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Posted on 05-04-2018

Credit:  Dr. Dustin Houser, DC at our Durham/Chapel Hill Chiropractic Partners office.

We recently posted a link to a research article on our Facebook page, “Strengthening the gluteus maximus in subjects with sacroiliac dysfunction,” which was published this past February in the International Journal of Sports Physical Therapy. This article detailed a case series which studied 8 individuals with lumbopelvic pain and clinical indicators of SI joint dysfunction. The purpose of this study was to assess the effect of adding an exercise program focused at strengthening the gluteus maximus muscles, sometimes referred to simply as the “glute max.” Significant weakness was discovered in this muscle when comparing the affected and unaffected sides. After 10 treatments of five exercises over a five week period, there was significant increase in glute max strength and function, as well as reduction in pain levels.

Many patients present to our office complaining of lumbopelvic pain and/or SI joint pain. This symptom may be their primary complaint, but the site of pain is not always the source of pain. Due to the positive response these individuals had to the exercise program, the likely source of their symptoms was joint dysfunction. Since weak glute max muscles were noted in all the participants of this study, that was the muscle targeted in the prescribed treatment plan. Below I will detail the five exercises that were used to get these people better, so you will have some tools when your low back begins to bother you. I will use the same exercises listed in the study, but give my own personal spin on how I think to perform them most effectively.

  1. Bilateral Glute Bridge
    1. Lie face up on the floor, with your knees bent, and heels as close to the buttocks as possible. Keep your arms by your side, with palms down. The picture provided shows the feet flat on the floor, but I ask my patients to stay on their heels, with toes pointing upward. I believe this helps take the calf muscles and hamstrings out of the equation, to better target the glutes.
    2. Lift your hips off the ground until your knees, hips and shoulders are in a straight line. Drive through your heels. Squeeze the glutes and draw in your abs so you don’t hyperextend the low back. Make sure your hips are not dropping on either side. Hold the bridge for 1-2 full breath cycles (inhale + exhale = 1 breath cycle). Slowly return your back and hips to the ground.
    3. Perform 10 repetitions of this exercise.
  2. Single-Leg Glute Bridge
    1. Begin in the same starting position as the Bilateral Glute Bridge.
    2. Extend one knee until the leg is completely straight.
    3. Lift your hips off the ground, driving through the heel on the floor, until your body is in a straight line from your shoulders to the toes of the outstretched leg.
    4. Squeeze your glutes and draw in your abs. Make sure neither hip is dropping. Hold this position for 1-2 breath cycles, then slowly lower yourself to the floor.
    5. Perform 10 repetitions.
  3. Hip ABduction in Quadruped (“Fire Hydrant”)
    1. Begin on the floor in the quadruped position, with hands directly under the shoulders, and knees directly under the hips.
    2. While maintaining core activation, lift the knee sideways (like a dog does when he goes to pee on the fire hydrant, thus the nickname).
    3. Maintain neutral spine, and avoid rotation of the pelvis.
    4. Return to starting position. Perform 10 repetitions on each side.
    5. You may use a resistance band, just above the knee, to add an extra challenge.
  4. Prone Hip Extension
    1. You can perform this exercise in the position pictured above, or lying flat on your stomach, which is how I will describe it below.
    2. Begin lying face down on the floor. Bend your elbows with hands under your forehead or chin.
    3. Activate core muscles. Keeping the leg straight, lift it off the floor about 6 inches. Squeeze the glutes. Hold for 1-2 breath cycles. Return to start position.
    4. Perform 10 repetitions on each side.
    5. You may use a resistance band, just above the knee, to add an extra challenge.
  5. Single-Leg Deadlift
    1. Instead of using the resistance band around the legs, I have my patients fully extend one leg, and hold a kettlebell with the hand on that same side.
    2. Balancing on one leg in an upright position, hold the kettlebell in the opposite hand, with arms by your side.
    3. Keeping a neutral spine and the one hip fully extended, slowly lower the kettlebell to the ground, touch the floor, and then return to the starting position. Hold your chest up during this motion, and allow your plant leg to bend slightly at the knee.
    4. Perform 10 repetitions on each side.

These exercises are aimed to strengthen your glutes, and to help prevent lumbopelvic and SI joint pain. They are not meant to diagnose any medical conditions. If any of these exercises cause pain, stop, and go see your chiropractor.

Click HERE and make an appointment with us today! 

Link to research article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808006/

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