Your Glutes: Movers and Stabilizers for optmal performance

Dear Friend,

Today's blog is about the importance of strong buttocks for human performance, whether for athletic performance, physical labor or simply Activities of Daily Living (ADL) and the  negative effects of gluteal weakness.
 
Anatomy:
Your buttocks are made up of three gluteal muscles, The Gluteus Maximus, the Gluteus Medius and the Gluteus Minimus.

The Gluteus Maximus is your strongest hip extensor, helping you get off the chair or toilet seat, lift up your grand child, safely climb stairs and manage curbs, and simply stand upright. Gluteus Medius and Minimus counter gravity's adductive forces at the hip through hip abduction and external thigh rotation and stabilize the hip during the swing phase of walking gait. Understanding the job discription of these muscles gives you already an idea of the negative effects that weaknesses in one or more of these muscles can mean to physical performance.

Causes of Gluteal Weakness:
In today's modern world an ever growing number of our population is spending their eight hour work day sitting on chairs in front of computers, returning home to a dinner table and later on to the TV couch and finishing the day off lying in bed. In other words twenty-two hours of most days they spend keeping their gluteals inactive (unloaded/inhibited), leading to atrophy of the gluteals and tightening of hip flexors. Other causes of gluteal weakness include:

• overuse of quadricep dominated exercises
• Muscular imbalances especially abdominals and back extensors
• Knee-, Hip- and/or Back Pain (secondary)
• Postural Deviations i.e. sway back or flat back

Effects of Gluteal Weakness on human performance:
Gluteal inhibition negatively effects performance, lumbar-pelvic-hip stability, postural alignment, and lower body strength causing often chronic pain and injuries whether it's on the athletic playing field or at home performing ADL. In athletics optimal postural alignment means more efficient movement, less muscular fatigue, less stress on joints and ligaments, and a more optimal transfer of energy while moving (more power). In older adults optimal posture reduces the chance of cumulative injuries due to static positions. Gluteal weakness is often the reason for a transfer from independent to assisted living. Conditions caused by weak gluteals:

• Hamstring Strains
• Low back pain
• Anterior knee and hip pain
• ACL (Anterior Crucial Ligament) sprains
• Ilio-Tibial Band Syndrome
• chronic ankle instability etc.

What came first, the egg or the chicken?
In many cases it's not clear whether gluteal weakness causes the condition or the condition causes the weakness. Example: An older adult suffering from osteo-arthritis in the knee might adopt pain related gait changes leading to gluteal inhibition. On the other hand, weak gluteals lead to hip and knee instability and an increase in wear and tear and therefore result in osteo-arthritis.

Treatment:
Studies show that gluteal inhibition/weakness can be successfully addressed and almost fully reversed within a few weeks through appropriate exercises, introducing regularly loaded activities. In order to re-activate the gluteals often functional hip mobility has to be restored first. Sit to Stand Stretch, Active Hamstring Stretches and isolated gluteal stretches i.e. Piriformis Stretch can help with mobility. The second phase should include simple gluteal activation exercises such as Bridging (2 to 1 leg), Clam Shell Exercises, Quadruped Hip Extensions, Fire Hydrant Exercise etc. This phase is followed by loaded exercises to increase/restore gluteal strength. Exercises such as Squats, Dead Lifts (progressing from bilateral to single leg and single plane to multi planar), Farmers Walks, Resisted Walking (sagital as well as frontal plane), and resisted Reverse Lunges promote great gluteal activation and contraction forces.

For detailed exercise descriptions please watch ViEW (Video Exercise Workshops) on "Gluteal Activation and Strength" by visiting our website: www.backinform.com

In summation: Weak Buttocks are a common occurrence in adults of all ages. Untreated, those weak buttocks can cause severe problems and injuries associated with lumbar-pelvic-hip instability and significantly reduce performance on the every day- and athletic playing fields. The good news is, that gluteal inhibition and weakness can be reversed through an appropriate exercise program.

If you need help recreating your buns of steel please give me a call!

