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The Lazy Bum Epidemic

As one of the UK’s leading London physiotherapists, I regularly write about injuries, treatment and assessment techniques.

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One of the issues I see very regularly in my physiotherapy practice (by which I mean, several times a day) is that of the lazy bum.  In fact, it’s becoming something of a City epidemic.  Over the next few weeks, I’m going to explain what to do about it – but I’m going to start this week by explaining what I mean and why I think it’s important.

First, anatomy.

Each of us has lots of buttock muscles – it’s not just one muscle on each side.  There are the glutes (gluteus maximus, gluteus medius and gluteus minimus), piriformis, ischiococcygeus, quadratis femoris, the gemelli (superior and inferior) and the obturators (externus and internus).  Each of them has a slightly different job, and each of them behaves differently when things go wrong.

As I explained a couple of weeks ago, there are three types of skeletal muscle.  We have prime movers which provide the power, local stabilisers which support the individual joints, and global stabilisers somewhere between the two.

In an optimal situation, you decide to move, your local stabilisers make sure your joints are controlled, your global stabilisers then join in; and finally your prime movers activate, and off you go.

However, when things are not optimal, the sequence also goes wrong, resulting in your joints becoming jammed rather than stabilised – ie, muscle imbalance.

Why is this a problem?

Specifically around the glutes, this is super important because their job is to move and control your pelvis and hips, which are fundamental to upright movement.

Specifically around the glutes, this is super important because they are attached to your pelvis and hips, which are areas you use to move and support you, virtually all the time. So a muscle imbalance in your glutes can’t cause all sorts of issues.

How should they work?

Using walking as an example, as your right heel hits the ground, the first thing that should happen a thing your hip is that the local stabilisers should fire – gluteus minimus, obturators, gemelli. Their job is to stop your hip from falling out of the socket, and to keep your pelvic bones attached to each other. Then your global stabilisers need to join in – gluteus medius keeps your hip from rotating inwards. Finally, it’s the prime movers’ turn: gluteus maximus contracts along with your hamstrings to propel you forward over your leg.

If this sequence gets out of order, due to pain, bad habits, or not recovering fully from an old injury, then your walking gait will not be smooth and bouncy, and you may not have good flexibility, shock absorption or control. This could affect the hips (for example, arthritis or torn cartilage) and/or may have knock-on effects elsewhere in your body.

People with muscle imbalance around the glutes often come to physio complaining of knee pain (often because the hamstring muscles at the back of the thigh try to compensate for the tight glutes; and the hamstring tension causes excessive pressure through the knee joints which may then become painful) or low back pain, or even neck and shoulder pain.

So… can this be fixed?

The good news: yes, you can fix it.  And specifically, you can fix it using our own RSM Model – Release, Stabilise, Move – which I’ll explain next week!

Do you have a lazy bum?  Want to know more?  Over the next few weeks, I’ll be explaining how to use our RSM Model to treat your own lazy bum – but if you can’t wait, call us on 0207 175 0150 to book an appointment, or you can go straight to our online course, Pelvic Pain, Pelvic Drivers, which teaches you how to release, stabilise and move your glutes.

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