Recently I was treating a patient, guiding them through exercises to activate her gluteal (buttock) muscles when she pointed out that all the physiotherapists she had seen were fixated on her glutes! But are we? And why?
It’s all about the glutes
The better your buttocks are working, the more control you have over hip, knee, ankle and lower back movement. The more control you have, the less likely you are to overload structures when you move, whether that’s running, dancing or simply walking to the bus stop.
The muscle we often target in Pilates with both the side-lying and single-leg standing work is the gluteus medius, this muscle is a hugely important stabiliser and serves to keep your pelvis level when you are on one leg.
Should we all be strengthening our glutes?
The answer is probably! The reality is that muscle strength can be very different to movement control- so how we advise you to perform your exercises will depend on your issue.
The other issue is that we are all spending a lot of time sitting on our glutes. I think if we all had to resort to cave men foraging tomorrow, most of the developed world would struggle to survive due to the relative inactivity and subsequent weakness, tightness and stiffness our bodies have developed from sedentary work.
There is copious research on the best way to engage/ activate/ strengthen/ “Wake up” our glutes and it’s different for everyone, so this is when the good assessment skills of a physiotherapist can be useful.
For example, if your primary issue is knee pain going up and down stairs, then to ask you to do lots of squats would only serve to ramp up your pain. We might however get you onto your side, (we are aware this is non-functional but it’s a good starting point), to introduce endurance and strength to the area.
Others can have issues higher up with low-grade hip pain on prolonged standing, so here weight bearing gluteal activation, such as a squat or wall press, can be fantastic to improve endurance.
In Pilates we change positions to challenge movement control in both non weight bearing and weight bearing positions, non-functional and functional, and anyone who has been to a class can quickly tell you their “better” or “stronger” side very quickly after performing their glutes exercises.
To find out more, as always, just get in touch!