Lateral Chain Instability

The deep-lying gluteus medius muscle is normally associated with

movement and is usually trained in a standing or seated concentric

motion, but its key role in running is to act as a stabilizing force, to

slow the downward drive of the pelvis on the opposite side during

stance phase. It does this by decelerating lateral hip sway of the

weight bearing leg by eccentric muscle contraction.

This pelvic restraint prevents excessive hip sway of the type that is

classically known as “Trendelenburg gait”.

But even short of the tell-tale waddle of a Trendelenburg gait, there

are various adaptations that runners make to compensate for

weakness in the gluteus medius.

All these various compensations can develop into chronic injuries for

the runner, including SI joint dysfunction, TFL IT Band Syndrome,

Snapping Hip Syndrome, shin splints, over-pronation, ankle sprains,

and plantar fasciitis.

Now, before you rush out to your nearest fitness center and jump on

to the seated abductor machine to strengthen and tone your backside,

keep in mind that we really need to strengthen the muscle in a

dynamic position which means in the way in which we use it. In

order to do this, we want to simulate a running gate. Another important

consideration is the physiological adaptation referred to as

reciprocal inhibition. Simple stated, when one muscle is physically

tight and overactive, its antagonist or the muscle which has the

exact opposite function is neurologically inhibited, so it’s very difficult

to effectively activate the muscle you are attempting to strengthen.

Another important factor in effectively activating the gluteus medius

is foot mechanics. Over-pronation directly results in neurological

inhibition of the gluteus medius.
 

So, you might ask…how do I overcome this imbalance. The key

is to follow the strategy of restoring alignment, inhibit, activate, and

re-enforce. First, we want to restore proper alignment of the pelvis

by chiropractic manipulation, Muscle Energy Technique or some form of positional release.

Secondly, we want to inhibit the overactive muscles through the

use of Active Release Technique. Thirdly, we want to activate the

underactive muscle through Muscle Activation Technique. Lastly,

we want to reinforce proper movement patterns through corrective

exercise. Utilization of this system works synergistically to

get patients better faster and keep them better longer.