A while back a client had sciatic pain. She’d had some help, who’d diagnosed gluteal problems. Later, she visited me – “how can you help weak glutes ?” She asked this knowing full well that it was never going to be just the glutes…
In the first part of the blog, I covered what those glutes are and what they do, with some simple assessments to understand glute weakness…
In this instalment, I’ll explore how to help weak glutes. I’ll look into possible causes of weak glutes, and how Bowen Therapy (and some exercises) can help bring balance back to the body – and reduce pain !
help weak glutes ? what’s the cause ?
I wish there was a single straightforward answer to this.
In some ways there is – glutes generally become weak due to an overactive, tight, contracted something(s) else. These tight somethings else are often the result of something else. This could be an injury, inactivity, certain actions – or bad habits. And glute weakness may be one-sided, or both…
The less straightforward answer involves working through the interactions between glutes and other muscles, and what those certain actions (or inactions), or bad habits may be to help resolve – and it may not be just one thing…
The assessments covered earlier help determine which of the glutes may be weak or inhibited, rather than strong. That’s all well and good, but it’s not a direct help when it comes to treatment or recovery. Which should leave many to the next question – “well, why are those glutes weak ?”
A key concept to keep in mind when dealing with weak or inhibited muscles is what’s called reciprocal inhibition.
In simple terms, muscles in the body work in pairs, that work together to make movement possible. For one muscle to shorten or contract (agonist), the opposite muscle needs to lengthen or relax (antagonist).
An easy example to help understand this is the bicep/tricep pair when bending the elbow. Try this on yourself. Straighten the arm and place fingers on both the bicep and tricep. As the arm is bending, the bicep can be felt contracting. When the arm is straightened, the bicep relaxes and the tricep can be felt contracting.
Similarly, our gluteal muscles are part of agonist/antagonist relationships with other muscles. Overactivity and continued contraction of muscles such as hip flexors and adductor muscles can result in underactive and weak/inhibited glutes. The glutes lack the tone to shorten, so there’s no corresponding call for antagonist to lengthen – or overactive (aka tight) muscles inhibit the glute’s ability to contract.
Many movements of the body require use of more than a single muscle pair. This can make the agonist/antagonist relationship much more complex.
weak glute maximus ?
One of the key actions of gluteus maximus is hip extension. It’s especially active when doing actions such as squats, running, or going up steps.
Signs of lower crossed syndrome would be a first place to start looking.
This syndrome describes muscle imbalances in the pelvic region – specific patterns of muscle weakness and tightness in a cross-pattern. Lumbar spine and hip flexor (iliopsoas) muscles tend to be overactive and strong. This results in underactive or weak deep abdominals and gluteus maximus muscles. Hamstrings are often found to be impacted in this pattern, feeling “tight” but often being stretched and held in a long position, unable to spring back.
This imbalance usually results in the pelvis having an anterior tilt. The hips become flexed, making the butt stick out, and a noticeable arch (hyperlordosis) in the lumbar spine.
I’ve also had a couple of clients who have developed a one-sided pattern through injury. One spoke of a bad landing when playing netball – a sharp jarring into the hip and muscles in the area, that then resulted in a range of back, knee and hamstring issues. One side of the pelvis thus becomes more tilted than the other, creating a torsion effect.
A sedentary lifestyle often plays a large part in this pattern, especially when both sides of the body are impacted. Glute maximus doesn’t need to do anything while sitting, so become disengaged. Hip flexors and lower back keep the body upright. Often the hamstring takes over the glute’s actions – an overactive synergist (leaving many people to think that their hamstring is the main problem).
Treating weak glute maximus problems usually involves helping overactive lower back, hip flexor and hamstring begin to relax. Glutes and abdominals are then in a position to fire – I’m afraid that this really means a little strength work !
weak glute medius ?
Glute medius is the main muscle involved in hip abduction, and is key to frontal plane stability of the pelvis.
While gluteus maximus is an agonist/antagonist with hip flexors, gluteus medius has more an agonist/antagonist relationship with hip adductor muscles. Tight hip adductor muscles (on the inner side of the thigh) are inhibitors to glute medius. Adductors don’t just pull the thighs together, but they also medially rotate the hip and assist to flex the hip. This may also present as an anterior pelvic tilt, or as a hitched hip.
