I am often told when I meet a new patient, “I have weak glutes”, or, “My glutes aren’t firing properly”. They may have been told this from a health care practitioner or they went to Dr. Google to do some research. Let’s clear up what “weak glutes” actually means.
Quick Glute Anatomy
– We have three glute muscles: Gluteus Maximus, Medius and Minimus. For the sake of this discussion, when I refer to “glutes” I am referring to Gluteus Minimus and Medius.
What do Glutes do? – Glutes have many functions including stability of the hip and pelvis.
Are my Glutes really weak? – When I assess a runner, I muscle test them from head to toe. A strong and functional muscle scores a 5/5. More often than not, glute testing scores weak, ~3/5.
So, if the glutes score 3/5, then they are weak, right?
No! In my clinical experience I have never had a patient who had actual “weak” glutes.
An example of “weak” muscles.
– Someone breaks their arm and is casted for six weeks. During that time the muscles of the arm aren’t used because they are immobilized. When the cast comes off the muscles of the arm test “weak”, 3/5. Why? Because the muscles have been immobile they have atrophied (they have become smaller and weaker). These muscles are, in fact, weak and need to be strengthened! A rehab program including strengthening and range of motion exercises would soon follow.
So, if my glutes are not weak, then what is going on?
Muscle Inhibition 101 – When a muscle is inhibited it does not work to its full potential. An inhibited muscle still “works” but it’s neurological input is diminished. The muscle is impaired.
Think of it like this, your body has protective mechanisms. Your brain-to-muscle system has controls and regulators. The brain controls muscle like a dimmer switch. The brain has the ability, when necessary, to dim the signal to the muscle in order to prevent harm to the body. It is not possible to score 5/5 on a muscle strength test when a muscle is inhibited.
My glutes score 3/5 on a muscle test because of inhibition and I am a runner. How does this affect my running and my body? – When glutes are inhibited the pelvis becomes unstable. When there is instability the body will protect this area by tightening the muscles around the instability. This tightness is often what runners feel and attempt to rectify with stretching. It also creates a domino effect down the entire lower extremity. This makes every muscle in the lower body tight and susceptible to injury and can result in pain and dysfunction of the knee, ankle and foot.
Do I need to strengthen my glutes? – If your glutes are inhibited, they are not weak. Therefore, they do not need to be strengthened.
Glute specific exercises have a place, however, if there is inhibition, specific glute exercises will not fix the issue. In fact, you are often wasting your time and may be putting your muscles at greater risk of injury.
How do I un-inhibit my glutes? – Determining the root cause of glute inhibition is the first and most crucial step. Once you understand the mechanism behind it you will be empowered and pro-active in the correction of the inhibited muscles. There are a number of reasons for the inhibition and a functional physical assessment is the only way to determine the cause of the impairment.
