15/10/2018

You may have seen these exercises done at your local gym, on instagram, facebook or on the television. Chances are you’ve seen them done very poorly. So this is a blog focused on understanding why, how and when you may want to do these exercises.

 

What are the glute muscles?

To put it bluntly, your gluteal muscles are important, pretty damn important. They are a group of muscles that sit around the hip and pelvis and consist of 3 main muscles:

  • Gluteus Maximus (the biggest muscle in the group, which sits on top of the other 2)

  • Gluteus Medius (a muscle, which really wraps around the hip joint and is underneath ‘maximus’)

  • Gluteus Minimus (the smallest (but still as important) muscle, which wraps ¾ of the way around the hip and pelvis and sits underneath both ‘maximus’ and ‘medius’)

Now there are actually 6 more muscles in the general vicinity of the glutes that people may be aware of, which do assist the main functions - in fact there are many, many more muscles that assist the main functions of the glutes - but let’s keep it simple and focus on these three. One of the main functions of the big ‘maximus’ muscles is to extend the hip like this:

 

Think POWER! Again, this muscle is kind of important! But, not the main focus of the blog, so note it down and ask me later.

 

In the clinic, the next muscle gets blamed and named a lot - hands up if you’ve ever heard the phrase ‘we need to switch your glutes on..’? This is a really bad turn of phrase, because it probably makes you think your ‘glutes’ went to sleep, or are on hiatus and, ‘hell if one muscle can just go to sleep, other muscles may just decide to start nodding off at a rate of knots!’ I want to assure they, this is NOT how the body and brain work.

 

No, no, no, no, no!!! WRONG.

 

There is some merit to tracing some knee, hip and ankle issues back to the ‘glutes’ and particularly the ‘medius’ and ‘minimus’ muscles, because it has been found that strengthening these muscles have a beneficial effect on pain and function for knee pain (Ref) and hip pain (Ref, Ref). But unfortunately, the naming and shaming of the glutes as the cause of ALL knee and hip pain is flawed and causes you - the patient - more anxiety because guess what, now you’ve got a hip problem as well! Trust me, you don’t also have a hip problem. Chances are, your glute ‘medius’ and ‘minimus’ are just weak and need to tolerate more load. There is good evidence to demonstrate that no-one really knows if ‘weak gluteal muscles’ are a cause or a result of knee pain (Ref), so the easiest take-away I can give you is, generally having weak muscles makes you more at risk of injury than those with stronger muscles; to reduce this risk, being stronger is good for you - especially at the gluteal group.

So if your physio, osteo or chiro properly tests this muscle group and determines it is weak, it is something to take note of and work on, because the glute medius and minimus muscles have a large role to play in ensuring your lower limb and trunk have a stable base through which to produce force in walking, running, lifting heavy things etc. etc. etc. The list goes on! Glute medius and minimus have actions to abduct your hip and also create rotation of the hip. It is important to have strong glute medius and minimus muscles, because it gives you a stable base from which to work; you are a better bipedal animal with strong glute medius and minimus muscles. Hence this blog on the infamous ‘crab walk’, ‘lateral walk’, ‘mini band walk’ - whatever you want to call it - this exercise is targeted at the gluteal muscle group and is commonly performed by regular gym-goers. The only problem is, it’s generally done very poorly.

Why do the ‘lateral band walk’?

There is some evidence to show that this exercise results in a moderate to high loading on the gluteal muscles (Ref). It is has also been shown that this exercise has a high ratio of activating gluteal muscles over other muscles, which are more anterior in the hip - hip flexors (Ref). What we really don’t know is that if it is actually bad to strengthen anterior hip muscles, it’s just we know that you should be focusing - and feeling - your gluteals over anything else.

Other reasons this exercise may be chosen and is of use is that your glutes function predominantly to create a stable base of support when you are standing, and this exercise mimics that role. Notice I haven’t used the word ‘functional’... What is functional anyway!!!?

Some technique points

So, if you have chosen, or have been given this exercise, there are a few key points to focus on that will achieve what you actually want to achieve.

  • It has been shown that performing the ‘band walk’ in an ‘athletic’ position results in more glute muscle activation (Ref).

  • It has been shown that performing this exercise with your hip in internal rotation - your toes turned in or straight ahead - results in higher glute and trunk activation (Ref).

My technique points, which have no evidence, but are based on my anecdotal observations:

  • People take large steps and bring their feet together. If you want the most of the exercise, take small steps and always have tension on the band.

  • In your ‘athletic position’ or ‘self-selected squat’ position, make sure that you don’t lean into each step. This loses all activation of important trunk muscles and renders some of the other goals of the exercise (to be standing…. Cough… not functional!) useless.

Some considerations for those in pain

I think for all patients and practitioners, it is important to note the amount of load going through the gluteal muscles in each exercise you choose. If I had to put this into a basket of when to use, I would use this when you can be confident that someone is aware of - and utilising - glutes in the standing position and has the basic strength to resist the band in a standing position. It is not something to begin without first having your therapist properly test you.

It has been shown that the stance limb has higher glute activation (Ref), so one way of doing this exercise is that the painful limb could be used less as a stance limb and more as the moving limb. My takeaway from this is to be clear on what you want to achieve and just understand that the stance limb is generally doing more work; if it is still weak, work up to it.

If you are not in pain, and want to give the old ‘monster walk’ a go, because the latest instagram post has got you all ‘green-eyed monster’, then be sure to follow the technique prompts above and you’ll be achieving the ‘bubble butt’ you so highly covet (that bubble butt BTW is likely heavily contributed to by a combination of genetic factors and surgical enhancement).

What we don’t know

In short, we don’t know a lot. The evidence base I have presented is from very low-quality studies, it’s always wise not to come to any firm conclusions based on this kind of evidence.

We also don’t know if ‘activating’ glutes is, in fact, something you want to achieve prior to performing any other exercise - for example squats or deadlifts - it is a common practice with no basis on evidence. If performed as a warm-up, another thing we don’t know is the mechanism of how this is working; it could be a central ‘awareness’ of muscle action more than anything else. But it seems it does get some local musculature working, so it is still an exercise I would program regularly for my patients and athletes.  

 

Til next time gang, let us know how you get on!