Tight or short hip adductors are often single-sided, and may be caused by some every-day actions. Standing with the body weight shifted to one leg can do it. The pelvis is swayed to one side, with hip adductors holding. Sleeping on the side can lead to the top leg being flexed and adducted, keeping glute medius in an elongated position. And a very common posture – sitting with one leg crossed – is another major culprit. An active hip adductor is in play to help the leg rest in this position, resulting in the glute medius (and more) being held in an elongated position, beyond it’s normal rest length.
When glute medius is inhibited, other muscles often compensate to prevent the pelvis form dropping when standing on one leg or walking. The same side tensor fascia latae and opposite quadratus lumborus often become overactive in compensation.
Treating weak glute medius problems usually involves helping overactive hip adductors, tensor fascia latae and quadratus lumborum begin to relax. Glute medius (and minimus) then have a chance to fire. Again, some strength work is key – together with changing some bad habits !
weak glute minimus ?
Gluteus minimis works hand-in-hand with gluteus medius, but it also has it’s own set of antagonist muscles. As an internal rotator, it’s antagonists are lateral rotators. The lateral rotator group are 6 small muscles, deep in the buttock area – gemellus superior and inferior, obturator internus and externus, quadratus femoris, and (the infamous) piriformis.
The piriformis joins the sacrum to the top of the femur, and is critical to supporting the sacroiliac joint of the pelvis. When the pirifomis on one side of the sacrum becomes short, the other side becomes strained, and likely creates pull on the opposite femur.
or more than one weak glute ? probably…
While the above covered glute muscles separately, it is not trying to say that someone would only have one glute being weak. The interconnectedness of the body would likely result in more than one weak glute muscle, possibly on opposite sides of the body.
When it comes down to it, if you think (or have been told) that you have weak glutes, in reality there’s probably a range of muscle imbalances going on.
Consider someone who’s fairly sedentary, sits a lot – and sits cross legged. Glute maximus is likely weak from lack of exercise, with one glute medius weak from elongation. Glute minimus may be short as it supports internal rotation of the hip (together with other muscles), which then creates strain on the piriformis muscle. Unbalanced piriformis muscles contribute to sacroiliac joint issues, or sciatic pain.
Is it worth continuing ? I think you get the picture…
what is Bowen Therapy ?
Bowen Therapy (or the Bowen Technique) is a very gentle form of bodywork. Small, gentle, precise moves are made on muscles, tendons, ligaments and nerves, triggering the body to begin a healing process.
Bowen Therapy addresses the entire body, through restoring balance in the autonomic nervous system. The Bowen moves prompt the shift from the stressed, sympathetic “fight or flight” mode, to parasympathetic “rest and repair” dominance.
A Bowen session aims to help the body holistically – balancing the body, while also addressing the injury/pain site. Posture and compensatory patterns are assessed, to ensure the problem has a higher chance of staying resolved. The treatment initiates changes in the body that continue for up to a week. Some people feel immediate relief, while most experience changes in their body over the following days.
how Bowen Therapy can help weak glutes
Gentle Bowen moves are fantastic for helping bring the body back into balance, to help weak glutes have a chance to fire.
Weak glutes are usually a symptom, not a cause. Therefore it’s important that a range of assessments are used to help guide the treatment. This may be as simple as visual assessment of how the pelvis and rest of the body appears. Range of movement checks can help show where muscle restrictions lie. Muscle-specific tests may help, such as thomas test for tight iliopsoas. Palpation of muscles, including during moves, help give a picture of muscle tone patterns in the body. Muscle firing patterns give clues, as shared in the previous blog. And a variety of other assessments can give clues to the body’s asymmetries and tensegrity issues.
The main goal of Bowen Therapists is to restore symmetry in the body.
Relaxing Bowen moves on the length of the body help the spinal muscles and begin to restore balance in the total body.
Specific moves can help those restricted overactive areas let go. This is likely to include moves around the pelvis – adductors, psoas, coccyx and sacrum, hamstrings, and/or lumbar region – but may require work in other parts of the body. The goal is to give the weak glutes space to move and regain strength.
Bowen alone will definitely help. But further exercises and lifestyle changes are key to achieving a long term result.
To strengthen weak glutes, a few strength exercises really are needed – they’re not going to magically “unweaken” by themselves ! Some simple exercises will help, together with a few stretches, to help the glutes and posture overall.
Bad habits will also need to change. A less sedentary lifestyle involving moving, walking and taking the stairs will definitely help, especially glute maximus. Learning to stand evenly on both feet, and stopping sitting with legs crossed, are essential !