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Your Butt and Your Gait

As a podiatrist most patients present with a range of foot and lower leg issues.  Heel pain, Achilles Tendinopathy, Medial Tibial Stress Syndrome, Shin Splints and Patellofemoral Joint Pain are all common presentations to my clinic.  Given these injuries and issues affect the foot an lower leg both referrers and patients alike assume that the cause of these issues are located primarily in the foot.  This assumption is simply not true.  Of those people experiencing those injuries mentioned above the vast majority have issues at the level of the hip and pelvis and in particular the glutes.

The gluteal complex is an extremely important group of muscles. These are the muscles that not only drive you forward when walking, running and jumping, but they are also incredibly important in stabilizing the pelvis when the athlete is supporting the entire body weight on one leg, otherwise known as single support phase in running or midstance when walking.

When we run, the glutes hold our pelvis level and steady, extend our hip, propel us forward, and keep our legs, pelvis, and torso aligned.  It then follows that if there is substantial weakness, or poor recruitment/inhibition of the glutes, the knock on effect to the entire kinetic chain is substantial and potentially a real source of injury.

An example of this is with regard to your knee.  Your glutes prevent your femur (thigh) from rotating inwards.  If this doesn’t occur it will result in an increase in both the valgus (knock knee) and rotational forces through the knee joint, increasing the risk of injury.  Another potential effect on the leg of gluteal inhibition is reduced ankle joint motion.  If the gluteals can’t extend the hip due to inhibition the brain will act to limit hip extension.

One way to restrict hip extension is to reduce ankle motion, which, if present, can contribute to lower limb injuries. There are numerous studies linking glute weakness/inhibition to pathologies such as Achilles tendinopathy, shin pain, patellofemoral pain, plantar heel pain and iliotibial-band syndrome.

The gluteal complex is a bit of a problem group for most athletes (recreational or otherwise) but particularly runners and walkers, because whilst their role in stabilizing the pelvis is critical, they do not really get a strength workout during a run. This can make your hamstrings, quadriceps, and calves disproportionately stronger. Another issue is that most strength-training routines don’t isolate the glutes. If an exercise requires several muscles to perform the movement, the majority of the work will be done by the strongest of those muscles. Finally, tight muscles, specifically the hip flexors, can inhibit the glutes and prevent their muscle fibres from firing.

The upshot of all of this is to not neglect the glutes as part of a training program.  Start with a simple activation program and progress as you get better.  If you are unsure of what you should be doing seek professional advice.  It will ultimately reduce your risk of injury and as an added bonus will provide for improved performance.