PODIATRY NEWS & REVIEW:
By Columnist Andrea Castello – Biomechanical, Sports and Paediatric Podiatrist:
As a podiatrist, I find that most patients present with a range of foot and lower leg issues – heel pain, Achilles Tendinopathy, Medial Tibial Stress Syndrome, Shin Splints and Patellofemoral Joint Pain are all common presentations to my clinic. Given these injuries and issues affect the foot and lower leg, both referrers and patients alike assume that the cause of these issues are located primarily in the foot. This assumption is simply not true. Of those people experiencing the injuries mentioned above the vast majority have issues at the hip and pelvis level, and the glutes.
What Role do the Glutes Play in Movement?
The gluteal complex is a highly important group of muscles. These are the muscles that not only drive you forward when walking, running and jumping, but they are also incredibly important in stabilising the pelvis when the athlete is supporting the entire body weight on one leg, otherwise known as single support phase in running or midstance when walking.
When we run, the glutes hold our pelvis level and steady, extend our hip, propel us forward, and keep our legs, pelvis, and torso aligned. It then follows that if there is substantial weakness, or poor recruitment and inhibition of the glutes, the knock-on effect to the entire kinetic chain is significant and potentially a real source of injury. An example of this concerns your knee. Your glutes prevent your femur (thigh) from rotating inwards. If this doesn’t occur it will result in an increase in both the valgus (knock-knee) and rotational forces through the knee joint, increasing the risk of injury.
Another potential effect on the leg of gluteal inhibition is reduced ankle joint motion. If the gluteals can’t extend the hip due to inhibition the brain will act to limit hip extension. One way to restrict hip extension is to reduce ankle motion, which, if present, can contribute to lower limb injuries. There are numerous studies linking glute weakness/inhibition to pathologies such as Achilles tendinopathy, shin pain, patellofemoral pain, plantar heel pain and iliotibial band syndrome.
The Gluteal Complex Issue
The gluteal complex is a bit of a problem group for most athletes – recreational or otherwise – but particularly runners and walkers, because while this group of muscles stabilise the pelvis, they do not get a strengthing workout during a run. This issue can make your hamstrings, quadriceps, and calves disproportionately stronger. Another issue is that most strength-training routines don’t isolate the glutes. If an exercise requires several muscles to perform the movement, the majority of the work will be done by the strongest of those muscles. Finally, tight muscles, specifically the hip flexors, can inhibit the glutes and prevent their muscle fibres from firing.
The upshot of all of this is to include the glutes as part of a training program; to do this, start with a simple activation program and progress as you get better. If you are unsure of what you should be doing, seek professional advice. It will ultimately reduce your risk of injury and as a bonus will cater to improved performance.
About Our Podiatry News and Review Columnist
Andrea Castello graduated from the University of South Australia in 1999 and has worked in the public and private sectors in both the country and the city. After completing a Masters Degree in Health Services Management in 2006, Andrea decided it was time to put his education to work and start his own practice, which culminated in the inception of AC Podiatry in late 2007. Since then it has grown to include 8 clinics employing 11 podiatrists.
As a podiatrist, Andrea has spent much of his professional career refining his skills with particular attention given to biomechanical, sports and paediatric podiatry. In addition to standard podiatric skills, Andrea has also completed numerous workshops in Dry Needling and Mobilisation. He is a member of Sports Medicine Australia, the Australasian Academy of Podiatric Sports Medicine, a Mentor to final year students and new graduates, and is currently the podiatrist for the Central District Football Club in the South Australian National Football League.
Disclaimer: The information published in this column is the author’s own professional and personal knowledge, and opinion. This information and opinion are not intended to be a substitute for professional medical advice, diagnosis or treatment of any manner. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding any medical condition and consult a qualified medical professional before beginning any nutritional program or exercise program. Never disregard professional medical advice or delay in seeking it because of something you have read on InShape News.