Build Strong Glutes and a Pain-free
Lower Back
Provided by
American Council on Exercise
There
are two things many of our clients have in common: They want to have
nice-looking buns and, at some point in their lives, they will experience
lower-back pain. The
good news is that developing strong, shapely glutes can contribute to a
pain-free lower back. In this article, you’ll learn
why deconditioned and/or dysfunctional gluteal muscles and lower-back pain
often go hand-in-hand. You’ll also learn which exercises
build strong glutes and can help keep lower-back pain at bay.
What
Causes Back Pain
Many people
mistakenly believe that lower-back pain is caused by a
problem with their lower back. This is understandable given that movements of
daily life, sports and most weight-bearing exercise modalities require the
spine to move forward, backward, side to side and in
rotation (McGill, 2002). When you lean forward, for example, the spine
rounds/flexes. When walking and running, it moves from side to side as you
transfer weight from one foot to the other. When performing sporting movements
like golf, tennis and baseball, the spine must rotate to achieve the desired
motion (Chasan,
2002).
However, all
these movements of the spine require other parts of the body to work as well.
When bending forward to pick a weight up from the ground, for example, the
ankles, knees and hips should also bend to help lower the torso. Similarly, as
the spine moves from side to side during walking, the legs and hips should also
move from side to side (i.e., adduct and abduct) to help provide a good base of
support for the spine as it moves. Rotational
movements of the spine should be accompanied by rotational movements in the
legs and hips so the tremendous force created by swinging a tennis racket or
golf club, for example, is dissipated throughout the entire body. When
actions of the spine are not accompanied by correct movement
in the rest of the body, the spine and its surrounding muscles (e.g.,
the lower back) have to take up the slack and may become overworked and
injured.
How
Strong Glutes Can Help Prevent Back Pain
The gluteal
complex of muscles (i.e., gluteus maximus, medius and minimus) plays a key
role in helping take stress off the spine during multiplanar
movements. That’s because these muscles help control
movements of the torso, pelvis, hips and legs. When you bend forward or squat,
for example, your hips should bend backward to counterbalance the forward
motion of your upper body to help you stay upright (Figure 1). The gluteus maximus works to decelerate flexion of your hips to help
counteract the downward pull of gravity and prevent your lumbar spine from
over-rounding forward (Price and Bratcher, 2010). If your glutes are not strong
enough to fully engage when your hips bend backward, your spine must round
forward excessively to lower your arms to the ground (Figure 2).
Similarly, much of the rotational movement stress experienced by the spine
during sporting activities is moderated by the gluteus maximus
muscle. When the spine rotates over the leg on one side of the body
(e.g., when taking a backswing or follow through in golf, tennis or baseball),
the hip and leg should also rotate to take stress off the lower back (Figure
3). Because the gluteus maximus muscle attaches to
the structures of spine and pelvis and to the leg, rotation of the hip and leg
should engage and lengthen this muscle, thus helping to decelerate rotation of
the torso (Golding and Golding, 2003). If the gluteus maximus
muscle is not working properly, stress from rotational movements is instead transferred to the lumbar spine and may manifest
as pain in the lower back.
Side-to-side
movement stress to the spine is moderated by the smaller muscles of the gluteal
complex—the gluteus medius and minimus (Dimon
and Qualter, 2008). As the spine moves from left to
right as a person takes alternating steps when walking and running, the pelvis should also move from side to side (Figure 4). This shifting
motion of the pelvis with the torso is decelerated by
the gluteus medius and minimus
because of their attachments from the pelvis to the side of the hip and leg.
When they are healthy and functional they act as a
brake for the lumbar spine, protecting it from excessive movement and stress.
If they are not working correctly, pain may manifest in the hips and lower
back.
How
to Build Strong Glutes and a Pain-free Lower Back
As you have
seen, correct functioning of the gluteal complex of muscles can help protect
the structures of the lumbar spine as it moves during multiple planes of
motion. However, before you begin overloading these muscles in an attempt to
build strong glutes and a pain-free back, it is extremely important to adequately prepare them so as not to injure your lower
back (Price and Bratcher, 2010). The following “warm up and wake up” series of
self-myofascial release exercises and neuromuscular activation techniques will
help ensure your gluteal muscles are working correctly and can protect your
lower back as you move through various ranges of motion in the
glute-strengthening program that follows.
