Glutes for Runners - The Key to Preventing Knee and Low Back Pain
Yuri Elkaim, BPHE, CK, RHN
Running is a sport which places tremendous demands on the body. Many runners eventually, after running hundreds or thousands of kilometres, begin to exhibit wear and tear injuries related to weak core and gluteal muscles. These injuries include but are not limited to low back pain, patellafemoral sydrome, wear and tear of the meniscus (in the knee), and shin splints. Fortunately, many running injuries can be prevented and/or alleviated by following a proper strength and conditioning program that focuses on strengthening the core and gluteal muscles.
Many core stability programs tend to focus on the trunk muscles (transversus, multifidus, obliques and paraspinals); however, the glute muscles are also very important for core stability and preventing low back pain.
The gluteals are a group of muscles that make up the bum area, called the gluteus maximus (image on the left), medius (image to the right below) and minimus (image to the left below). In anatomical terms the gluteus maximus is a hip extensor muscle (pulling the leg back) and the medius and minimus are hip abductor muscles (pulling the leg up to the side). However, for the purposes of injury prevention and improving stability, the function of the gluteals is to stabilise the pelvis and trunk and not to move the legs.
Stabilisers and Mobilisers
Mobiliser muscles act to move a limb or the trunk. They tend to act at specific times with concentric actions or stretch-shorten cycle (plyometric) actions and the muscle activity tends to be at a high level.
For example, during running the hamstrings are one of the main mobiliser muscles which concentrically contract during the latter half of the stance phase at a high level to extend the hip joint to produce a push off.
Stabiliser muscles act to control the motion of a limb or the trunk. They tend to act more continuously either in a 'quasi-static' manner or with a controlling eccentric pull. The muscle activity tends to be at a low level. For example, during running the gluteus maximus acts to maintain upright posture and laterally rotate the femur as the leg pushes off, helping to achieve the toe-off position.
The medius and minimus work to maintain a level pelvis when weight-bearing on one leg, preventing the free side from dropping down. They also control the rotation of the pelvis as the free leg swings forward. These are not muscle actions at a specific time which produce a movement but more of a continuous activity to maintain the optimal pelvic position.
From the example of running, it can be seen that during any functional task the muscles work in different types of ways to perform different roles. This is true of any activity of daily living (ADL), such as vacuum cleaning or picking up boxes, and athletic movements, such as jumping or swinging a golf club. These different muscles must work together in a co-ordinated fashion, with the strong mobiliser muscles powerfully contracting through the full range of motion and the stabiliser muscles switching on at the right times to control the joint positions.
This is the key difference between functional tasks and exercises where muscle groups work in isolation and explains why the mobiliser/stabiliser system is so important to understand. For effective core stability and injury prevention one must train 'movements' and 'positions' rather than 'muscles'. By this I mean that exercises are more effective when they mirror the demands of ADL's or athletic movements. It is possible to perform exercises which isolate the gluteus maximus (ie. leg extensions) and gluteus medius and minimus (ie. hip abductions), but this is not how these muscle act in reality.
The system tells us that stabiliser muscles need to switch on easily at low-load levels, they need to be able to maintain joint position and they need to have good endurance. Stabiliser muscles tend to become inhibited and are not active enough for sufficient duration. Therefore to train stabiliser muscles correctly, exercises should involve positions that mirror ADL or athletic movements, they should be trained with light loads and many repetitions or made to hold the correct position for a prolonged period.
Here a 4 Running-Specific Exercises to Help Strengthen Your Glutes and Keep Your Low Back and Lower Body Free of Injury:
This is a static exercise where the gluteus maximus must work to support the back. Proper technique is essential if the correct stability mechanisms are to be improved.
Lie on your back with knees bent. Draw in the lower abdominals and curl the bum off the floor, lifting the hips until the knees, hips and chest are in line. Hold this position, purposefully squeezing the glutes to support the bridge position. Start with 10 x 10 seconds, building up to 2 x 60 seconds. Keep the pelvis level and the lower abdominals drawn in. If you feel a strong contraction in the hamstrings or the lower back is straining, then you are not using your glutes strongly enough. Focus on squeezing your bum cheeks together to ensure they do the work.
The Wood Chop
This is a dynamic exercise where the gluteals must work to extend the trunk from a flexed position.
Stand with feet shoulder-width apart, knees slightly bent. Stand up tall and hold a weight in two hands above your head (5kg men, 3kg women).
As if you are wielding an axe to chop wood, bend from the waist and bring the weight down between your legs in a controlled manner. Do not bend your knees any further as you bend forward. At the bottom, draw in your abdominals and squeeze your glutes for support before returning to the start position. When you return upright, ensure it is with the correct sequence, extending your lower back first, then bringing your shoulders up and finally lifting the weight above your head. Begin with 2-3 sets of 10 reps building up to 20 reps.
The Hip Hiker
This exercise involves recruiting the gluteals to maintain a level pelvic tilt.
Stand on one leg, bending the free-leg knee slightly so it does not drag on the floor. Stand up with good posture, head looking forward into a mirror. Tilt the pelvis so the free side drops down. Your stance-leg knee should not have moved nor should your head or back. Then, focusing on the top and outside of your gluteals, pull the pelvis back until the free side is level or even slightly higher. Slowly continue this hitching motion up and down. Complete 3 sets of 10 building up to 20 reps each side.
This exercise is normally for the legs, but if performed with perfect technique it also works the medius and minimus very hard to maintain pelvic stability.
Stand on one leg in front of the mirror. Ensure your head is up and your shoulders are back, with the lower abdominals drawn in for support. Arch your foot slightly to ensure your knee is not pointing inwards. Squat down with your bum going back and your knee staying over your laces. Keep the free-leg knee next to the stance knee to ensure you stay aligned. Keep your pelvis level and square as you squat down. Stand back up, ensuring everything remains aligned. Build up to completing 3 sets of 10 each leg.
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