The Vital Glutes: Connecting the Gait Cycle to Pain and Dysfunction

The Gmed posterior fibers assist the Gmax in controlling the alignment of the hip through the knee to the foot during the gait cycle. If for some reason the Gmed posterior fibers are weak, the knee can drift medially when walking or running.

A refractory period (the brief period needed to restore the resting potential) of about 20 seconds occurs with RI; however, RI is thought to be less powerful than PIR.

We have already looked at how the relative shortness of the iliopsoas, rectus femoris, and adductors can be responsible for the apparent weakness inhibition or misfiring of the glutes. These three muscles are antagonistic to the Gmax and Gmed, and because of their anatomical position, any shortness in these muscles can result in a compensatory neur

• Ayotte et al. (2007): the best exercise for the Gmax is the forward step-up. • Ayotte et al. (2007): the best exercise for the Gmed is the unilateral wall squat. • Bolgla and Uhl (2005): the top exercise for the Gmed is the pelvic drop.

• Distefano et al. (2009): the best Gmed exercises, in order of effectiveness, are side-lying hip abduction, single-leg squat, and single-leg dead lift. • Distefano et al. (2009): the top exercises, in order of effectiveness, for the Gmax are single-leg squat, single-leg dead lift, and side-lying hip abduction.

Tip: Overactivity of the adductors will result in a weakness inhibition of the abductors, in particular the gluteus medius. This can result in a Trendelenburg pattern of gait as explained in chapter 6

Sherrington’s law of reciprocal inhibition (Sherrington 1907) states that a hypertonic antagonist muscle may be reflexively inhibiting its agonist. Therefore, in the presence of short and subsequently tight antagonistic muscles, we must first look at restoring normal muscle tone and/or length before attempting to strengthen a weakened or inhibited

It is known that 60–70% of the walking or running cycle is spent on the stance phase, which is restricted to one leg at a time (with 30–40% being spent on the swing phase). If you recall the lateral sling discussion in earlier chapters, we know that the stance phase incorporates the abductors, adductors on the ipsilateral leg, and the QL on the con

When they walk, the hip has to naturally extend; as they perform this function, the tight structures mentioned will limit the hip extension movement. To try to compensate, the innominate bone will rotate even further into anterior rotation, which will have the effect of switching off the Gmax and switching on the hamstrings, potentially causing mic