Many runners do not realize it when they have trouble with glute activation, but their times can suffer and they can put themselves at more risk for injury if they don’t address the cause.
The gluteal muscles are a group of three separate muscles that make up the buttocks and are responsible for much of the power and strength displayed in athletic events. The gluteus medius and minimus muscles are located on the side and upper part of the hip and allow you to abduct the thigh or hike the hip on the opposite side. The main job of the gluteus maximus muscle is to extend the thigh at the hip and it forms the rounded shape of the buttocks in profile. The gluteus maximus is the largest muscle in the body, but has the tendency to be relatively weak or inhibited in most people, including most runners. These muscles have slightly different functions but all three work together to stabilize the pelvis and keep the lower extremity in alignment.
Gluteal amnesia is a problem where the gluteal muscles are not contracting appropriately during normal activities. Occasionally, this problem can also come with numbness and tingling in the buttocks and/or legs and sometimes people refer to this as “dead butt syndrome”. The cause for gluteal amnesia results from people remaining in sitting positions for long periods of time. People in occupations that spend long periods of time in a sedentary position like commercial drivers and desk workers are more likely to develop the problem and it even has the tendency to affect people who have long commutes.
The sitting position stretches out the gluteus maximus muscle and shortens the hip flexors. Over time, the shortening of the hip flexors causes them to become shorter and tighter and can even begin to decrease mobility in allowing the hips to extend backwards. This causes a process known as reciprocal inhibition, where tightness in one muscle can cause weakness and lengthening of its antagonist muscle.
Arguments can be made of whether or not it’s the tightness that causes weakness or weakness that causes tightness and ends up being a chicken or the egg type of scenario. While sitting, the hamstrings become shortened at the knee while they are simultaneously lengthened at the hip, which keeps them at the same length and does not have an inhibitory effect on the hamstrings.
Even people who are active and exercise on a regular basis can be at risk for developing gluteal amnesia. This is even true for runners and weightlifters because several hours on the road or at the gym per week do not outweigh the hours a day spent sitting. This is the reason that many are considering sitting to be a public health crisis, along the lines of smoking cigarettes. Not only is daily prolonged sitting associated with decreased life span and increased risk of heart problems, diabetes and weight gain, but it will hurt your speed and performance.
Every time your foot hits the ground while running, your hips and pelvis are presented with a load to overcome. You are basically jumping from foot to foot and one leg must hold up the opposite hip to prevent it from dropping due to the impact. Imagine hopping on your right leg and how the force of your body coming down is going to try to make the left hip drop down. The two lateral gluteal muscles resist the falling of the opposite hip and help stabilize the pelvis as the opposite leg is swinging through during gait. Lack of strength in these muscles can result in decreased efficiency and excessive movement, which can lead to energy leaks like a cross-over gait.
The gluteus maximus muscle is extremely important for hip extension. Lack of strength in this muscle and/or decreased mobility into hip extension will affect your capacity to drive your leg backwards during your running gait or straighten up while performing a squat or a deadlift. If the gluteus maximus is not properly engaged, smaller/weaker muscles can fire and will try to take up the slack, but they are not strong enough. Proper gluteal activation is important because it helps to stabilize the pelvis and the biomechanics of the thigh and leg depend on this stability. In runners, a weak glute will alter the running gait and can cause imbalance and asymmetry of the firing patterns in the hip and lower extremities, which can eventually result in pain.
One of the first signs that you might have a problem with a dead butt or gluteal amnesia is a lack of definition in the buttocks. People that say that they do not have a butt or that they have a “flat butt” probably need to do exercises to activate and build the glutes.
Another way to know that you have problems with gluteal activation is to look at your posture while standing. If someone wearing a belt looks like the belt buckle is leaning forward, this is called an anterior pelvic tilt. It typically means that the abdominals and glutes are not engaged, while the hip flexors and lower back have too much tone and could be a sign of gluteal amnesia.
Lack of activation of the glutes tends to lead to painful conditions. Again, a lack of stabilization in the pelvis can lead to problems with Achilles tendinitis, knee pain and iliotibial band syndrome. Also, when smaller muscles need to pick up the slack to compensate for weak firing of the glutes, overloaded accessory muscles can cause problems with low back, hip and knee pain. This is specifically an issue when it comes to pain in the upper hamstrings. The upper hamstring has the tendency to extend the hip and will do the job for the glutes if needed. The problem is that this upper hamstring is typically not strong enough to actually do the work by itself and it leads to hamstring strains and/or tears.
There are couple of quick ways to see whether you know how to activate your glutes. Some people just don’t even know how to squeeze their glutes at all, whereas others cannot get an efficient contraction, so they cannot generate the proper amount of power. One way to test for this is to lie faceup on the ground and place your hands flat underneath your buttocks. Can you squeeze your buttocks together? Can you squeeze the right butt cheek and then the left butt cheek? You should build to do each of these in this position. Was it difficult to even get down on the ground? On a side note, if it is difficult to get up from or down to of the ground then there is a good possibility that you have issues with strength.
