Is Lack of Glute Strength Causing Your Low Back Pain?

Published:  03/24/2014

One cause of back pain is "gluteal amnesia ". The gluteus maximus doesn't remember how to work correctly so the body ends up not using the glutes correctly in coordination with the rest of the muscles of the body. This can happen to people who have a job in which they sit for prolonged periods.

Glutes are part of the chain of muscles in the back of your body that help with posture, strength, daily activities and injury prevention of the back. On a daily basis the glutes help push you up and out of a chair.

As a person sits for extended periods of time, the hip flexors (think front of hip) become tight and the gluteus maximus becomes weak. When that happens other muscles must compensate. Typically it's the low back lumbar extensor muscles and/or the hamstrings. As a result there is a compensation pattern that occurs during every day activities or in exercise training as the glutes aren't working and then the low back and/or hamstrings try to do the glutes' job. Normally, the glutes should be activating BEFORE the hamstrings and low back lumbar extensor muscles. The inability to activate the gluteus maximus in a normal pattern can lead to numerous injuries.

The treatment for 'gluteal amnesia' is re-education of the neuromuscular system to "teach" your body to fire the glutes. To begin, you need to learn how to activate the glutes, then how to stimulate and integrate them, and finally you can train them with weight lifting exercises.

One of the main problems exercisers find, is not being able to tell the difference between lumbar extension and hip extension, meaning are they using their back or glutes? So, when they try to target the glutes and hamstrings, say with a regular glute bridge, they are not able to fire the glute or stabilize the hips and core. This then uses a lot of lumbar extension (back) rather than hip extension (glutes).

If you'd like to test, I have a simple test you can do here to see if your glutes are potentially weak. See how she hesitates as she puts her hips back towards the bench and then plops uncontrolled onto the bench? Here is a demo of the same client after targeted training for her glutes. 

Trainers and physical therapists typically recommend clients perform the Glute Bridge or Supine Hip Extension for glute training.But there is a better choice. One of the best exercises to isolate the glutes is the Cook Hip Lift. The Cook Hip Lift solves this problem by maintaining the lumbar spine in a neutral position so that the glutes are isolated more effectively than a Bridge oe Hip Extension for the person who hasn't learned to recruit the glutes.

So it is best to begin to re-educate your neuromuscular system to recruit the glutes by first performing the Cook Hip Lift, an excellent gluteal activator, for several weeks. Once you have mastered the Cook Hip Lift you can then move on to the Glute Bridge video demo here, Supine Hip Extension and then the One Leg Glute Bridge.

Perform glute activation at the beginning of every workout to develop better awareness of the glutes and to wake them up so that they can contribute better to our workouts.  

If you are doing the Cook Hip Lift as part of your mobility and dynamic warm up then perform one set of 8 to 12 on each leg. If you have back pain you can do more sets as part of a low back rehabilitation program.

How to Perform a Cook Hip Lift
1. Lie on your back with knees bent upward and feet planted on the floor.

2. Pull one knee tightly to the chest. So that the knee stays tightly against the chest place a tennis ball just under the bottom rib so that the thigh must pin the tennis ball in place. The tennis ball limits lumbar extension so that the back isn't being used to do this motion.

3. The opposite knee stays bent at 90 degrees and the foot stays planted on the floor.

4. Push that foot into the floor at the heel and lift the hips upward and hold for 5-8 seconds. At the top position you should feel all the tension on the glute. If you feel it in your hamstring, then chances are you're having problems activating your glutes. If you feel a cramp in your hamstring, push your foot a bit farther away from you. If you have been doing Glute Bridge or Supine Hip Extension you might notice you can't get the hip as high as you normally would. This should improve with practice.

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Maria Faires, RD

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