And other physical therapists can’t deny that functional glutes are necessary.
Today, I’ll be talking specifically about one of the three gluteal muscles, the glutetus medius, which is also known as the glute med.
So what is the glute med? The front part of the glute med flexes and turns the hip in. The back section helps to extend and turn the hip outwards. Together, these both help to lift the hip and leg to the side and stabilizes the pelvis. The glute med is a vital muscle that helps with pelvic and hip stability. What does all that mean? Basically, the glute med helps to prevent the ‘model walk’ where the hips drop as they strut forward. This is also known as a pelvic drop.
What happens when you have a weak glute med and a pelvic drop? Both of these can contribute to back and knee pain. Physical therapists often monitor for the ‘Trendelenberg Sign’ to observe glute med weakness. The pictures below helps to show how pelvic drop can lead to back and knee issues. When the glute med is weak, the other side of the hip drops, as shown in the ‘abnormal’ picture. As a result, your weak glute med side’s thigh internally rotates, knee goes into valgus (aka knocked knees), and foot over pronates (flat foot).
These changes can lead to foot, knee, and low back pain. An overpronated foot can lead to stress on both sides of the ankles. With the foot overpronated, the knee is going to have extra pressure on the inside of the knee because the line of force is not running straight down as it should. Additionally, as the hip internally rotates, you see the same issue with the knee -> medial knee pain. Weak glute meds also contribute to low back pain as they are vital to maintaining hip stability. Without their contribution, the low back is forced to ‘pick up the slack’ with improper biomechanics. The spine also has an increase in irritation due to the extra pressure on the segments as they twist to one side to compensate. This can lead to abnormal weak and tear on the intervertebral disks of the spine (the disc in between each spinal segment.)
What do you do if you have weak glute meds? I encourage the use physical therapists as the main medical professional for musculoskeletal complaints. You can also refer to these blog posts below by Mr. Tom Goom, a running expert in the field of physical therapy. They cover ideal glute med exercises to help strengthen this vital muscle. (I was planning on including my own exercise recommendations, but there is no reason to recreate the wheel when such a friendly, well-written, and informative post is already made!)
Gluteus Medius – Evidence Based Rehab: this post goes into the research of effectively strengthening the glute med. He also lists and explains different exercises in regards to their efficacy.
Back Pain and Running – Rehab Exercises: this post describes the importance of glute med muscles for spinal health and explains the three main reasons for back pain.
Be sure to refer to the research articles and posts linked in the text above for additional information. Thank you, Mr. Tom Goom, for such wonderful resources in your posts.
Feel free to post any questions or comments below; I look forward to hearing from you!
Much of what I have learned about physical therapy and online health/wellness, I have learned from Greg Todd, the founder of Physical Therapy Builder. He is a fantastic physical therapist whose mission is to help physical therapy students and physical therapists provide patient focused care without becoming overwhelmed. Greg Todd is also known as a “social media guru,” and I have a lot of thank him for. I highly suggest his courses, especially Smart Success PT. In May, I attended Smart Success PT Live, a business, marketing, and branding course by some of the top PT entrepreneurs in the field.