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| Ref: https://www.physio.co.uk/ |
Gluteal muscles are one of the most common to use all the time e.g. sit on it, supine on it, stand, and walk. In fact, gluteal muscles combine more than one muscle and work together for multi - function.
Gluteal stretching is one of the most common physiotherapy procedures for treatment, relaxation, prevention, and health promotion. I often stretch them together with the hamstring to increase flexibility for forward bending improvement.
In my physiotherapy experience, I have designed many poses to stretch glute muscles that depend on the condition of the participant and place. In my opinion, the lady cross leg stretch may be the most difficult of all stretches because it reverses all Gmax functions.
10 options to stretch gluteus family muscle
Exercise #1: Trendelenburg's stretch: In case of standing on the floor, stand on target leg with bend un - target leg. Then drop the pelvic bone of un - target leg side. In case of standing on step, move the un - target leg off the step that means target leg is on the step. Then, drop the pelvic bone of un - target leg side.
Exercise #2: Seat knee to chest: for convenience to stretch, lean back on back - rest and then start stretching.
Exercise #3: Seat figure 4 stretch: Keep back straight, then bend forward by folding the hip joint (groin) . That means do not curve the back and bend forward.
Exercise #4: Seat cross leg with knee to oposite shoulder stretch: Keep back straight during stretching and try to move your knee close to the opposite shoulder.
Exercise #5: Floor figure 4 stretch: Keep back straight during stretching to prevent back pain. For more stretch, keep the knee and chest closer.
Exercise #6: Floor cross leg stretch: Keep back straight during stretching to prevent back pain. For more stretch, pull the knee to the opposite shoulder stronger.
Exercise #7: Supine single knee to chest
Exercise #8: Supine cross leg: Do not lift shoulder and pelvic from the floor during stretching. For more stretch, pull the knee to the opposite shoulder.
Exercise #9: Supine figure 4: Keep back straight during stretching to prevent back pain. For more stretch, keep the knee and chest closer.
Exercise #10: Supine cross leg with hip internal rotation: Keep back straight during stretching to prevent back pain.
The members of gluteus family consists of
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| ref: https://fitnessvolt.com/ |
1. Gluteus maximus (Gmax)
Gluteus maximus has been used to stretch by me the most. Because it connects to ITB, stretching Gmax may help to release ITB tension.
It is superficially the largest muscle of the body. It is a one homogenous muscle and a single joint muscle.
Gmax is a multi-functional muscle for human living so it provides more than one function than sitting. This muscle is distinctive in comparison with other primates due to evolutionary postural changes from quadrupeds to bipeds. The human Gmax plays a very important role in deambulatory actions such as walking, running and climbing, lifting weights because it has an important role in extending the hips and stabilizing the pelvis.
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| Ref: https://www.nytimes.com/ |
Anatomically, Gmax is originated from the the dorsal segment of the ilium where is posterior layer of the thoracolumbar fascia, posterior superior iliac spine, posterior gluteal line, posteroinferior sacrum and coccyx, sacrotuberous ligament and the overlying gluteal fascia.
The distal attachment has two major sites. First, the superior fibers of Gmax, together with the superficial fibers of the inferior portion of Gmax, insert into the superficial layer of the ITB. Second, the deeper inferior fibers have a fibrous insertion, via the deep layer of the ITB, into the gluteal tuberosity. The attachment of Gmax to the ITB is particularly strong and Fibrous.
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| Ref: https://study.com/ |
The Gmax is divided into superior and inferior portions by variations in functional activation, muscle fascicle orientation, muscle thickness and insertion pattern, not by structural boundary between each subdivision. As indicated in EMG studies, the orientation and attachment of superior gluteus maximus supports its proposed function as a hip lateral rotator and abductor. The role of the inferior portion of gluteus maximus as a hip extensor is supported by its vertical orientation and its attachment to the gluteal tuberosity. However, there are different characteristics between the muscle fascicles, however, inferior fascicles pass to inferolateral direction at angles varying between 60 degrees and 45 degrees for superior fascicles.
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| Ref: https://www.performancehealthacademy.com/ |
The Gmax has been reported to have basic function as an extensor, external rotator, and abductor of the hip joint. In addition to its main insertions, the Gmax also inserts into the iliotibial tract and consequently plays a role in stabilizing the knee when extended. It is important to note that the Gmax plays a significant stabilizing role in core stability, forming part of the hip muscles that contribute to core stability. Since, the Gmax has been described as being connected to the lumbar paraspinal muscles by the thoracolumbar fascia, allowing it to transfer loads from the lumbo-pelvic region to the legs.
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| Ref: istockphoto.com |
I always have seen patients with limited torso bend over and hand to floor because of Gmax shortening. Anyways, it has the potential to induce hip abduction and external rotation along with a limited flexion and adduction. There is always difficulty in crossing or overlapping the legs (cross sign), Ober’s sign is positive, reverse Ober’s sign, out-toeing walking, flattened and cone shaped buttock, pelvic obliquity, compensatory lumbar scoliosis, and apparent leg length discrepancy. The leg appears longer on the involved side as there is pelvic obliquity due to continuous traction by contracture bands. Due to one insertion being on a greater trochanter, patients may produce snapping sound as the fibrotic band glides over the greater trochanter. Some patients may complain of knee crepitus or anterior knee pain.
