Have you ever experienced low back pain? If the answer is yes, you know how debilitating it can be, leaving you unable to walk, run, sit, or stand for long periods of time comfortably. Luckily, I want you to know that there are several precautions you can take to prevent low back pain, but one in particular that is the best- glute strengthening. The glutes (aka the butt or buttocks), more properly known as the gluteal muscles, are the large muscles surrounding the pelvis, responsible for holding us level, propelling us forward, keeping us aligned, and extending our hip. The glutes have several major duties in daily life, which is why Dr. Josh Alvarado advises his patients to strengthen their glutes to prevent low back pain.
The glutes consist of many muscles, but the three major muscle groups that we’ll focus on for low back pain are: the gluteus maximus, the gluteus medius, and the gluteus minimus. The gluteus maximus is regarded as the biggest and strongest muscles in our body, and is responsible primarily for upper leg extension, and movement of the hip and thigh. A simple example of our gluteus maximus doing it’s job is going from a sit to stand position, which we do several times per day, making this large muscle highly important. The gluteus medius and the gluteus minimus are the smaller, deeper muscles that perform together. The gluteus medius is responsible for thigh internal and external rotation, which contributes to a steady walking gait. The gluteus minimus is responsible for hip extension, which allows you to move your leg up toward your torso, or to bend forward at the hip. (Kelso, 2017)
I mentioned above that the glutes may not be working properly, and what I mean by that is they are often a neglected muscle group. Some people may not even realize they are neglecting their glutes, but if you take a look at what the average person does on a day to day basis, it becomes noticeable that our population has grown sedentary, and being at a desk for 8 – 12 hours per day does not help. We’ve all heard that “sitting is the new smoking,” right? Although an extreme statement, it is true that we aren’t made to sit all day. Our glutes stop functioning when we sit, thus restricting blood flow and weakening the muscles. Since many of us are not able to quit our day jobs, so I will lend some suggestions for glute activation and exercises that can help overall glute functioning and strength and help prevent low back pain
There are several low impact exercises that strengthen the glutes to prevent low back pain. These exercises are suggested by Dr. Josh Alvarado, and used at our office. When we do glute strengthening exercises regularly, we teach those muscles how to activate, by creating a mind to muscle connection. (Dionne, 2017) Once the mind to muscle connection is established, our glutes are able to properly fire. How can we initiate the mind to muscle connection? Easy- by actively working to SQUEEZE your glutes at every possible moment! I am serious when I say that I often tell patients at Arlington Pain and Rehab Courthouse to think about actively squeezing their glutes throughout the day. Do it when you’re walking, when you’re standing at your desk, when you’re cooking dinner, etc. The more often you can train your muscle to activate, the less low back pain and the better off you will be.
I stress the importance of learning glute activation in order to prevent simply going through the motions and never activating them at all. Some exercises to help reinforce glute activation are the clam shell, side lying lateral leg raise, bridge, single leg bridge, monster walk, and fire hydrant. The clam shell is a great glute medius and glute maximus exercise. Dr. Josh Alvarado suggests placing the hand along the iliac crest to cue the body not to engage the glutes. The side lying lateral leg raise primarily works the abductors, the muscles responsible for moving the thigh to the side of the body. A tip for that exercise is to begin with the working leg behind the static leg. Bridges are easily the most well known of all, and are great for glute strengthening and low back pain. Our best advice for this exercise is to keep the chin tucked and drive through the heels, keeping the lower back stable and secure. There are a lot of subtleties to this exercise and Dr. Josh Alvarado can help que you in progressing through the proper motions.
After the bridge has been mastered, Dr. Josh Alvarado suggests progressing to single leg bridge. The key to performing single leg bridges is to keep the working leg straight, and avoid pointing it upward. When the working leg is pointed upward, it does not directly strengthen the glute. The monster walk is an exercise we often help patients perform at Arlington Pain and Rehab Courthouse, which helps train the abductors and the glute medius. It is important to look straight ahead, stand upright, and keep tension on the band. The fire hydrant is a great exercise to increase hip mobility and perform external rotation. We suggest engaging your core and keeping your spine in line when performing this exercise.
Some of these exercises will require the use of more tension with the use of mini loop bands. As you can see from the pictures, we use mini loop bands (found on Amazon.com or sporting good stores) for the clamshell, side lying lateral leg raise, and monster walks. Dr. Josh Alvarado suggests doing these exercises each day if possible, for 3 sets of 10 – 12 or to fatigue- but always with good form! When our patients adhere to these movements, glute strength and muscle awareness are increased. When we strengthen the glutes to prevent low back pain, we take stress off the spine, thus improving overall mobility and flexibility. Becoming more mobile, strong, and flexible is the ultimate goal for patients that come into Arlington Pain and Rehab Courthouse, as we want them to maintain an injury free lifestyle.