Warm-up
Exercises
For gluteal
muscles to be flexible enough to lengthen effectively and decelerate movements
of the pelvis, hips and spine, have your clients perform some self-myofascial
release techniques on the muscles of the glutes and lower back prior to
exercising. This will ensure the tissues are warm and mobile and can move in
all three planes of motion.
Tennis
Ball on the Butt
Massaging
the gluteal complex of muscles before working out can help promote better
movement of the pelvis, hips and legs, and ensure you get the most out of the
strengthening exercises that follow.
Have your
client to lie on his or her back with the knees bent. Place a tennis ball under
the right side of the butt and scoot the body up and down and from side to side
to move the ball to any sore spots, from the base of the spine all the way out
to the side of the leg. You can progress this exercise by coaching your client
to place the right ankle on the left knee. Place a rolled-up towel under the
left hip to help keep the pelvis level. Roll out each buttock for one to two
minutes. While a tennis ball is the easiest piece of equipment to purchase and
use, a foam roller can also be used to massage the
gluteal complex.
Tennis
Ball on Lower Back
The gluteus maximus muscle ties into the fascia of the lower back
(i.e., thoracolumbar fascia). Therefore, massaging the muscles on either side
of the lumbar spine is important before performing glute-strengthening
exercises.
Instruct
your client to lie on his or her back with the knees bent. Place a tennis ball
under the right side of the lower back (away from the spine itself) and scoot
the body to move the ball to any sore spots between the bottom of the rib cage
and the top of the hip. (Note: Do not place the tennis ball directly under the
bottom two ribs. These are “floating ribs,” which do not attach to the sternum
at the front of the rib cage.) Massage the area on each side of the spine for
one to two minutes.
Foam
Roller on Side of Thigh
The
iliotibial band on the side of the thigh attaches the gluteus maximus muscle to the lower leg. Increasing
blood supply to this structure will encourage correct movement of the hip and
leg.
Instruct
your client to place a foam roller beneath and perpendicular to the right leg,
which is extended, and to balance the body on the
right elbow and the left foot. Roll the leg up and down over the roller and
pause on any sore spots. If your client has shoulder problems, or finds it
difficult to balance, instruct him or her to lie on the ground with the head
supported by a pillow, and place a tennis ball under the outside of the thigh.
Perform this exercise for one to two minutes on each side.
Wake-up
Exercises
People with
lower-back problems typically have difficulty activating their glutes
correctly. The following isometric and/or single-joint neuromuscular-activation
exercises for the gluteus maximus, minimus and medius ensure these
muscles are receiving correct input from the nervous system before you load
them up with dynamic, multiplanar strengthening
exercises.
The
Duck Stand
The gluteus maximus muscle can lose neural input and become
dysfunctional in people who have chronic lower-back pain. This isometric
activation exercise helps “wake up” the gluteus maximus
muscle by reestablishing a better connection with the nerves that supply it.
Instruct
your client to stand with the feet hip-width apart and toes turned outward like
a duck. Tuck the pelvis under (i.e., posteriorly rotate) and try to rotate the
legs outward without moving the feet. As the legs rotate outward, the ankles
roll out slightly, the arches of the feet rise up, and the glute muscles on
either side contract. Stand erect with good posture and hold each repetition
for 10 to 15 seconds. Perform three to four sets. Teach your client to pay
attention to the sensation he or she feels on each side specifically and notice
if both sides are working correctly. If one side is not working as well as the
other, instruct the client to perform the “Glute Activation Over
Ball” exercise that follows.
Glute
Activation Over Ball
This
neuromuscular activation exercise highlights and remedies deficiencies in one
or both sides of the gluteus maximus muscle.
Instruct
your client to lie prone over a gym ball using the hands to balance.
Posteriorly rotate the pelvis (i.e., tuck under) and turn the right foot out
slightly while lifting the right leg. Make sure to keep the hips level and
square and the pelvis posteriorly rotated. It is also extremely important to not arch the lower back while lifting the leg. To help
enhance activation of the gluteus maximus muscle, try
different foot positions (i.e., turn the foot out more, keep it straight, turn
it in slightly) while the leg is raised. Complete eight to 10 repetitions on
each side, performing more sets on the side where the glute is most deficient.
