Low Back Pain: Gluteal Muscle Weakness - Contributing Factor

Dr Ozello's Sports Medicine Report: Low Back Pain: Contributing Factor: Weakness of Gluteal Muscles

***Disclaimer: Viewing this video does not take the place of seeing a medical professional or working with a certified fitness professional. Please visit a medical professional for evaluation, diagnosis and treatment. Please work with a fitness professional to learn proper exercise technique and to develop a proper training program. Never perform an exercise that elicits or intensifies symptoms. If an exercise elicits or intensifies symptoms, stop immediately and use a viable substitute. Always perform all exercises through a symptom free range of motion. Begin your training at your current health, fitness and strength levels. Increase intensity in small gradual calculated increments.

Gluteus Maximus
Largest & most superficial gluteal muscle.
Origin: Broad area on posterior surface of ilium, posterior gluteal line, area of bone superior & inferior to this line, upward to iliac crest, aponeurosis of erector spinae, dorsal surface of lower sacrum & side of coccyx, sacrotuberous ligament & fascia that covers gluteus medius.
Insertion: Upper part & superficial fibers of lower part: Iliotibial band.
Deeper fibers of lower part: Gluteal tuberosity.
Innervation: Inferior Gluteal Nerve (L5, S1 & S2).
Concentric Action: Hip Extension (along with hamstrings) and hip abduction.

Gluteus Medius
Deep to gluteus maximus.
Origin: Gluteal surface of Ilium.
Insertion: Lateral aspect of greater trochanter.
Innervation: Superior Gluteal Nerve (L4, L5 & S1)
Actions: Hip abduction. Assists in thigh external rotation when the hip is extended. Most Importantly - Maintaining a stable (level) pelvis while standing on one leg, walking and running.
Extremely important in kinetic chain and pelvic stability

Gluteus Minimus: Actions: Hip abduction and hip internal rotation.

Weakness in Gluteus Maximus creates poor posture, incorrect movement patterns and places increased workload on the spinal muscles. The increased workload leads to fatigue and eventually pain. Often times caused by prolonged sitting and a combination of tight hip flexor muscles or a strength imbalance. The muscles which flex the hip (Hip flexor muscles - psoas and iliacus, which form the iliopsoas muscles) overpower the weaker hip extensor muscles (Glute Maximus and hamstrings). Major contributor to a postural condition known as lower cross syndrome.

Weakness in the Gluteus Medius may lead to instability in the pelvis. One side of the pelvis may be higher than the opposite side when standing or one side may raise higher or dip lower than the opposite side while walking. The instability in the pelvis leads to an increased workload being placed on other structures including but not limited to: piriformis muscles, spinal muscles, hip joints, sacroiliac joints, iliotibial pain, hip flexor muscles, tensor fascia lata, hip adductor muscles and hip extensor muscles (Gluteus maximus and hamstrings). Weakness in the gluteus medius can contribute to not only low back pain but to a wide assortment of musculoskeletal conditions including but not limited to lumbar spine sprain/strain, sacroiliac joint sprain/strain, iliotibial band syndrome, patello-femoral pain syndrome, hamstrings strains and proximal hamstrings tendinopathy. Major contributor to a postural condition known as lower cross syndrome.

Prevention: Training routine which includes functional multi-joint exercises and exercises that directly target the glute muscles.

Functional Multi-joint exercises: Gluteus Maximus – Squats, lunges and leg press.
Exercises which directly target Gluteus Maximus – Hip Thrust/Pelvic Bridge, donkey kicks, hip kickbacks.

Functional Multi-joint exercises: Gluteus Medius – X-band walking, monster walk
Exercises which directly target Gluteus Medius – Side lying Hip Abduction, side lying hip external rotation (Clams) and pelvic bridge with band hip abduction.
Low Back Pain _ Seek professional care to get evaluation, diagnosis and treatment plan,

Rehab – Start with exercises that directly target gluteus maximus and gluteus medius. Advance to functional exercises.

Side-Lying Hip Abduction
Spine straight. Neck in line with spine.
Hips and knees straight. Feet stacked.
Abduct hip through a symptom free range of motion.
Build to fifteen repetitions.
Perform sets with hip in external rotation, neutral and internal rotation.

Dr Donald A Ozello DC of Championship Chiropractic in Las Vegas, NV
Web Site: http://www.championshipchiropractic.com/
Blog: https://www.championshipchiropractic....
Twitter:   / drdozellodc  
Facebook:   / championship-chiropractic-280141628688300  
LinkedIn:   / dr-donald-a-ozello-dc-716b3233  
YouTube:    / drdozellodc  
"Running: Maximize Performance & Minimize Injuries" https://www.amazon.com/Running-Perfor...