describe the function of the gluteal muscles:

Gluteus Maximus extends and rotates the thigh laterally
Gluteus Medius and Minimus abduct and rotate the thigh medially.

Are your Gluteal Muscles Weak or Inhibited?

An inhibited muscle means the muscle is not firing correctly (the neural signal is not reaching the muscle). A weak muscle indicates the muscle is firing normally (not inhibited) but lacks strength.

A way to determine if the gluteal muscles are inhibited is to perform a prone hip extension test.

To perform this test, lie on a table face down and, keeping the straight leg, lift it off the table. If raising the leg, the knee significantly flexes, or if a "dipping" is noted in the lumbar spine, indicating lumbar extension, the gluteal muscles are inhibited.

Hip Extension Test

Liebenson (2006)^[2] states that if a lack of coordination is seen when walking backwards, it indicates a weak gluteus maximus.

What causes weak or inhibited gluteal muscles?

If you spend long periods sitting in a chair, the front of the hips (hip flexors - psoas) become short and tight, while the back (gluteal muscles) become long and weak. Soon the body forgets how to use the gluteal muscles because it will divert the neural signal intended for them to a stronger muscle close by to do the job instead. IIf the neural system is now asking less powerful muscles to perform the task that requires the gluteal muscles' potential power, then this is likely to lead to injury.

What is the impact of weak or inhibited gluteal muscles?

Weak or inhibited gluteal muscles can result in overactive hamstrings. It can be the reason for low back pain, tight iliotibial bands (ITB syndrome) and patellofemoral pain (runner's knee).

Without a strong gluteus medius to align the femur, knee and ankle, you are likely to overpronate your feet, which can lead to plantar fasciitis (heel pain), Achilles tendinitis and shin splints.

The gluteus medius holds our pelvis upright as we stand. When it gets weak, the piriformis has to compensate. As a result, the piriformis gets bigger and tighter, and you may experience piriformis syndrome.

How will I know if my core muscles are engaged?

Your core engages naturally just before you cough. Try this to get an idea of how it will feel to engage your core.

How can I get my gluteal muscles functioning correctly?

The following exercises will help develop gluteal activation and core stability.

Bridge Form a bridge as in Figure 1 (start position) Engage the core muscles Push the hips higher and hold for 30 seconds Lower the hips to the start position Repeat three times	Figure 1
Bridge with leg extension Form a bridge as in Figure 1 Engage the core muscles Extend the left leg as in Figure 2 Ensure there is no tilt in the hips Hold for 30 seconds Repeat three times Repeat with the right leg	Figure 2
Glute Kick Assume the position on hands and knees as in Figure 3 Engage the core muscles Push the left heel up approx. 2 inches towards the ceiling (Figure 4) Ensure no hip tilt Hold this position for 30 seconds Return the left leg to the start position as in Figure 3 Repeat three times Repeat with the right leg	Figure 3
	Figure 4
Leg Lift Stand tall and erect Lift the left foot off the ground Assume the position as in Figure 5 Engage the core muscles Push the left heel up back as in Figure 6 keeping the left leg straight Ensure there is no hip tilt Hold this position for 30 seconds Return the left leg to the start position as in Figure 5 Repeat three times Repeat with the right leg	Figure 5
	Figure 6
Lunge Stand tall and erect Engage the core muscles Lunge forward with the right leg to assume the position in Figure 7 Check right knee is above the right ankle and the back is straight Hold this position for 30 seconds Push back with the right leg to bring you back to the standing position Repeat three times Repeat with the left leg	Figure 7
Squat Stand tall and erect Engage the core muscles Lower the body to assume the position in Figure 8 Hold this position for 30 seconds Push down through the heels to bring you back to the standing position Repeat three times	Figure 8
Superman Stand tall and erect Engage the core muscles Lower the upper body and raise the left leg to assume the position in Figure 9 Hold this position for 30 seconds Return slowly to the standing position Repeat three times Repeat with the right leg Try to get into a position so that there is a straight line through the arms, neck, back and rear leg	Figure 9

What is Piriformis Syndrome?

If you have a short tight Piriformis muscle, you may experience low back pain, pelvic pain, and pain in the buttock or hip. As the piriformis gets bigger, it may trap the sciatic nerve, which can cause numbness and tingling going into your leg or foot; it may hurt to sit, walk or lie down.

Exercise to lengthen the Piriformis

Supine Stretch

Lie on your back with knees bent
Cross the right leg over the left leg as in Figure 10
Pull the left leg toward your chest
The right will also move closer toward your chest, stretching the piriformis
Hold the stretch for 30 seconds
Repeat three times
Repeat with the other leg

Figure 10

What is the impact of a short/tight Psoas?

The rectus femoris acts as a hip flexor and knee extensor. The synergists are the psoas and the tensor fascia latae (TFL). Once the femur reaches about 90 degrees of hip flexion (Figure 11), the psoas takes over because the rectus femoris has shortened and is incapable of applying the necessary force to move the knee above 90 degrees of flexion (Figure 12).

Psoas Test

Stand up tall and maintain a posture to lift one knee past hip height (Figure 12). If your psoas is short/tight, you may experience cramping in the TFL, as your TFL attempts to carry the load, or your hips tilt back as the quadratus lumborum's attempts to carry the load.

Figure 11

Figure 12

Exercise to lengthen the Psoas

Psoas and Quadricep stretch

Kneel on the ground with the left knee well behind you
With the left hand, grab the left leg just above the ankle
Engage the core and glutes
Assume the position in Figure 13
Keep your back straight and vertical
Keep your hips square
Hold the stretch for 30 seconds
Before the next stretch, move the left knee further back
Repeat three times
Repeat with the other leg

Figure 13

and finally

This exercise strengthens your weak hip muscles, glutes and core while challenging your hip flexors

Form a bridge as in Figure 1
Engage the core and glutes
Lift your left foot off the ground and pull your left knee toward your left shoulder as in Figure 14
Lower left your foot to the ground and do the same with your right leg
Maintain the bridge position the entire time you do the exercise
Complete 15 lifts with each leg

Figure 14

How Often?

Suggest the above exercises are performed three times a week with at least 24 hours of recovery between sessions to allow the muscles to adapt

Best Exercises

Research by Distefano et al. (2009)^[3] found that: "The best exercise for the gluteus medius was the side-lying hip abduction, while the single-limb squat and single-limb deadlift exercises led to the greatest activation of the gluteus maximus."

References

TORTORA, G and ANAGNOSTAKOS, N. (1990) Principles of Anatomy and Physiology. 6th ed. USA; Harper Collins Publishers
LIEBENSON, C (2006) Rehabilitation of the Spine: A Practitioner's Manual. USA; Lippincott Williams & Wilkins
DISTEFANO, L. et al. (2009) Gluteal muscle activation during common therapeutic exercises. Journal of orthopaedic & sports physical therapy, 39 (7), p. 532-540

Page Reference

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MACKENZIE, B. (2012) Gluteus Maximus [WWW] Available from: https://www.brianmac.co.uk/glutes.htm [Accessed