It—the throb—comes out of nowhere. It feels like the burn of a shin splint, except the pain can’t be a shin splint as the sensation traverses my left knee into my left thigh, ricocheting around my hip. I limp into the treatment room.
‘So?’ Gabby, my physiotherapist, quizzes me as I lie back on the therapy table. ‘What’s going on?’
‘I feel the ache down here.’ I point to the front of my left leg. ‘Especially when I climb steep subway stairs. Or as I attempt to fall asleep, it feels as if something is kicking me in my left shin.’
‘Your left glute is not working properly,’ Gabby says, after watching me do a couple of bridges. ‘In fact, your left glute is very weak.’ (I must confess I’ve heard this before: from a physio in a training seminar. But I didn’t have pain, so I ignored it).
The ‘glutes’ is a short form for gluteals. These are a group of muscles in the buttocks, the most well known being gluteus maximus as it forms the shape of your bottom. There are also several smaller muscles that work together, including gluteus medius and minimus, and piriformis. Among the key functions of the gluteal muscles are: helping you rise up from a seated position, keeping you upright, and preventing you from falling when walking or running.
‘Try another bridge,’ Gabby prompts me. ‘Slowly.’ The bridge is a simple exercise where you lie on your back with your knees bent and raise your hips off the ground. Yet according to Gabby, who is watching me closely, I’m not doing this correctly. I’m using my back more than my glutes.
‘Don’t flatten your back,’ he says. ‘Don’t move your back at all. Just lift your hips two inches.’ He moves to the end of the table to observe me lengthwise. I try to ‘perform’ under his critical eyes. ‘Don’t come up so high,’ he adds. ‘Lift straight up. Squeeze the glutes as if you’re trying to pinch a coin between each buttock.’
If I feel self-conscious about not doing the exercise properly, how do others feel? I think of my students, especially the new ones. How vulnerable they must feel as they’re lying on an exercise mat, and I ask them to execute some movement, maybe one their body hasn’t done for years. As I lift my pelvis, I notice what Gabby sees: my hips sort of pull (jerk) to one side. I’ve seen this faulty movement pattern before in myself, but have clearly not done anything about it. How can I expect my students to do this exercise properly when I have trouble with it?
‘It happens all the time,’ Gabby says, when I sheepishly announced that I do this exercise zillions of times with my students. ‘We all get complacent, go through the motions.’
I sit up and draw my legs over the table. I realize that Gabby is right. Why be so hard on myself? No body is perfect. Each of us has deficits. It’s natural for the body to try and compensate for those weaknesses by recruiting other muscles instead. Our movement patterns become more limited as we age. But then, so do our excuses.
Human beings are one of the few mammals, and the only primate, to walk completely upright. Because of this, as compared to chimps, dogs, or horses we have the biggest gluteal muscles. The big meaty muscles of the buttocks are among the strongest in our bodies. Why then can our glutes become so weak?
Because we sit on them too much? But wait, we don’t only sit on them! We use our buttock muscles to climb stairs, walk, and do exercise, some of us a lot. How can they still be feeble? Dr. Stuart McGill, a Canadian low back specialist, calls this common weakness gluteal amnesia. Dr. McGill’s research has shown that many of us are not able to activate our glutes properly. This weakness intensifies as we age, but gluteal amnesia can be found in young people as well. It is also one of the leading causes of low back and other pain.
The buttock muscles work with the lateral hip rotators to create motion at the hip joint and stabilize the pelvis while the legs are moving. Glutes help you climb stairs or rise up from a seated position, both essential movements that we often lose the strength to perform as we age. When the glutes don’t work properly, an extra load can be placed on the spine, knees, ankles, and feet.
When these muscles ‘go to sleep’, or in my case one side works half as well as the other, other muscles step up to take over. Muscles that are not designed for the job. Perhaps you have felt this yourself when doing a bridge: a sudden sharp cramp in the back of your thigh. This is probably the hamstrings taking over in the place of the glutes.
Something else—if the glutes are not activated properly, the brain loses its connection to them and ‘forgets’ them. When this happens, you have to work hard to re-educate the body. This means you need to relearn even the most basic exercise. And once you’ve relearned the exercise you need to continue to practice the exercise in a good movement pattern, over and over, to create a clear memory pathway from brain to body.
It is not easy to create and reinforce a new movement pattern. At first the ‘correct’ pattern feels wrong – or, rather, different. You have to work at it, but at the same time, it’s important to not push your body too far too fast. Working too quickly or without awareness causes faulty motor patterns. You may want to consult your physio as many times as necessary to make sure the correct movement pattern is in place. The goal is to make these connections correct and automatic. ‘It takes much longer to undo these patterns than it took to establish them,’ warns Dr. McGill.
Still not sure if your glutes are working? Don’t fret. And don’t give up. Remember that gluteal amnesia is a common problem and it may take a while to learn to activate the glutes, both sides, properly. In today’s video we will look at the bridge, an important exercise to build your core and strengthen your buttocks. For the next three weeks we will add in new glute exercises, and practice other approaches, to ‘wake up’ these sleeping muscles.