Download Gluteal function training 1

GLUTEAL FUNCTION, TRAINING AND
HIP MECHANICS
Ed Harper MSc, BSc,
ASCC
Session Aims:
• Define Gluteal function and relate to hip mechanics and general
movement patterns.
• Compare methods of Gluteal Assessment.
• Evaluate proposed ‘3 Stage’ Training progressions.
• Myths and Misconceptions – Squatting
Where to start
• Bipedal Locomotion
only in humans!
• 4 Considerations:
• Stability in upright posture
• Ability to raise & control trunk
over hind limbs
• Ability to balance on one leg
• Walk with feet underneath body
The most misunderstood, undertrained and
important muscle in the body!
• In order to enhance performance we need to
understand what underpins movement.
• The muscles of the gluteal region are primarily
responsible for extension, abduction, lateral
rotation and slight medial rotation of the hip joint.
Gluteal Function
• Therefore walking, running, jumping, standing, throwing, sitting
in every direction!
Gluteal Strength:
• Encourages good lifting/movement mechanics and less lumbar
rounding. This also spares the knee joint by allowing the hips to
share the load when lifting rather than overloading the knees.
• Stabilises the knee preventing valgus which decreases the
likelihood of patellofemoral pain and ACL tears.
• Enhances overall structural health, reducing the risk of postural
weakness (e.g. lower- and upper-cross syndrome,
groin/hamstring/quad strains, shoulder issues, spinal issues,
Sciatica, and hip pain).
Injury Prevention
Fredericson M, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA (2000) ’Hip
abductor weakness in distance runners with iliotibial band syndrome’ Clin J Sport Med Jul;10(3):16975.
Robert Griffin III
• Washington Redskins officially signed him to a four-year, $21.1
million contract with a $13.8 million signing bonus in 2012.
• 2012 ACL tear.
Gluteal Region
Obturator Internus
ORIGIN
Inner surface of obturator membrane and rim of pubis and ischium
bordering membrane
INSERTION
Middle part of medial aspect of greater trochanter of femur
ACTION
laterally rotates and stabilizes hip
NERVE
Nerve to obturator internus (L5, S1,2)
Gemellus Superior
ORIGIN
Spine of ischium
INSERTION
Middle part of medial aspect of greater trochanter of femur
ACTION
laterally rotates and stabilizes hip
NERVE
Nerve to obturator internus (L5, S1, 2)
Gemellus Inferior
ORIGIN
Upper border of ischial tuberosity
INSERTION
Middle part of medial aspect of greater trochanter of femur
ACTION
laterally rotates and stabilizes hip
NERVE
Nerve to quadratus femoris (L4, 5, S1)
Sacrotuberous Ligament
Sacrospinous Ligament
Piriformis
ORIGIN
2, 3, 4 costotransverse bars of anterior sacrum, few fibers from superior border of
greater sciatic notch
INSERTION
Anterior part of medial aspect of greater trochanter of femur
ACTION
laterally rotates and stabilizes hip
NERVE
Anterior primary rami of S1, 2
Gluteus Minimus
ORIGIN
Outer surface of ilium between middle and inferior gluteal lines
INSERTION
Anterior surface of greater trochanter of femur
ACTION
Abducts and medially rotates hip. Tilts pelvis on walking.
NERVE
Superior gluteal nerve (L4, 5, S1)
Gluteus Medius
ORIGIN
Outer surface of ilium between posterior and middle gluteal lines
INSERTION
Posterolateral surface of greater trocanter of femur
ACTION
Abducts and medially rotates hip. Tilts pelvis on walking
NERVE
Superior gluteal nerve (L4,5,S1)
Quadratus Femoris
ORIGIN
Lateral border of ischial tuberosity
INSERTION
Quadrate tubercle of femur and a vertical line below this to the level of lesser
trocanter
ACTION
laterally rotates and stabilizes hip
NERVE
Nerve to quadratus femoris (and
obturator internus) (L4, 5, S1)
Gluteus Maximus
ORIGIN
Outer surface of illium, sacrum, coccyx, sarotuberous ligamens
INSERTION
Illiotibial tract, gluteal tuberosity of femur
ACTION
Extends and laterally rotates thigh at hip, through illiotibial tract extends knee
NERVE
Inferior gluteal nerve
Tensor Fascia Lata
ORIGIN
Outer surface of anterior iliac crest between tubercle of the iliac crest and anterior
superior iliac spine
INSERTION
Iliotibial tract (anterior surface of lateral condyle of tibia)
ACTION
Maintains knee extended (assists gluteus maximus) and abducts hip
NERVE
Superior gluteal nerve (L4, 5, S1)
Sciatic Nerve
Whole Picture
Glute (Max) Squeeze - The vast majority of glute fibers insert into fascia,
with only a small percentage insert onto the gluteal tuberosity of the
femur. Research suggests 70-85% but it might be even higher.