A Sante,

Hartmut


Sources:
http://functionalresistancetraining.com/articles/re-activating-and-strengthening-the-gluteal-muscles
http://wannabebig.com/injury-rehab-and-stretching/how-gluteal-atrophy-effects-posture-performance/
http://www.shapefit.com/exercise/gluteal-amnesia.html
http://redefiningstrength.com/glute-activation-10-exercises/
http://www.higher-faster-sports.com/noglutes.html
http://drjohnrusin.com/top-5-glute-activation-techniques/
https://experiencelife.com/article/go-to-glutes/
http://www.brianmac.co.uk/glutes.htm
http://well.blogs.nytimes.com/2010/12/21/when-the-diagnosis-is-dead-butt-syndrome/?_r=1
http://www.healthline.com/human-body-maps/gluteus-maximus-muscle
http://physicaltherapy.about.com/od/humananatomy/a/Gluteus-Medius-Muscle.htm

Fitness Training for Seniors: From Frail 2 Fit

This month I would like to write about fitness for the aging population.  More than half of our clients at BACK IN FORM are 60 years of age or older. We truly cherish this group and love working with them. We offer a program called “Frail-2-Fit” that suits every Senior no matter what stage of life or what level of physical ability he or she is in. Today's blog will explain how aging affects us physically, and how exercise and fitness training can help slow down the process of aging.

It is a well-known fact that there are individuals who live abusive lifestyles and exercise very little if at all, but live to celebrate their 107^th birthdays, think Winston Churchill or George Burns.  Understand that this is the exception and not the norm.  For most of us, exercise is the key to maintaining a high quality of life and preventing the physical decline that often ends in assistant living or nursing care at a very high price. (See also my previous blog: "Your greatest financial asset is you")

According to statistics the US population over the age of 65 will reach 70 million by 2030, with the group of those 85 and older growing faster than any other segment. Unless Seniors adopt healthy living standards that include physical activities and balanced nutrition, the US could experience unprecedented growth in health care cost. 

The physical effects of aging and the counter effects of fitness training

Endurance,
is reflected by the level of cardio-respiratory fitness (CRF) which is being measured and expressed through the VO2max (maximal Oxygen uptake). CRF declines at a much greater rate after age 45 in both men and women depending on exercise habits, Body Mass Index and smoking. Those leaner, trained and non-smoking experienced in many different studies far lower declines in CRF than their untrained, overweight and smoking counterparts.However even those who smoked or were overweight were protected from early death if they exercised/walked at least 30 minutes per day, reinforcing the importance of exercise.

Strength,

loss, outside of a stroke or accident, is the leading cause of immobility and loss of independence. We tend to lose about 3%-5% per decade starting in our 40's and that loss increases often by 1%-2% per year after age 50. However, the good news is that hypertrophy and improved neuro-muscular adaptation can be achieved at any age. That means strength can be regained and maintained after loss, by increasing muscle mass and fine tuning the communication between the Brain/Spinal Cord and the muscle. Strength increases of up to 200% in lower extremities and well above 100% in upper extremities have been found in many case studies with weight and resistance training.

Flexibility,

decreases with age because of reduced movement and the natural reduction in soft tissue elasticity due to the inability of cells in the aging body to retain water in an sufficient manner. There is no clear science as to how much stretching should be described. However regular stretching can help preserve functional range of motion and joint health preventing increased wear and tear (Osteoarthritis).

Balance,
depends on several physical abilities that all decline with age, such as strength, mobility, neuron-transmission speed, eye sight, proprioceptive information flow, depreciation of vestibular system etc. Many of these physical abilities can be corrected and/or their regression slowed through adequate fitness training. For example: A loss of strength and decreased mobility and flexibility commonly effects posture negatively increasing the challenge to maintain the body's center of gravity over the base of support. Exercises geared to correct postural deficiencies can reduce the negative impact on balance.Another example: Reducing physical activities such as golfing, tennis or dancing reduced the stimulus for the proprioceptors, starting up a fitness program and reintegrating some of the activities done earlier in life will awaken those receptors and can reverse the negative effect on balance.

