Why We Need Strong Buttocks to Prevent and Fix Back Pain

Why We Need Strong Buttocks to Prevent and Fix Back Pain

The gluteals (buttocks muscles) are a very important muscle group; they serve many functions in the stability of the lower back and pelvis. However, nowadays we spend more time sitting on our buttocks than actually using it.

In fact, according to the Australian Bureau of Statistics, on average we are sitting at least 4 hours a day (usually watching television) and spending only 30 minutes doing some form of physical activity. That’s a total of 13 hours of watching TV per week!

One in three workers spend at least three-quarters of their time sitting. Office workers sit up to 23 hours per week compared to less than 4 for labourers.

Is it no wonder we see many people with back pain coming into our clinic. If we are all sitting for most of our day our bottoms are probably asleep!

To help you understand a little more, there are 3 layers of buttocks muscles. The smallest (Gluteus Minimus), medium (Gluteus Medius) and biggest (Gluteus Maximus).
The three muscles are all intertwined and yet have different roles to play, overall they help support and stabilise your pelvis, hips and of course your spine.

Without proper use of these muscles we tend to be more inclined to injuries such as back pain, pelvic pain, hip pain and much more.

When we conduct our Full Body Assessment, we look at the entire human body and how one area affects another. One very common thing we see is poor gluteal strength and activation. This can be caused by many things such as previous injury, but the biggest contributing factor is our lifestyle.

In today’s society, we are sitting more then ever and when we are seated; our glutes (particularly Gluteus Maximus) is on constant stretch and not being used. This results in poor gluteal activation which leads to weakness and eventually injury.

If there is weakness throughout the gluteal muscles, we lose significant support for the lower back, pelvis and hips, causing increased loading on passive support structures such as bones and ligaments. Increased loading of these structures is the major cause for spinal injury. One such example is picking up a heavy object off the floor with poor technique. When you do this there is more compressive loading on your back and you are more likely to experience back pain.

One of our main focuses is to improve the strength of our glutes to prevent an injury. If you already have back pain, done worry it is never to late to strengthen your bottom, in fact it will be a major part of your rehabilitation.

Strong glutes should be the main focus for many people, but as always, you should be properly assessed by a qualified health professional such as a Physiotherapist, Exercise Physiologist or Sports Doctor for a tailored and specific strengthening program.

By Nick Adkins
Exercise Physiologist

Exercise Safely in the Heat

Exercise Safely in the Heat

Summer in Australia is a great time to get outside and enjoy the sunshine whilst increasing your health and fitness. However exercising at this time of year can pose some dangers, particularly with scorching temperatures. So with the hottest part of the year upon us in Melbourne, we thought we would share with you some tips on how to stay safe when exercising in the heat this summer.

1. Slip Slop Slap!

For those of us who have grown up in Australia we have always heard this message since we were kids! But it is always important to be reminded of being sun smart when exercising outdoors, especially during summer. Make sure you wear good quality sunscreen (at least SPF 30+) and if your activity involves water such as swimming or kayaking, make sure you chose a waterproof option. Appropriate clothing is also important to protect against skin damage and overheating. Selecting light, breathable and UV protective clothing which covers large areas of skin is recommended especially when exercising outdoors for long periods such as hiking or cycling.

2. Stay Hydrated

Adequate fluid intake before, during and after exercise is always important, but even more so during the warmer months as we are likely to lose more fluid during exercise due to increased sweating. To avoid dehydration, Sports Medicine Australia recommends drinking 2 cups (500ml) of water in the two hours prior to exercise and for exercise lasting longer than one hour drink 2-3 cups (500-750ml) of water every hour. Fluid intake is also important to keep our core temperature down and prevent overheating in hot conditions.

3. Exercise At Cooler Times Of Day

Exercise involving moderate to high intensities should be performed at the coolest part of the day such as early in the morning or in the evening to avoid some of the risks associated with exercising in extreme heat.

4. Exercise Indoors

When temperatures are extreme, exercising in an alternative environment should be considered where possible. This could include going to a gym and running on a treadmill in an air conditioned environment rather than running outside.

Written By Jack Hickey
Exercise Physiologist at MD Health Pilates

Sacro Illiac Joint Pain SIJ Explained

Sacro Illiac Joint Pain SIJ Explained

What is the Sacro Illiac Joint Pain (SIJ)?

The SIJ is the joint between the lower segments of the spine, the sacrum, and the illium bone of the pelvis. The SIJ is given structural support by strong ligaments and muscular support gives the SIJ some degree of dynamic stability. Movements of the SIJ are subtle and can be confusing; however the main movements which occur at this joint are nutation and counter-nutation. Basically speaking, nutation refers to the top end of the sacrum tilting forward relative to the Illium and counter-nutation refers to the top end of the sacrum tilting backwards relative to the Illium.

