For lack of a better term…so my PT has noticed that I have a turned in left femur and very tight (read, almost non-functioning!) hip flexor, which she really thinks is the cause of all my IT band problems. Her recommendation is for me to strengthen those small glute muscles, but without using my over-active IT. Its very hard for me, since my quad has always done the work…
What I have been doing is side-stepping with a theraband, toes pointed in, wall slides on my “involved” side, toe pointed out, and those funky step stool exercises, standing on the involved leg. I’m trying to only use my butt muscles, but I just can’t seem to figure this out. Any suggestions?
I don’t have any pictures of exercises off the web that I can share, just from what my PT has shown me, or from what I have read off of other posts…in terms of the glute muscle itself, I’m talking about the small ones just below and about 5 inches back of your hip bone, if that is a little clearer!
I had the exact same problem, and was prescribed this exercise, with excellent results. Get a couple of small dumbbells (10 lbs.), put one in each hand. Stand in front of a mirror to help visualize and balance. From a standing posture, take a step forward so one foot is two feet or so in front of your hips, the other is slightly behind the hips. The glutes that will be worked are on the leg that is behind you. Drop the hips slightly (six to twelve inches), and focus on keeping the tibia of the forward leg from going past vertical. To go back up to starting position, you focus on contracting the glute of the back leg. That is the crux of the exercise, and isolates that muscle nicely. The dumbbells in your hand are more for balance than anything else. I found this exercise to be quite hard, and slowly worked up to 2 x 12 after a few months. Good luck !
oh, did I miss something? sorry, don’t have any pictures of my backside, except maybe my mom’s horrible pictures of me jumping my horse over fences. She was always on the wrong side of the jumps, hence, the lovely shot of my butt. They wouldn’t be much help here, but they are funny.
is your swimming affected by this? swimming breastroke, with the kick in particular, covers a wide range of motion which works the gluteal muscles. if it doesn’t otherwise act up the itb problems, that might work out due it being non-impact in nature.
I just did my first 100 m of true breastroke last night. Didn’t want to push it past that (I hadn’t done breast in 2 months!). The torque on your knee can be a little much, but it is a good idea.
you may need to modify your kick to make it more compact and reduce the outward rotation of the knees. basically make the kick a little less frog-like by not sweeping the feet out wide, and try to keep the feet and ankles within the width of your elbows. also, don’t bring your knees as far up towards your body, but instead start to kick them back once they are bent about 90 degrees. think of the motion more like a jump, rather than a squat. the kick will be shorter as a result, but will also be less stressful on the knees with the reduced torque outwards.
Did the PT say your left leg was turned in, as in your toes in, or out, as in your toes are pointed out? Normally the toes pointing out is more common when someone has ITBS. Their IT band is tight making it uncomfortable for the toes to point forward (or inwards).
The glute medius helps in the tracking of the femur. When this muscle is strong the femur can track correctly and can help in overpronation, inversion or eversion of the knees and ankles, lots of issues that plague a runner or cyclist. When the glute med is NOT strong, which is actually quite common in runners and cyclists, the body will rely more heavily on the other muscles in the area such as the piriformis and tensor fasciae latae. The latter, TFL, is the muscle at the top of the IT band and inserts at the tibia. When this is overused or weak, it will tighten, creating that ITBS.
So that is why they suggest the “crabwalk” exercise - the one with the band around the ankles or thighs with a lateral walk. With toes in it concentrates on those muscles surrounding the posterior hip. With toes out it will call upon the hip flexor.
Make sure all exercises are done with toes pointing forward or a bit inwards. Also make sure your back is in a neutral position, and I prefer the knees bent in an “athletic position” with the bum out. This helps you to not “cheat” and rock back & forth.
The articles I posted on here in the training section deal with this issue and has a list of exercises I recommend. I also have a dvd available on my website that gets more in detail on posture and form of these exercises, which is impossible to do in still pics and print.
I will try that again! Actually, my toes end up being straight, so there’s a torque going on in my knees, I suppose. I have looked at your articles, that’s where I got the idea. maybe I need the CD too…I just got my foam roller also to try.
