16/02/2021
Hello everyone,
Whilst I am unable to work at present (although hoping to be back very shortly) I thought I'd share some information about this KEY muscle.
"The Vital Glutes"- Strength and control in Glute Maximus and Medius are a very important factor in creating a biomechanically efficient pattern.
GLUTE MEDIUS:
ANATOMY: originates from the outer surface of the ilium below the iliac crest (hip bone)
Inserts- Greater Trochanter of the femur
MAIN ACTION- Abduction (leg away from the body)
Internal Rotation turning leg into body
Assists with Flexion (anterior fibers) and extension (posterior fibers) at Hip joint
KEY muscle in dynamic pelvic stability and is crucial during the gait cycle (preventing one side of the pelvis to drop whilst only one leg is off the ground) as it is part of the lateral sling system. You can assess this by standing on one leg and seeing whether pelvis heights remain level- Trendelenburg test
Weakness in the glute medius can cause many problems (to name a few)
1. Lumbar spine pathology/Sacral torsions
2. Patella Mal tracking
3. Femur falling in towards body (adduction) and inwards rotation
4. Increased weight transference to inner aspect of foot causing pronation at subtalar joint making conditions such as Plantar fasciitis, Shin splints, Achilles tendinopathy much more prevalent.
5. Muscle imbalances e.g. over active QL on opposite side.
This is why it's a KEY muscle focus to strengthen during rehabilitation of many conditions and in classes such as Pilates. This muscle is mentioned to me daily by many of my clients e.g. my gluteals aren't firing enough or they are generally weak.
To assess the firing sequence of Glute medius:
Patient side lying making sure shoulder, hip and knee are in line with no forward tilting pelvis or hip hitch. The therapist stands behind patient feeling the glute medius (behind hip), Tensor fascia Lata (in front of hip) and QL (below rib cage) and asks patient to lift leg off the bed (not very high)
CORRECT FIRING SEQUENCE
1. Glute Medius
2. TFL
3. QL
If incorrect, the focus should be on stretching the short tight muscles such as adductors (groin), QL and TFL and this can be done using MET's in clinic and other specific stretches. Rarely the glute medius is weak, usually these other muscles have become over active. If in 2 weeks if this has not improved the glute firing sequence, then isolated glute medius strengthening exercises should be started e.g. Clam exercise, hip Abduction side lying.
Endurance test of glute medius- Side lying in neutral position and lifting leg away from body. Can you hold this for 30 seconds? If so, endurance is ok and good to compare left and right sides.
Moving back into practice, I am more than happy to assess glute med strength (all fibers) and observe natural firing pattern. It's a key topic of discussion and a great way of preventing injuries in everyone.
Thank you and look forward to seeing you all soon,
Lizzie
