|
Weak buttocks ruin the runner
“The gluteus
medius should be considered in every running injury.” So says Sean Fyfe in the
opening words of his article in the new Sports Injury Bulletin. Fyfe, an
experienced Australian sports physio and regular contributor to SIB, explains
his reasoning thus:
“So many
athletes with running overuse injuries of the lower limb present with poor
gluteus medius function that I have come to the view that the strength and
function of this muscle is probably the most important active component in the
achievement of a biomechanically efficient running technique.”
The deep-lying glut med muscle is
normally associated with movement, but as Sean Fyfe points out, its key role in
running is to act as a stabilising
force, to slow the downward drive of the pelvis on the opposite
side during stance phase. This pelvic restraint prevents excessive hip sway or
roll of the type that is classically known as “Trendelenburg gait”.
But even short of the tell-tale waddle
of a Trendelenburg, there are various adaptations that runners make to
compensate for weakness in gluteus medius. Sean summarises these as follows:
How athletes
cheat to compensate for weak buttocks
|
Adaptations |
Areas at risk of structural overload |
|
1. Excessive lateral pelvic tilt (Trendelenburg)
|
Lumbar spine, sacroiliac joint (SIJ), greater trochanter
bursa, insertion of muscle on greater trochanter,
overactivity of piriformis and tensor fascia lata (TFL)
|
|
2. Medial knee drift |
Lateral tibiofemoral compartment (via compression),
patellofemoral joint, patella tendon and fat pad, pes
anserinus, iliotibial band (ITB) |
|
3. Lateral knee drift |
Medial tibiofemoral compartment (via compression), ITB,
posterolateral compartment, popliteus |
|
4. Same-sided shift of trunk (lateral flexion of trunk)
|
Lumbar spine (increased disc and facet joint compression),
SIJ (increased shear) |
All these
various compensations can herald potentially chronic injury for the runner,
including shin splints and Achilles tendinitis.
Sean Fyfe explains the three tests he
uses alongside video analysis to assess glut med strength, including this one,
the “clam”:
“In side-lying,
both hips are flexed to 30 degrees with knees bent and hips and feet stacked in
line. The athlete has to open their knees while keeping heels together, and most
importantly, holding the pelvis completely still. If the pelvis moves it means
the athlete is unable to isolate the muscle and is trying to recruit ‘cheating’
muscles such as TFL.”
Fyfe also recounts the case of Chris,
who had just begun training to run his first marathon, but had rapidly run into
trouble with a painful right knee. Sean located the source of the problem to
weak glut med function and explains how he and his podiatrist colleague together
put Chris back on the road to a marathon bid.
Thanks to the guys at
http://www.sportsinjurybulletin.com/
for
allowing us to use this article.
|
