Assessing Your Posture for Preventing Injuries & Maximizing Performance - The Glutes
The Muscles of the Glutes
The glutes, nicknamed for the gluteus muscles, are the power muscles of the hips for runners. There are three of them that exist on each side of the body. They are:
The Gluteus Maximus
The Gluteus Minimus
The Gluteus Medius
The Actions of the Glutes
The job of the glutes is to extend the legs, abduct the legs, and externally rotate the hips. These three actions are what propel us into motion with running. When we are running in one straight line it may be confusing to think that the glute muscles need to abduct and externally rotate. The reason is because we are moving in a spiral or rotational pattern every time we propel forward from one foot to the next and twist our body with each arm moving forward and back.
To see and feel it in your own body, stand up for a moment and take a few steps forward. After a couple steps freeze your movement exactly at the time you plant your foot forward. Do you notice how your body twisted to the opposite side of the planted foot? That’s the spiral rotational pattern occurring when you walk and run which takes into account the abduction and rotation needed in your glute muscles.
Assessing the Glutes
When both sides of the body are balanced and symmetrical you are likely to stay healthy and run at your optimal performance. Oftentimes we get out of balance and don’t even know it which sometimes leads to injury or suboptimal results in attaining our running goals.
That’s where having an assessment with your acupuncturist, chiropractor, or physical therapist could come in handy.
When assessing the glutes we look for seven things:
Is the strength on the right balanced with the strength on the left?
Is there full range of motion?
Are there trigger points or dense tightnesses in the glute muscle tissue?
Are the hips symmetrically balanced on the left and right or is one hip higher than the other?
Do the hips rotate to the right or the left when standing still or are they balanced evenly facing forward?
Are the hips shifted forward or backward when compared to the ankles?
Are the hips tilted forward or back or are they level when compared to the legs?
1. Strength
When assessing the strength of the glutes a test called a manual muscle test can be done. When doing a manual muscle test the goal is less to see how strong the muscle is but more to see if one of the glutes is inhibited to action and strength.
Manual muscle test of Glute Max
Manual Muscle test of Glute Medius and Minimus
Inhibition or weakness in the glutes (or glutes overly strong and overworking) can lead to back pain, sacro-iliac joint pain, overworked adductor muscles, opposite side glute pain to name some of the most common
2. Range of Motion
Assessing for range of motion entails either active range of motion or passive range of motion. With an active range of motion you, the patient, are moving your glutes into the three different types of actions of extension, abduction, and external rotation. With passive range of motion I, the therapist, would be moving your glutes into the three different types of actions.
By seeing your range of motion it gives us an idea of what your joints are doing when you run. If there are limitations in your range of motion during the assessment then it means you have range of motion limitations when you run and we can then address it with acupuncture and corrective exercises. When you are running with full range of motion of your glutes you are able to generate more power with your runs using less energy of the muscles. This means you’ll start running faster using less effort.
3. Trigger Points
Trigger points are little balls of adhesions that form within the muscles. With practice and delicate touch these trigger points can be felt with palpation on your skin in the assessment process.
Trigger points are buildups that are formed when muscles are repetitively or overused with the same action, position, or activity. The trigger point forming or not forming are often correlated with your self care routine.
One trigger point may become two, then three, then many. After a while the trigger points will begin to inhibit your range of motion and potentially cause you to feel pain. The pain often isn’t where the trigger point is but follows a pattern away from the trigger point. In my office I have a poster with common trigger point pain referral patterns.
With the glutes, pain is often felt in the sacrum and lower buttocks area for the glute medius. For the glute minimus pain is commonly felt in the lower buttocks, on the side of the hip, and radiates down the hamstring down to the calf or down the IT Band to the ankle. For the glute max pain is commonly felt in the sacrum and lower buttock radiating into the upper hamstrings usually on the inside of the leg.
4. Hip Hike
Assessing whether one hip is higher than the other is part of the assessment process. To find out I would just put my hands on top of your hip bones from the side and measure if they are even or if one sits higher than the other.
One hip being higher than the other is usually not caused by one leg being longer than the other. It’s usually because one hip is stronger than the other and when a muscle get stronger it can also get tighter and shorter. When the other hip is weaker or is not being used it will become more flaccid and longer. So one side gets shorter and the other gets longer. Hence one hip sits higher than the other.
With acupuncture for the glutes, stretching, corrective exercises, and strengthening over time the hips can balance out again.
5. Hip Rotation
Hips rotate either internally or externally. Normally the hips rotate and then return back to a neutral position. Sometimes with our posture, running form, or overuses the hips will form a new neutral position of being more internally rotated or externally rotated. This has a domino effect of changing the neutral position of your upper leg, knee, lower leg, ankle, and foot. You can probably imagine how that might affect your running form and how the muscles and joints are used on a regular basis.
By assessing your glutes we can see if there is any hip rotation by feeling to see if one hip comes more forward than the other when standing and also taking into account your range of motion. Can you picture if one side comes more forward than the other there will be rotation in the whole body? Its usually so subtle its hard to even tell. If there is hip rotation it’s common for one side to be internally rotated while the opposite side has the opposite of being externally rotated.
6. Hip Shift
I’ll touch on this one really briefly. The hips in a neutral position stack up directly on top of your knees and then over your ankles. You can imagine how this creates a solid base of support for the whole body. Sometimes the hips will shift forward past your ankles like you have a forward lean or your hips will shift back behind your ankles and it looks like you are slightly falling backwards.
To assess this we’ll often just look at you in a standing position to see how the hips stack over the ankles. Another test is to put a little body weight and pressure downward onto your shoulders straight down into the ground. If you buckle forward there is probably a forward (anterior) hip shift and the opposite with a backward (posterior) hip shift.
7. Hip Tilt
In addition to there being hip hikes, rotations, and shifts the hips can also be tilted. There are two types of hip tilts that can be assessed. An anterior pelvic tilt or a posterior pelvic tilt.
Think of your hips being a bowl filled to the brim with water. In a neutral position the water stays in the bowl without spilling out. With an anterior tilt the water will spill out forward and with a posterior tilt the water will spill out backwards. The tilting doesn’t always affect both sides. Sometimes the hips will be titled only on the right or only on the left.
Conclusion
There's a lot to assess here with the glute muscles of the hips!!! It’s so important to evaluate because the hips and glutes are the midpoint that will alter movement above to the back, shoulders, and neck and down to the legs, knees, ankles, and feet. If you’d like to have an assessment, schedule a 30 minute Comprehensive Acupuncture Assessment Session for only $39.