Just above the hip joint lies the gluteus medius. This muscle is responsible for a host of important functions. First, it works in conjunction with the lower back muscles to support the torso and pelvis to allow for weight bearing functional tasks to be accomplished. If the glute med is weak, the lower back muscles overwork to compensate and can strain or go into spasm. When some one has pain on one side of the lower back, I usually find that either gluteus medius (one above each hip) is weak causing the lower back muscle to strain.
Another function of the ggluteus medius is to stabilize the hip joint so that muscles that pass the hip joint and attach to the knee can create movement at the knee. Another of these hip stabilizing muscles is the piriformis. This muscle runs deep to the glute med. Once the glute med stains if weak, the piriformis tries to compensate and eventually strains. This can cause pain at the gluteal region. If the piriformis strains and thickens enough, it can impinge on the sciatic nerve creating sciatic symptoms from the gluteal region as far down as the foot.
The gluteus medius also serves to support the leg when standing on one leg as in the action of walking or running. If the gluteus medius is weak, a connective tissue band called the ITB can become irritated. The band attaches from the hip to the lateral knee. Once shortened, it can pull the knee cap laterally causing it to impact the outer border of the knee joint creating knee pain.
The gluteus medius is also responsible for weight bearing through the middle of the foot when single leg standing. If weak, weight bearing moves toward the inside of the ankle/foot. This causes stress to the arch of the foot and the medial ankle. This can cause the muscles that support the medial ankle to overwork and strain. The main muscle that is responsible for this is the posterior tibiailis. This muscle runs along the inside of the shin and passes along the inside of the ankle. If this muscle strains and weakens along with the gluteus medius, then the medial arch of the foot can be compromised. This can stretch the plantar fascia. This tissue runs from the heel to the balls of the feet. If this becomes overstretched, it can create pain at the heel.
The last of the important roles the gluteus medius plays in function is to keep the pelvis level when single leg standing. If the gluteus medius is weak, it can allow the pelvis on the opposite side to drop. When this occurs the opposing leg no longer will appear to be the same length as the leg being stood on. It will appear to have gotten longer. This sets an individual up to catch their foot as they swing the foot through to place it in front when walking. I have often been told by patients they thought they were clumsy because they catch a foot a lot when walking. They did not realize there was an logical reason for the occurrence.
To strengthen the gluteus medius, perform sidelying abduction. Here's how to do it:
- Lay on your side and bend the knee of the leg you are laying on to create stability. The leg you are raising is straight and runs straight down in line with your torso. The leg should not be in front or behind the torso. It should be one continuous line from the shoulder to the ankle.
- Slowly lift the leg up until it is hip height. Then return it down onto the other leg. If you go higher than hip height, you will no longer use the glute med, you will be using your lower back muscles which is something you don't want to do.
- Perform the exercise for three sets of 10 repetitions. Purchase a cuff weight if possible so that it can be worn at the ankle to provide resistance. There are cuff weights with one pound slugs that can be added to continuously increase the resistance used for the exercise.
Strengthening the gluteus medius may be the answer to a bunch of the aches and pains you are experiencing from the lower back to the foot.