Largest muscle of the 21 hip muslce’s, accounting for approx. 16% of total
cross-sectional area of musculature.
Gluteal Assessment
• Bilateral – Squat (Bench, OH, BW)
• Unilateral – Trendelenburg Test/Hurdle Step
• Timing
• Activation
• Load?
• Hermes
Scratching the surface
Exercise Hierarchy
Level 1
•Position of high stability – Stimulus – Position of high stability.
•Maintain torque and maximum stability throughout.
•Squat, Deadlift, Bench Press.
Level 2
•Position of high stability – Complex element – Position of high stability.
•Start and finish in same position with implementation of speed.
•CMJ, Running, Snatch Balance.
Level 3
•Position of transition – Speed/Complex element – Position of high stability
•Actions resembling sport/movement, starting and finishing in different positions.
•Snatch, Clean, Jerk, Sport Specific
Individual Exercise Progression
Client
Test
Level
1
Level
2
Level
3
Rugby Player –
Bilateral Max
Strength
OH Squat,
Hurdle Step/SL
Squat
Rack
Pull/American
Deadlift
Dead Pull
Clean
Middle Age
Man – ACL
Rehab
OH Squat,
Hurdle Step/SL
Squat
Paloff Press
BW Bench
Squat
BW MB Jump
Squat
Netball Player
– Unilateral
Power
OH Squat,
Hurdle Step/SL
Squat
Lunge
SL Linear
Hurdles
SL Box Jump*
*Q Angle
Brett Contreras - Research
Myths and Misconceptions - Squatting
+++
• Form of Assessment.
• Strong correlation to sport/movement.
• Fairly easy to teach/learn and progress.
• Good for teaching lumbo-pelvic hip complex mechanics.
-----• Little focus on fine detail –
Crossfit, Insanity, 30 day squat
Challenge.
• Easy(ish) to hide poor form.
Foot Position
• Externally rotated feet (for comfort, support or to selectively strengthen
individual muscles – quadriceps) is not supported by research (Boyden 2000;
Signorile 1995).
• Rotation greater than ~20° may increase mobility but reduces gluteal
activation. Also commonly causing dropped arches and collapsed ankles.
• Inadequate gluteal/hip strength, in addition to overactive hip adductors,
prevents proper stabilization of the femur. Forcing the hips to move into
adduction and internal rotation. Reducing
Gluteal (+ext. Rotator) activity = knee valgus.
Mobility
Narrow Vs Wide
Don’t make excuses for form or depth!
Hyperextension
Addressing hyperextension shortens hamstrings.
(lumbar
flexion/posterior pelvic tilt)
When you descend into a squat, the hamstrings are being lengthened at the pelvis,
but shortened at the knee. So it would seem to me that the net length change is
• negligible
Femur – Pelvis = Hip ‘pinching’
• Cause? Joint Mobility, Muscle Flexibility, Motor
Control/Stability?
• Tight anterior hip musculature 9-5ers - Corrective exercises:
• ½ Kneeling Stretch/Bucket Stretch (*Hip + Shoulder)
• Raised Lunge
• Extended horiz./vert. Squat (+ regressions/progressions)
• Start as you mean to go on
• Hamstring length commonly
Research suggested limited ankle dorsiflexion alters squat mechanics (Macrum et al.
blamed
when...
2012). Tight
ankles during a squat will push the body into a backwards weight
shift. Leading to either falling backwards, or dropping the chest and rounding the back
as a counterbalance.
Conclusions
• Every case is individual
• Vital to include some form of gluteal activation, strengthening and hip
mobilisation.
• ‘Go to’ Exercises –
• Pre-hab/Activation always in warm up
• Clams, Bi and Unilateral Squats and Bridges, Linear and Lat Lunges
• Main Focus
• Hip Thrust/Bridge, SL
Thrust/Bridge, Squat,
Deadlift, S.S./Lunge
• Additional/Assitive
• Pallof, DB Bench etc
References
Holmes et al. (1992). Erector spinae activation and movement dynamics about the lumbar spine in
lordotic and kyphotic squat-lifting. Spine.Vol 17 (3).
McKean et al. (2010). The lumbar and sacrum movement pattern during the back squat exercise.
The Journal of Strength and Conditioning Research. Vol 24 (10).
Walsh et al. (2007). Three-dimensional motion analysis of the lumbar spine during “free squat”
weight lift training. The American Journal of Sports Medicine.
Macrum et al. (2012). Effect of limiting ankle-dorsiflexion range of motion on lower extremity
kinematics and muscle-activation patterns during a squat. J Sport Rehabil. 21 (2):144-50.
Presswood L, Cronin J, Keogh J, Whatman C (2008). Gluteus Medius: Applied Anatomy,
Dysfunction, Assessment, and Progressive Strengthening. Strength and Conditioning Journal,
30 (5), 41-53
http://bretcontreras.com/