2. Gluteus medius (Gmed)
I have hardly given Gmed stretches. The most, I have provided strengthening more often than stretching.
The proximal attachment of the gluteus medius was found to be from the outer surface of the ala of ilium, between the iliac crest and the posterior gluteal line above and the anterior gluteal line below, and from the overlying deep fascia. It inserts into the lateral surface of the greater trochanter in the tendinous area. Some study said, in contrast to Gmax, Gmed has only a weak connection to the ITB.
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| Ref: https://www.howtorelief.com/ |
It consists of three portions; include, anterior, middle and posterior that division is based on variations in muscle fascicle orientation, muscle thickness, innervation and insertion pattern, rather than a clear structural boundary. It appears that the anterior and middle portions insert onto the posterosuperior surface of the trochanter, while the posterior portion converges to a pointed insertion on its superomedial aspect. The posterior portion of gluteus medius has a more horizontal orientation than the more vertical middle and anterior portions. The orientation of these posterior fascicles actually more closely resembles the orientation of Gmax than its own anterior and middle fascicles. Both the anterior and middle fascicles of Gmed have a broadly similar orientation to TFL, and the anterior fascicles are attached via fascia to that muscle.
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| Ref: https://www.pinterest.com/ |
The more vertical anterior and middle portions of gluteus medius appear better positioned to abduct the hip, than the more horizontal posterior portion. So, It is a key muscle of the abduction and internal rotation of the hip and plays an important role in postural stability particularly in frontal plane stability during functional tasks.
The gluteus medius provides lateral stability in several functional and common activities such as walking because it is responsible for preventing the opposite side of the pelvis from dropping during gait; if this muscle is weak it can give rise to an orthopedic condition known as “Trendelenburg gait”. This dysfunction is characterized by the whole trunk swaying across the affected limb while weight-bearing because the abductors are incompetent and pelvis drops to the opposite side, but it would be compensated quadratus lumborum in the same side.
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| Ref: https://desertridgelifestyles.com/ |
I have not provided stretching treatment to this muscle often that I gave sometimes with muscle spasm or soreness. The most physiotherapy treatment to this muscle has been strengthening.
Once, one patient who does love to play tennis had lateral hip pain which made the patient unable to sleep on the pain side came and saw me in the clinic. The patient has weakness of hip abduction and limited hip range of motion by tightness. I gave ultrasound therapy on Gmed muscle and tendon, including, arrange hip flexibility by stretching and massage Gmed and TFL, and focus on strengthening Gmed. The progressive was very slow, however the patient could be discharged afterward.
3. Gluteus minimus (Gmin)
Gluteus minimus is the deepest muscle of the gluteal family. It is covered almost entirely by gluteus medius. Although, it has a similar formation with fan - shape, but it has a shorter lever to produce abduction torque than Gmed. It has the highest percentage of slow twitch fibers.
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| Ref: https://www.corewalking.com/ |
The Gmin was attached proximally to the outer surface of the ala of ilium between the anterior and inferior gluteal lines. It is described as arising from the external iliac fossa between the anterior and inferior gluteal lines that is below the anterior superior iliac spine and runs posteriorly, parallel to the iliac crest to the iliac tubercle.
Insertion of Gmed is on the front of the greater trochanter. The anterior part had vertically directed fibers running from the ilium to the greater trochanter. Its distal end blended with that of the anterior part of the Gmed and shared its attachment to the ridge on the lateral aspect of the greater trochanter. The posterior part was formed of nearly horizontal fibers; its distal end passed deep into that of the anterior part to be attached to the anterior aspect of the greater trochanter. Because the muscle bulk had two distinct parts (anterior and posterior) making up a fan shape, the muscle fibers converge from the area of origin to a tendinous insertion into the capsule of the joint.
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| Ref: https://www.sportsinjurybulletin.com/ |
The primary function of Gmin is similar to Gmed which is abduction of the hip joint. The function acts as a flexor of the hip and also as either an internal or external rotator, depending on which part of the muscle is active and on the position of the femur relative to the pelvis. So, the function of gluteus minimus is also uncertain except hip abduction.
The principle to stretch this muscle is the same as the others: stretch to the point where “tightness with pain” or “noticeable tension without pain” will hold at the point for 30 seconds of 3 - 5 reputations following demonstrated VIDEO.
Reference:
https://www.mskscienceandpractice.com/article/S1356-689X(15)00008-9/pdf
https://ciafel.fade.up.pt/aehd_archives/files/journals/1/articles/161/public/161-739-1-PB.pdf
https://www.sicot-j.org/articles/sicotj/pdf/2017/01/sicotj160031.pdf
https://core.ac.uk/download/pdf/59349742.pdf
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