Let's get to the bottom of this!
As a musculoskeletal (MSK) physiotherapist, barely an assessment goes by whereby I do not assess and treat a patient's gluteal, or your bottom muscle strength. Our gluteals are responsible for so many things.
In a biomechanical manner, our gluteals take the leg away (abduct) from the body and medially rotate (turn inwards) and laterally rotate (turn outwards) the leg. Gluteus maximus (the muscle responsible for the shape of your bottom) also extends (takes backwards) the hip. So what does this mean in daily, functional tasks? This means we use our gluteals for walking, ascending or descending the stairs, standing up from a chair, getting up from the floor, getting in and out of a car, turning corners, the list is endless.These muscles are also extremely important in an abundance of sports, for example: running, cycling, swimming, gymnastics. Equally, the list is endless. The gluteals also provide us with our balance. Therefore any activity that requires us to stand on one leg, requires us to activate our gluteals. However, it has become apparent during my time as an MSK physiotherapist, we seem to use our gluteals less and less as we mature and age, and find alternative methods to perform activities that require gluteal activation. We stop playing childhood games (skipping, hop scotch, hopping etc, all activities that require balance). We stop playing out on our bikes, we stop walking and running because we have passed our driving tests and we now drive everywhere. We use the handrails on the stairs to pull us up the stairs, or use escalators or lifts. We have learnt to take a more sedentary lifestyle.
Not only that, there are muscles that are able to compensate for the gluteals, which perpetuates the problem further. The gluteals continue to do less and less, and the compensating muscles perform more and more, leading to muscle imbalances and increased likelihood of muscles strains and imbalances. Ultimately, this leads to the reason you see a physiotherapist: YOU'RE IN PAIN!
I tend to see predominantly two types of patient as an MSK physiotherapist: Those suffering with low back pain or those who have suffered a lower limb injury due to a sudden increase in physical activity. People tend to see a solution to the former as performing "core stability" work and see this as abdominal exercise, and completely ignore the gluteals even then. The latter tend to suffer some kind of knee or ankle pain because their leg has given way on them and feel it is those joints letting them down. Sometimes it is difficult for patients to accept that many of their problems stem from weakened gluteals. Check for yourself. Stand up, place your hands on your buttocks and clench. Just how hard do they clench? Barely? Not at all? Now lay on your stomach, bend one knee and try and lift your knee off the floor. How difficult is that? Finally, stand on one leg. Do you wobble? Do you shift your body weight to compensate for this? Yes, your pain may be coming from your back, or your knee, or your ankle and this does need to be considered and treated accordingly. However, at Mike Stamp Physio, we try and ascertain why those parts of your body are causing you pain and therefore we want to reduce the likelihood of re-occurrence. After all, if we don't treat the cause and only the symptom, your pain is likely to return at some point or another. So if you suffer from any pain from your lower back down, let's make sure we do get to the bottom of this!
