The Case of the Missing Glute Med
One of the problems with modern life is that our bodies aren't designed for it, and they don't like or thrive on it. Our bodies are designed for uneven surfaces, near constant movement, adaptation to food sources that are available seasonally and an increase/decrease of movement multiple times a day that keeps your body working. With modern life we have sedentary lifestyles - sitting down to work, computers, televisions, commuting etc, etc. We have a ready supply of food, we have smooth even footpaths and escalators. Even when we exercise we have treadmills and cross trainers that make your work smooth and unlikely to challenge any muscles responsible for balance you have - and this is where the problem lies in the case of the missing glute med. We evolved to move around uneven landscapes and yet our modern landscapes are smooth and, well in a movement sense, boring. We have many muscles associated with balance and stability and they are being under used and neglected, and as a result are atrophying - wasting away.
But if I don't need them, does it matter if they waste away? - Well just because you don't need them to stabilise you on that run, doesn't mean you don't need them full stop. When people think about core stability they think about abs. When I talk to my clients about a strong stable foundation for training that is at the core of movement I mean your abs, glutes and all the muscles in your pelvic region and lower back that form the basis of the stability of your torso and the main muscles that propel you forward in our basic form of movement - walking.
If you don't have your supporting stabiliser muscles, like you glute med, your smaller lower back muscles (erector spinae and multifidi) take over the work for you, on the occasion when you do need a bit more support. These muscles are not designed to do this type of stabilisation so they become tired and tighten up to prevent tearing and hey presto - lower back pain.
From a study undertaken in 2010:
The study looked at how much disability is caused by lower back pain globally. It found that lower back pain caused more disability than any other condition, affecting nearly 1 in 10 people and becoming more common with increasing age.
How can you tell if you have weak glute meds? One of the easiest is to sit down and stand up using a chair or slightly lower bench or step and if your knees buckle inwards, or your feet turn outwards there's a fairly high chance your glute meds are weaker than they optimally should be.
So what can you do about it? Well if you are a runner or a gym bunny try and take your training off road. Start this slow and maybe reduce your usual distance to avoid shocking your body and developing compensatory injuries such as shin splints. Walk off road as much as possible and look to incorporate using shoes that don't have masses of in built support - how is your body to learn to stabilise itself when your shoes do it for you?
Finally some specific exercises can really help and for those you need to see the next article: Exercises for your missing glute med!
Happy training peeps.