Bone density,

decreases as we age. Significant decreases are more common in women than in men and more prevalent in post menopausal women. Moderate bone density losses are referred to as Osteopenia, the severe form is called Osteoporosis. US wide more than 40 million Americans (female and male) are affected by severe bone density loss. This disease causes roughly 1.5 million fractures in the US annually. Exercises such as lifting weights places stress on the bone as muscles contract causing the bone to thicken. Weight bearing exercises such as walking compressing bone structures in vertical direction which improves the nutritional situation inside the bone and helps repair bone density loss in lower extremities and spine. Please see also my previous blog: "Osteoporosis: maintain and recreate bone density"

Joint health,
is diminished in almost all older adults. Over time the cartilage that protects the bones inside the joints starts to degenerate and eventually bone starts to grind on bone. This degenerative condition is known as Osteoarthritis and affects nearly 27 million Americans. It leads to pain and joint stiffness and often results in joint replacement. Studies have shown improvements in joint function and joint pain in those who exercise regularly choosing low impact aerobics and light to moderate weight lifting. The Arthritis Foundation has created an exercise program called PACE (People with Arthritis Can Exercise) that offers tips and instructions for land and water based exercising with Osteoarthritis.

Cognitive functions,
can become impaired as we age. Studies have shown that adults ages 55 and older showed in MRI testing substantial declines in brain tissue density in areas associated with memory and thinking. Those who were actively involved in regular cardiovascular fitness training showed significantly lower losses. Another study showed that individuals 65 and older, who walked at least 3 days per week had a 35% lower incident rate of dementia than those who walked less or not at all. These results are very encouraging and should be taken into serious consideration when battling Alzheimer's Disease and other forms of dementia.

Mental Outlook
In the US about 14% of males and 18% of females over the age of 55 struggling with some form of depression or another. There is unfortunately very little research on exercising and depression in older adults. It is however safe to assume that it shows similar results as we see in younger adults with depression. Even if it's not a depression cure for Seniors aerobic exercises can at least help alleviate the negative impacts of depression and enhance the mental outlook.


Conclusion
It doesn't come as a surprise that exercise is a great tool to improve quality of life, stave off disease and the negative effects of aging as it has made it's way into almost every therapy protocol known to men. There is no age limit on when to start, and there is no success limit due to age as long as we take preexisting conditions that require changes to an exercise routine and the slower adaptation to training into consideration. I recommend you start by discussing your training plan with your physician and let a fitness professional guide you in the set-up of a program that takes your individual situation into account.

A Sante,
Hartmut



Sources:
Andrew S. Jackson; Xuemei Sui; James R. Hébert; Timothy S. Church; Steven N. Blair. ” Role of Lifestyle and Aging on the Longitudinal Change in Cardiorespiratory Fitness.”  Arch Intern Med. 2009;169(19):1781-1787
http://www.acsm.org/docs/current-comments/resistancetrainingandtheoa.pdf
http://www.medicinenet.com/senior_exercise
http://www.arthritis.org/what-is-osteoarthritis.php
http://www.ncbi.nlm.nih.gov/pubmed/19363089

Los Gatos Rec Department "55 Plus" offers Back In Form classes

BACK IN FORM has joined forces with the Los Gatos Recreation Department and their "55 Plus" program. Starting this fall we will start offering two classes, "Balance and Fall Prevention" and "Yogilates". For more information see links below. These classes are available for all ages but geared towards the mature adult. Los Gatos residency is not required. If you have a relative, friend, neighbor or colleague that could benefit from participation in these classes please pass the info along. As always, thank you for your friendship and support.

In good health, Hartmut Broring

Links to the LG Rec Fall Catalog:
"Yogilates": http://www.caseyprinting.com/lgsfall11/index.html#/54/
"Balance and Fall Prevention": http://www.caseyprinting.com/lgsfall11/index.html#/52/