Gluteus Medius

[Catrin]

Apparently my gluteus medius are quite weak, which is why I am starting to have pain while walking in one hip, and I guess it doesn't help that the piriformis muscles are tight (both sides). Thankfully neither bike nor spinning bike causes pain - and between my PT and trainer we will be able to reverse this.

What I don't understand is how this snuck up on me - it isn't like I haven't been very active for the last 1.5 years and have been doing a lot of walking and strength training Oh well, I guess that just means I am no longer 30, or even 49...

[OakLeaf]

very very common, especially in women. If you're not doing something with a lot of lateral movement, like board sports or yoga, pretty much everyone needs to target the hip stabilizers directly.

[Catrin]

very very common, especially in women. If you're not doing something with a lot of lateral movement, like board sports or yoga, pretty much everyone needs to target the hip stabilizers directly.

Thank you, I didn't know that and knowing that it is common really does help. I have started a Saturday morning mat pilates class - at least until riding season starts up. From what my new PT has told me, pretty much everything attached to my hips are weak. Guess it is just a case of our bodies letting us know that they need some attention!

[OakLeaf]

I like Pilates, but I think that it really overemphasizes spine flexion and movements in the sagittal plane. Not sure how much it will help your issues...

[Catrin]

I like Pilates, but I think that it really overemphasizes spine flexion and movements in the sagittal plane. Not sure how much it will help your issues...

I see what you mean - I don't know too much about Pilates so had not realized that. My new PT explained about the sagittal plane the other day so I've a better understanding. We DO have a power yoga class on Saturday mornings as well, it only costs $8 a session. I will check into it...

[indysteel]

I developed gluteal amnesia and weak glutes notwithstanding an active yoga practice. That's not to say yoga is a bad idea, but I'm not sure how much it will help you either. I'd just ask your PT for some exercises you can do at home as a good starting place.

[KnottedYet]

I am starting to have pain while walking in one hip,

Did you ask your therapist why this new symptom appeared now?

Weak muscles do not suddenly arise. They are a gradual phenomenon.

My vote is still lumbar derangement. Ask your PT to rule out "anterior derangement." Tell him nothing less than full RFIL and RFIS for a minimum of 20 reps, make him earn his Cert. MDT. Then tell him if he rules out anterior, he must also rule out lateral relevant, both weighted and unweighted. (and no, women DO NOT need to show a lateral shift to be lateral relevant; and women do NOT always have classically centralizing/radicular symptoms. A woman can have massive hip symptoms and little to no low back and still be a lumbar derangement... and if he doesn't know that, it's about time he learned.)

Tell him I'm watching...

[Catrin]

The pain in the hip started when seeing the other physical therapist. My new therapist thinks it is from the weak muscles - and apparently one of the stretches the first one was having me do was not helping and may have actually made things worse It WAS hurting a lot more at night, but that has greatly improved over the past few weeks.

Last night I wanted to put some time in on the Arc Trainer after meeting with my trainer - and my hip only tolerated 15 minutes before it started hurting

Thankfully it doesn't seem to matter how long or how hard I work it on the spinning bike - no pain at all - which bodes well for that bike deposit I am putting down tomorrow. It is also true that I've no discomfort when I am strength training - if we do an exercise that causes the hip to complain, it stops immediately upon completion of the exercise (assuming it was an exercise focusing on my hips - if not the exercise stops as soon as pain presents itself).

Oakleaf and IndySteel, thank you for your comments on the classes. The point of Pilates, at least for me, is core work. I've been told that my lower abdominal muscles are weak as well - though the upper ab. muscles are fine - and my lower back where everything attaches is also weak. Would the mat Pilates class help with any of that?

I've heard good things about the 90 minute "power" yoga class - but I don't know if those reporting know yoga outside of that class... They do tend to give creative names to classes at my club. Just to be safe, I will avoid the yoga class and focus on the exercises given by PT and trainer.

Knotted - thank you for your thoughts, I will take your suggestions to my PT when I see him tomorrow. I have asked him why this is all turning up now, when my over-use injuries are healed. He thinks at least part of the weakness came from the protracted healing period - while it is true that I went from REALLY working my lower body to only doing upper body work for almost 4 months, is that really long enough to create such weakness?

While I have been active for the last 1.5 years, it is also true that most of my life has been quite sedentary and I was much larger than currently.

Enough rambling, thanks!

[OakLeaf]

Here's my thoughts about Pilates, especially given Knott's opinion about your spine.

Not-very-expert Pilates instructors aren't well trained in recognizing when their participants are in neutral spine and when they aren't. They'll tend to put participants in imprint/C-curve more than they ought to, because when your legs are in the air, it's a lot easier to stabilize the spine if you flatten it against the mat, and you definitely don't want your spine flopping around when you're doing the movements. So rather than closely observe the participants and limit each one to what she can do in neutral, the instructors will put everyone in imprint and let them flail away.

Add the fact that classical Pilates has a lot more exercises in spine flexion than extension. Add in an aging pool of group fitness instructors who mostly came from the aerobics boom of the 80s when everything was "suck and tuck." Add in that most people these days are sedentary outside of their "exercise" activities, sitting in chairs with their pelvises tilted posteriorly and their lumbar spines collapsed back. What you get (what *I* got) is a severely flattened lumbar spine. I see it in lots and lots of people now that I'm learning to know what I'm looking at.

That's why yoga has been so wonderfully exactly what I've needed. Seriously, I'm getting better, but I really have to use some muscle to get my spine into neutral, and it "feels" like I'm putting a huge arch in my back. But I really can't generalize from my experience, because just as I've pretty much only done Pilates with poorly trained teachers and/or from videos, I've pretty much only done yoga with amazingly good teachers. So I can't say that with equally trained teachers, one is better than the other.

But I do think that when you have a potential undiagnosed spine misalignment, a gym Pilates class is a bad idea. Find out what certifications the teachers have. Sometimes you do get a really well trained teacher in a gym - someone who doesn't need to get a return on their investment and just wants to spread the love. But it's pretty unusual.

[Catrin]

Oakleaf - thanks for your thoughts on this. I know that we have one Pilates teacher who also teaches at private studios. She subbed this last Saturday and she was constantly giving variations for beginners, intermediate and advanced students and she wasn't adverse to walking around and looking at everyone to make certain they had proper form. She is probably the most qualified, but her usual class is when I am at work Oddly enough, I avoid her spinning class as it is total chaos, but she was totally different in her Pilates class.

I digress, I will avoid our gym Pilates class for now and work with my PT to determine if I do have a misalignment in my spine. We certainly need to figure that out if I do, for sure, and then go from there.

I did send an email to my new PT where I copied/pasted Knotted's suggestions. It may be that he has already done as she suggested - but as I don't know what it is that she suggested I don't know

[NbyNW]

I completely agree with Oakleaf re large gym Pilates classes.

It is possible to get some gluteus medius work into your Pilates, but this may or may not be addressed in such a large class.

The next to last paragraph in this article talks about working the gluteus medius with the side kick series. Your PT will likely give you some variations on these exercises, perhaps using Therabands or squeezing a ball between your knees.

Also, many of the exercises that will engage the gluteus medius are standing exercises or performed on apparatus, so you won't encounter them in a mat class. Here is an article by a Pilates instructor with a PT background -- in the last 3 paragraphs she describes her approach to weak gluteus medius.

I really got into doing the standing exercises when I started doing Pilates after being discharged from PT. These were emphasized for me in the context of private sessions, which was what I needed at the time. Privates can be pricey, but if the instructor is good, it is well worth it.