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Overlooked Cause of Back and Hip Pain?

Gluteus minimus…a hidden source of back and hip discomfort and pain? The smallest of our gluteal muscles, it can be felt as pain when standing after sitting, when sitting slouched in a chair, a limp when walking, or pain while standing straight or still. It’s trigger points can radiate pain that feels like it originates from the piriformis, IT band, hamstring complex, or the upper calf.

Glute minimus posterior pain pattern.JPG
 (Finando & Finando, 2005)

(Finando & Finando, 2005)

The deepest of our gluteal muscles, it lies just above the piriformis and is a stabilizer, internal rotator, and abductor of our hip. These muscles become chronically shortened due to excessive sitting, chairs or couches that provide inadequate support or put the spine and hips in a flexed position, gait distortion, and leg length discrepancies. Lack of mobility thru the lumbo pelvic hip complex as well as hips predominately in a forward flexed position are contributors as well.

Myofascial release using a smaller object versus traditional foam roller may be best. As you can see below, trigger points fan across the muscle and may be easier reached using a lacrosse ball up against the wall.

 (Finando & Finando, 2005)

(Finando & Finando, 2005)

For treatment, use hip mobility exercises in the active and dynamic warm up portions of the workout and start each exercise session with a sequence of myofascial release, stretching of the tight/inhibited muscles, activation exercises, and finish with a movement that involves the entire complex. An example would be:

Myofascial release: foam roll or lacrosse ball on trigger points, holding at least 30 seconds on any area that is sensitive or painful.

Stretch: stretch the gluteal complex. Examples could be the yoga pose pigeon or modified pigeon, lying on back pulling knee across body and then towards opposite shoulder, hip swings, or band assisted IT band stretch.

Activation exercise: muscle activation techniques, mini band walks, side lying clam shells, single leg step ups, single leg hip bridges. Higher repetition, lower resistance, aim for 12-15 reps.

Movement that involves the entire complex: use a movement that involves the gluteal complex as well as hip extension/flexion; this could be a body weight squat, squat with row, or hip bridge. Again, higher repetition, lower resistance, focusing on proper form and technique thru feet, knees, and hips.

Reference:

Finando, D. & Finando, S. (2005). Trigger Point Therapy for Myofascial Pain. Rochester, Vermont: Healing Arts Press.