What is Pelvic Instability?

Pelvic instability refers to uncontrolled counter-nutation of the SIJ. This puts direct stretch on the long dorsal ligament which is highly innervated with nerves and can cause pain often felt in the buttock and down the leg. The combined actions of several muscles are critical to achieve stability of the SIJ, including trasverse abdominus, multifidus, pelvic floor muscles, the gluteal muscles, latissimus dorsi, obliques and erector spinae. Weakness or poor neuromuscular recruitment of these muscles can cause sustained counter-nutation of the sacrum, increasing the risk of SIJ irritation.

Treating Pelvic Instability and SIJ Pain

Assessment to determine which muscles are deficient in stabilising the pelvis is critical for the treatment of SIJ pain. For acute SIJ pain, any exercise or movement which brings the sacrum into nutation should reduce pain. This includes SIJ mobilisations, stretching the hamstrings to inhibit them from pulling the sacrum into counter-nutation, taping across the SIJ or into nutation as well as traction in line of the SIJ to reduce stretch on the long dorsal ligament. Initially to achieve further pelvic stability, exercises to improve the strength and control of transverse abdominus are key. To then achieve dynamic control of the pelvis, strengthening the other muscles which stabilise the pelvis (Most commonly gluteus maximus and latissimus dorsi) is required.

Written By Jack Hickey
Exercise Physiologist at MD Health Pilates

FAI Hip Pain Explained

Femoro-Acetabular-Impingement FAI Hip Pain Explained

Functional Anatomy of the Hip Joint

The hip joint is a very stable ball and socket joint between the head of the femur and the acetabulum of the pelvis. The joint is enclosed by the acetabular labrum and joint capsule which increase joint stability. The main function of the hip joint is to support forces being transferred between the upper limbs, trunk and lower limbs. There are three groups of muscles which all play a role in the complex movement of the hip joint. The role of the deep muscle system is to control the position of the femoral head in the acetabulum as well as contributing to joint stability through a proprioceptive role. The intermediate muscle system controls movement of the pelvis on the femur during weight bearing as well as being secondary stabilisers of the femoral head in the acetabulum. The superficial muscle system is primarily used for force production around the hip joint.

What is FAI?

Femoro-Acetabular-Impingement (FAI) is a defect in the normal mechanics of the hip joint due to abnormal bony contact between the head of the femur and the acetabulum of the pelvis. This abnormal bony contact generally causes pain and discomfort in the anterior/later hip and groin area. Sitting for prolonged periods or activity requiring a large range of motion around the hip such as sports involving kicking actions often cause pain for people with FAI. FAI is more common in a younger active population and over time can lead to damage to the soft tissue structures, labral tears, muscle inhibition, bursitis, tendinopathy and osteo-arthritis.

What causes FAI Hip Pain?

There are two main forms of bony deformity that contribute to FAI Hip Pain either in isolation or in combination with each other. CAM impingement refers to a bony growth on the neck of the femur which butts up against the rim of the acetabulum during hip flexion and internal rotation. Pincer impingement refers to a thickening and widening of the acetabular rim, causing over-coverage of the acetabular rim in relation to the femur which does not allow enough room for the head and neck of the femur to move without making contact with the acetabular rim. Other factors which can contribute to FAI include tight posterior joint capsule, anterior instability and poor or delayed muscle activation of glute min, quadratus femoris and/or illiacus.

Treating FAI Hip Pain

Conservative management of FAI focusses on improving hip joint mechanics and optimising movement by improving muscle activation and strength of glute minimus and quadratus femoris, reducing posterior capsule tightness and strengthening the superficial muscle to a neutral position to avoid excessive anterior movement of the head of femur. In some cases surgical intervention may be necessary to reduce abnormal bony contact between the femur and the acetabulum by debriding the abnormal bony growth through arthroscopic surgery. If surgery is performed, pre-surgery and rehabilitation will focus on maximising hip joint function and addressing the factors outlined above during conservative management.

Written by Jack Hickey
Exercise Physiologist at MD Health Pilates

MD Health Clinical Pilates – Workout Wednesday – ITB Release on Roller

MD Health Clinical Pilates – Workout Wednesday – ITB Release on Roller

In today’s workout Wednesday video, Exercise Physiologist Jack Hickey, goes through how to perform an ITB release using a foam roller. This is great particularly for knee pain due to patella-femoral knee pain. ITB release can also be important for some hip pathologies