It sounds to me as though she has dominance in the short hip adductors which also have a flexing and internal rotation action at the hip. This results in excessive medial femoral rotation, it also inhibits the action of gluteus medius (on side of the hip) which stabilizes the pelvis and the deep lateral rotators such as piriformis (which are deep to the gluteus maximus in the posterior hip). She is also probably compensating with a muscle called “tensor fascia latae” which inserts into the ITB. (important the ITB is not a muscle! but a thickening of the thigh fascia over the outside of the thigh) When you get internal femoral rotation it also has been shown to inhibit the medial quadriceps muscle.
Basically you want to stretch the overactive muscles and strengthen the inhibited muscles. I wouldnt say the hip flexor is non functioning, more that it is overly dominant. I would suggest stretching for the short adductors. The tubewalking is a good idea, but I would say to turn your feet directly ahead rather than in, make sure the tibial tuberosity (bump below the kneecap) is directly postioned over the middle of the foot. One of my favorite exercises is a single leg romanian deadlift, keep the knee slightly flexed and the foot neutral and “hinge” at the hip brining your same side hand down to your shin, then fire the glutes and lift back up.
If you want any more info TG. pm me and I can send you some photos and directions of exercises. I worked in sports med. for 12+ years, and currently am faculty at a PTA training program.
No experience with your specific problem, but here’s a great glute excercise derived from ballet floor barre.
Lie on your stomach feet together legs straight. Keeping both thighs on the ground, bring one foot in towards the knee of the other leg(technical jargon: this will put you in passe position). Turn both legs out as much as possible (from the hip), so that the toes are pointing away from you. Just this will really start to activate your glutes. Now do raises with that straight leg, as high as is comfortable. Go at a medium tempo. Do one longish set(up to 40), then switch legs.
For even more fun, bend the leg that was formerly straight into a low passe position(like the other leg, but not quite as bent) and then do the raises with that bent leg. Quite a bit more aggressive.
Cumbersome explanation, but hopefully it makes sense.
If you hit the weightroom, there are a number of machines designed for working your arse.
I’ve always had a nice one (I guess it’s genetic, so I can’t say anything that specifically helps.)
I’ve tried…but its really hard to isolate that area and not use your quad (I’ve been keeping my hand on my leg to make sure I wasn’t using it). I’ve been told mine isn’t bad either, but apparently it is weak!
Toes pointing forward is fine, just make sure they don’t point out. People with ITB issues tend to point their toes fwd when I say point them in.
What I like about the DVD that I can only do otherwise in person, is explain the exercise with the posture that is best. It also shows each exercise with progressions meaning it will always be challenging. I can say “do a one legged squat” and yes, you could probably do one but your knees may invert, your ankles may fall in, whatever. But if you see me doing it with a voice over saying the following you will have a better idea of what to look for and how to correct certain common mistakes:
*The first progression of the squat would be to place feet about hip distance apart then slowly squat down making sure your knees do not fall over your toes. Your back should be in a neutral position, toes pointing forward and your hips should be pressed back. As you gain stability you can bring your feet closer together until they touch. Once you can accomplish this position down to where the femur is parallel to the floor, without your knees or ankles falling in or out and with a stable torso, then try it with only one leg down. You may need to hold on to a wall for support in the beginning. Try to only hold a finger or two then eventually let go. Only come down as far as you can with complete stability in your torso, knees and ankles. Make sure your hips and shoulders stay even, meaning one does not lean to the side or is raised. Once you can do a stable 1 legged squat to almost parallel then you can progress by placing an object that will challenge your balance. *
*A half foam roller is used here. You can also use a towel or one of the many balance implements that are available. *
*You can also progress by holding additional weight. Dumbells are a good choice. A weight vest would be even better but are normally not available at most gyms. Always add additional weight in small increments. *
Make sure your knees do not fall over your toes by placing your hips back. Keep that neutral spine throughout the movement.
I am the worst salesperson as I tend to give away more so then sell, but if you really can use the dvd and cannot afford it, pm me and I will make arrangements.
I like the foam roller for deep massage, helps to prepare the soft tissue for a good stretch.