After completing this exercise, repeat the “Duck Stand” exercise shown above
and ask your client if he or she now feels more activation of their gluteus maximus muscle.
Side-lying
Leg Lift
The gluteus medius and minimus muscles need
to be working effectively to help control side-to-side movements of the pelvis
and provide a good base of support for the spine. Help your client “wake up”
these muscles with this simple activation technique before performing the more
dynamic glute exercises that follow.
Instruct
your client to lie on his or her side with the head supported by pillow. Bend
the knee of the right leg and place the instep of that foot just below the left
knee. Gently raise and lower the right knee while keeping the pelvis tucked
under and stationary throughout the exercise. Don’t
“cheat” during this exercise by hiking the hip, arching the lower back or
rolling the hips. When performing this exercise correctly, your client will
feel a strong contraction on the outside of the right butt and hip. Complete
eight to 10 repetitions on each side, focusing more on the side that is the
weakest.
Gluteal-strengthening
Exercises
Once the
gluteal muscles are warm and awake, progress to the gluteal-strengthening
exercises detailed below. These exercises are designed to strengthen the
muscles in a lengthening fashion (i.e., eccentrically) to produce strong,
healthy glutes that can protect the lower back from injury.
Reverse
Step-lunge With Rotation
This
exercise targets the gluteus maximus muscle. Lunging
backward off a step requires the hip of the front leg to flex more and the
gluteus maximus muscle of that leg to work harder to
decelerate the movement. Rotating the torso over the front leg also promotes
better activation of the gluteus maximus during this
exercise.
Instruct
your client to lunge backward off a small step while rotating the arms across
the right leg. Keep the spine erect and shoulders level; push the big toe of
the right foot into the step to help keep the right knee toward the midline of
the body. Step back up onto the step and swing the arms across the left leg.
Perform 10 to 15 repetitions on each side for two to three sets.
The
“Ice Skater”
This exercise
is designed to strengthen the gluteus maximus, medius and minimus muscles to provide a good base of support for the
torso and prevent excessive side-to-side movement of the lumbar spine.
Instruct
your client to place one foot on a small gym ball while balancing most of his
or her weight on the right leg. Roll the gym ball out to the left side with the
left foot while performing a single-leg squat with the right leg. Rotate the
arms over the right leg while keeping the spine erect and shoulders level, and
keep the knee of the right leg toward the midline of the body. If this is
difficult, the client may need to regress back to doing more self-myofascial
release exercises to help release tension from the glutes (see above). Perform
two to three sets of 10 to 15 repetitions on each side.
Side
Lunge With Reach
This
exercise, while also strengthening the gluteus maximus
muscle, focuses on strengthening the gluteus minimus
and medius muscles.
Instruct
your client to take a lunge stance with the left leg forward and reach the
right arm away from the body while shifting the hips toward the left. The
shoulders should tip down to the right as the hips move toward the left to
counterbalance the torso. The left knee and ankle should rotate in the
direction of the midline. Return to a standing upright position and repeat.
Perform two to three sets of 10 to 15 repetitions on each side.
References
Chasan, N. (2002). Total Conditioning for Golfers: The Swing Reaction
System Biomechanical Golf Fitness Program. Bellevue: Sports
Reaction Productions.
Dimon, J.T. and Qualter,
J. (2008). Anatomy of the
Moving Body: A Basic Course in Bones, Muscles and Joints, 2nd
ed. Berkeley, Calif.: North Atlantic Books.
Golding,
L.A. and Golding, S.M. (2003). Fitness
Professional’s Guide to Musculoskeletal Anatomy and Human Movement. Monterey,
Calif.: Healthy Learning.
McGill, S.
(2002). Low Back
Disorders: Evidence Based Prevention and Rehabilitation. Champaign,
Ill.: Human Kinetics.
Price, J.
and Bratcher, M. (2010). The
BioMechanics Method Corrective Exercise Educational
Program. San Diego, Calif.: The BioMechanics Press.
AUTHOR
Justin Price
A sought after pain relief
expert, Justin Price specializes in biomechanics and correct exercise. He has been featured in Time magazine, Newsweek, The
New York Times, the Wall Street Journal, WebMD, Discovery Health and
numerous other publications. His techniques, culminated in The Biomechanics
Method he created, are used in over 25 countries.