Signs of Glute Dysfunction and its Corrective Rehab

One of the most common injury presentations seen at Elite Health and Performance are “tight hamstrings and low back”. So often these hypertonic muscles are due to inhibited gluteal muscles forcing the muscles above and below to overcompensate. As this group of muscles are some of the largest and strongest in the body when they are dysfunctional there is a very high chance of injury to the hip, low back or knee.

The two main reasons the gluteal muscles will show poor firing patterns is firstly that they are not being used. In our sit down society the glute muscles are rarely used. The hamstrings are then chronically shortened as they are flexed in the seated position and adopt this tightened position. Once chronically short the hamstrings are overactive and begin doing the glutes job and dysfunctional patterns are created. The second issue leading to inhibited gluteal muscles is prior low back injury. When injured the body naturally creates spasm to stabilise the area. When this occurs the larger muscles over compensate and again create dysfunctional movement patterns if rehabilitative exercises are not incorporated early into the treatment plan.

There are many warning signs indicating gluteal muscle inhibition here we will describe a few.

Poor hip mobility – when there is dysfunction through a joint the first action the body will take is to try and stabilise the area through muscle spasm. Many patients will constantly be stretching the area however without the proper rehabilitative exercises there will never be lasting results.

Anterior pelvic tilt and low back hyperlordosis (Sway back) – The hip flexors are the antagonist muscle of the glutes. Their job is to do the opposite of what the glutes do. Therefore if the glutes aren’t firing correctly there will be an imbalance in pelvic force and the pelvis will be pulled forward.

Low back pain – With anterior pelvic tilt the low back will be in a chronically shortened position and will be very tight. This tightness reduces the endurance of the muscles and can lead to excessive pressure through the lumbar discs.

Hamstring strains –The hamstrings will often be the lead hip extender when the glutes aren’t activated properly. When running or creating strong contractions the hamstring muscle will be under much more load than it is designed for as it has to do the job of two muscles. This overload of force will create strains through the muscle fibres and can lead to tears.To fix this common movement fault I have broken down the rehab into three phases.

Phase 1

First exercise is glute bridges with a theraband wrapped around the knees. Perform 3 sets of 10 reps. Be sure to engage your glute muscles as you lift you body. Second exercise is side bridge holding each side for 30 seconds for sets a side. Third exercise is sideway band walks 10 steps each direction for 3 sets.

Phase 2

First exercise is to drop one leg down about 20cm off the side of a box. It is important to keep the pelvis level and stable. Perform 3 sets of 10 reps per side. Second exercise is glute bridges with theraband again performing 3 sets of 10 reps. Third exercise is the side bridge again but this time adding clams into it for 3 sets of 10 reps each side. Fourth exercise is one legged kettlebell deadlifts 3 sets 10 reps per side.

Phase 3

First exercise is done in a plank position with one leg off the ground and knee flexed to 90 degrees. Extend the hip squeezing through the glutes for 3 sets of 10 reps a side. Second exercise is side bridge with hip abduction 3 sets of 10 reps a side. Third exerise is one legged glute bridge 3 sets of 10 reps per side.