Muscle of the month: The Gluteals
Gluteals, glutes, buttock, rear-end, hiney; these muscles have been given many names over the years, and I’m sure you can think of a few more! But (pun intended), did you know you have three gluteal muscles on each side? The gluteals consist of the gluteus maximus, the gluteus medius, and the gluteus minimus. Each has its own specific actions and pain pattern, which helps your massage therapist differentiate which glute is the dysfunctional one.
Gluteus Maximus: The big Kahuna
Actions – Extends, laterally rotates, abducts and adducts the hip (moves leg away from or toward the body)
Common pain culprit – Sitting for an extended period of time (underwork), or conversely, excessive hill or stair climbing (overwork)
The gluteus maximus is the largest of the glute muscles, as you can tell by its name. It covers the whole span of one cheek and plays a big role in the appearance of the buttock. When we sit for long periods of time, the glute slowly atrophies, reducing its ability to contract properly for actions such as ascending stairs.
The fix: Get up often from seat, prevent atrophy by hypertrophy (exercising)!
Squats, lunges, and stair climbing are good examples of exercises that engage the gluteus maximus. If you are unsure whether you are performing them correctly, ask your massage therapist, who can help you make the proper adjustments.
Gluteus Medius: The deltoid of the hip
Actions – Abducts, flexes, medially and laterally rotates, and extends hip
Common pain culprit – Standing on one side more than the other, jutting the hip out
The gluteus medius is similar to the big shoulder muscle, the deltoid. This is because of its position and actions: it covers both the front and the back of the hip joint, allowing it to do every movement of the hip (except for adduction, bringing the leg toward the body). This is the same as what the deltoid does for the shoulder joint. Having the hip too far forward or too far back can put this muscle into a shortened position, compromising its ability to contract fully. This can also happen when you place all your weight onto one hip or have even a slight imbalance of weight.
The fix: Share the weight of the hips, and strengthen the gluteus medius with abduction exercises (bringing the leg away from the body)
Gluteus Minimus: Pseudo sciatica
Actions – Abducts, medially rotates, and flexes the hip
Common pain culprit – Getting in and out of car
This muscle is the deepest of the glute muscles, and can cause some of the most intense pain. The trigger point referral pattern for the gluteus minimus mimics that of sciatic pain. Many clients fear that they have developed sciatica when it is, luckily, only a flare-up of the glute min trigger point. How can you tell? The sensation you feel normally lets you differentiate between a trigger point and sciatica. Sciatica will be a very sharp, shooting, and almost burning pain. Gluteus minimus trigger point will be a dull, achy pain along the same sciatic pathway down the back of the leg. If the trigger point is activated, getting in and out of the car or other hip actions can aggravate it further.
The fix: Massage, heat and stretch. The best stretch for glute minimus is the Figure 4 stretch, or pigeon pose (depending on your flexibility). Ask your RMT for guidance.
Stay tuned! Next week: How to stretch piriformis, one of the hip’s lateral rotators.