Is Your Low Back Pain A Real Pain in the Butt?

Many people don't now that having weak glute muscles and hip abducters can lead to lower body injuries and changes in gait. So next time you're in the gym don't just work on your squat to look better at the beach, but also for a better overall quality of life. Lifestyle factor that lead to weak glute muscles, and glute medius more specifically are, sleeping on your side and flexing and adducting your top leg over your bottom leg. Standing predominantly with all of your body weight on one leg can cause the pelvis to move sideways and the hip joint to adduct; contributing to weak hip adductors. Ilitiobial band (ITB) syndrome, which is quite common can result from weak gluteus medius. Being unable to control thigh abduction and external rotation can place greater tension on the tensor fascia and ITB. Gluteus medius dysfunction can also contribute to patellofemoral pain syndrome, which results in decreased hip control and increased femoral adduction and internal rotation.
The following exercises can help with the aforementioned conditions. Before starting any exercise routine make sure to consult your doctor.

Side Lying Clams

 



Starting Position






 Ending Position. Hold for 3 seconds and slowly return to starting position.









Squats

 Starting Position

Ending Position. Make sure to keep back straight and go as far down as possible.








Sidestepping

 Starting Position

   Ending position. Take a step to the side as far as possible and return to starting position. Repeat on opposite side.
















Single Leg Sit Up/Down

 Starting Position. Begin seated.

 


Ending Position. Stand up on one leg slowly, and then slowly return to a seated position. Repeat on other leg.













Single Leg Step Up/Down

 Starting Position.




















Ending Position. Slowly climb up on one leg and slowly return down to starting position.


















Reference: Glute Medius & Hip Abduction Functional Training, www.dynamicchiropractic.com

Case of the Week - Pes Anserine Pain

Even those with some anatomy background might be wondering, Did I miss something? Where is the pes anserine? The name pes anserine means goose foot. We use it to describe three tendons that splay out like the toes of a goose. These tendons, the gracilis, sartorius and semitendonosis, all belong to muscles with different functions. As a unit, however, they often cause pain in the medial knee. Patient with pes anserine pain often complain of ITB syndrome, and vice versa. See last week’s blog for information on ITB syndrome.

Patients with pes anserine pain often complain of pain in their knee, specifically the inner side toward the back. It should be noted that patients with pain within the knee joint itself are usually describing a different condition.

As with ITB Syndrome, pes anserine pain’s root cause is often muscle imbalance. The muscles that control the knee muscle contract with equal force, quality and endurance on all sides of the joint. When one group is weaker, it becomes overworked leading to tendonitis, pain with exercise and eventual pain at rest. Last week we discussed the importance of VMO strength in alleviating ITB syndrome in runners. With pes anserine pain, the strength of the ITB is key. The pes anserine tendons support the knee from the inner side and the ITB supports the joint from the outer side. As the quads and hamstrings flex and extend the knee, the supportive structures on the sides help guide the movement. If the ITB is weak at the knee, the pes anserine tendons must work harder to stabilize the joint. Eventually, this will cause pain and inflammation in the area.

The short-term solution is to alleviate the excess tension. Massage of the pes anserine tendons, including use of the foam roller, will decrease local tension. Patients should also stretch their thigh adductors and hamstrings on a regular basis. Massage of the ITB may also be indicated.

The long-term treatment plan should involve identifying and correcting muscle imbalances in the knee, hip and ankle. In the most common presentation, this involves strengthening the tensor fascia lata and gluteus medius (hip abductors) at the hip and stretching the hip adductors.

For a great article on knee anatomy, visit http://darkwing.uoregon.edu/~athmed/aclrehab/anat.html

Exercise: Adductor and hamstring stretch

Stretching your adductors and hamstrings is something most people have done at some point. The key here is quality. Always lean into a stretch slowly. For these stretches, keeping your spine straight and hinging your movement from the hip will give a better stretch, faster. Breathe into each stretch for 10 seconds and slowly return to center before moving on.


Suggestion of the week: Increase new exercise slowly

Especially with running, but with any sport, increase the intensity slowly to build up muscle and avoid injury. If starting a new running routine, increase by small increments depending on your fitness level. A beginner should start with increases of minutes, instead of distance. An experienced runner can increase at 2-3 mile intervals so long as they provide adequate recuperation time in between runs.