The next step is to try to squeeze your buttocks in a sitting position. Can squeeze your buttocks together while sitting on your hands? Can you do them each separately? The last step is to be able to do this while you’re standing. You should be able to squeeze your buttocks together and independently on a standing position and feel your glutes engage.
There is a more complex type of test that I do in my office, but you can learn how to do to test yourself. The prone hip extension test is done with the person lying face down on a table with the knee straight. The person being tested is supposed to keep the knee straight and lift the leg and thigh up and off the table and do extension. This is done while the low back buttocks and proximal hamstring are being palpated. Ideally, the gluteus maximus should fire first, followed by the proximal hamstring. The muscles in the lower back should not fire first and the back should not arch during this test. Bending of the knee during hip extension indicates that there is too much tone in the hamstring muscle. I show patients how to feel the firing of the muscles and you should be able to feel it on yourself. You only need to bee sure to completely relax the leg and glut prior to testing yourself.
It is easier to show you how to test for gluteal activation in a video so I’ll show you on my blog at https://harmonychiro.com/glute-activation-test.
Every time your foot hits the ground while running, your hips and pelvis are presented with a load to overcome. You are basically jumping from foot to foot and one leg must hold up the opposite hip to prevent it from dropping due to the impact. Imagine hopping on your right leg and how the force of your body coming down is going to try to make the left hip drop down. The two lateral gluteal muscles resist the falling of the opposite hip and help stabilize the pelvis as the opposite leg is swinging through during gait. Lack of strength in these muscles can result in decreased efficiency and excessive movement, which can lead to energy leaks like a cross-over gait.
The gluteus maximus muscle is extremely important for hip extension. Lack of strength in this muscle and/or decreased mobility into hip extension will affect your capacity to drive your leg backwards during your running gait or straighten up while performing a squat or a deadlift. If the gluteus maximus is not properly engaged, smaller/weaker muscles can fire and will try to take up the slack, but they are not strong enough. Proper gluteal activation is important because it helps to stabilize the pelvis and the biomechanics of the thigh and leg depend on this stability. In runners, a weak glute will alter the running gait and can cause imbalance and asymmetry of the firing patterns in the hip and lower extremities, which can eventually result in pain.
When athletes have a problem with activating the glutes, they are going to have to implement changes and not just continue their normal workouts. Continuing the same training will not help you to improve your performance or decrease your risk of injury. For runners, the quads will have the tendency to try to take over, so you should be working to strengthen the glutes in order to get the pattern correct. There will be certain exercises to activate the gluteus medius/minimus and other exercises to activate the gluteus maximus muscle. Remember that everyone starts from a different place and there are progressions of these exercises where each step gets increasingly difficult.
For the gluteus maximus and hip extension, usually the first thing that someone should learn how to do is a supine bridge. This is where you get on your back and lift your hips up and off of the ground. If you are planning on doing this outside, runners can often find a bench to put their back on in order avoid lying in the dirt. Regardless of how you do it, you should have a straight line going from your shoulders through your hips to your knees. This is typically held for a period of time and completely depends on your fitness as to what’s appropriate for you. There are multiple progressions with this exercise to include marching, kick outs and one-legged dips while holding the bridge. The bridge can be done on an exercise ball for an increased challenge as well. There are more advanced exercises for building gluteus maximus strength, but many involve hip hinging which can be a difficult concept to for people to understand.
Another thing is working on clenching the glutes while trying prone hip extensions. This is where you lay face down, like the test that is mentioned above. Instead of just lifting the leg, you are going to attempt to squeeze your glutes first before you move. After your glutes are contracted, you are going to lift the leg while keeping a posterior pelvic tilt (tucking your tailbone). Then set the leg back down and relax everything. This exercise is trying to get your brain used to firing your glute first when extending the leg.
The initial exercise to start off with for the gluteus medius muscle is the clamshell. This is where you lie on your side with your knees bent and legs lying on top of each other. The clamshell is simply opening up your legs and putting some distance in between your knees. This exercise can be progressed by using resistance bands in an upright position by starting to do more advanced exercises like monster walks.
For those who are interested, I will have some more information on how to do some glute activation exercises available on my Sports Medicine Blog at https://harmonychiro.com/glute-activation-exercise .
MORE INFORMATION ABOUT DR. ROYER
Dr. Bryan D. Royer has been practicing chiropractic medicine in the Toledo area since 2005. He has a specialty in Sports Medicine and is a Certified Chiropractic Sports Physician® (CCSP®). Dr. Royer is certified as a Graston Technique® Specialist (GTS), a Certified Kinesio Taping Practitioner™ (CKTP™) and a Corrective Exercise Specialist (CES). He is also a Board-Certified Chiropractic Neurologist and he has been voted “Best in Toledo” by readers of the Toledo City Paper five times.
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