When patients come into my office with shin or foot pain and I start talking to them about the function of their pelvic musculature including their gluteal or butt muscles, it often leads to confusion. They wonder why I’m asking about their butt when it’s their shins or feet that hurt.
There is a vital connection between your core musculature including your gluteal muscles (your butt) and the annoying pain of Shin Splints.
Before we clear up the confusion, let me start by confusing you a little bit more with this statement:
Running is a one-legged sport.
Huh? That’s the response I often get when I utter these words to a patient who is suffering with Shin Splints or other repetitive strain injuries of the legs.
Let me explain….the biomechanics of walking and running are quite different.
During walking, there is double support (i.e., two-feet support or both feet on the ground) between 25 to 30 percent of the gait cycle time.
During running, there is no double support, meaning that when you are in contact with the ground you are only ever on one foot at a time, hence: Running is a one-legged sport.
Ok, well that’s great but I am still confused about what all this has to do with Shin Splints and other running injuries. The gluteal muscles play an important role in stabilizing your pelvis when you are on one leg. If there is any biomechanical dysfunction involving the gluteal musculature, the entire leg (including your painful shins) can be affected.
Let’s learn a little more about your butt and how it works:
The Gluteal Musculature (Your Butt Muscles)
The gluteals are a group of muscles that make up the posterior pelvis or the butt area. The major gluteal muscles are the gluteus maximus, medius and minimus.
The gluteus maximus muscle is a hip extensor muscle which pulls the leg back and propels the body forward during the gait cycle. It is the biggest strongest propulsion muscle in the body.
The gluteus medius and gluteus minimus muscles are hip abductor muscles that pull the leg up to the side. They are also extremely important stabilization muscles that keep the pelvis and the trunk stable during the gait cycle when you are on one leg.
Biomechanical Dysfunction of the Gluteal Region
In my last post, we discussed the fact that human beings are designed to stand and walk and run and jump and hunt and gather. We are kinetic machines who should always be on the move. In modern day culture, instead of moving our bodies the way in which they were designed, all of us sit sit sit. We sit to go to school, to watch TV, to drive, to eat, to work at a computer and many of us sit all day at a desk for work.
Standing, walking and running all engage the gluteal and abdominal musculature and lengthen the hip flexor muscles (strong muscles on the front of the hip that help to pull the leg forward as you walk or run).
Sitting however, tightens and shortens the hip flexors and inhibits, or turns off, the gluteal and abdominal musculature.
The best way to understand this is to imagine that your gluteal muscles have gone on holidays….they are no longer doing their job.
Sherrington’s Law of Reciprocal Inhibition
This law of muscular contraction explains how the muscles in your body work in partnerships. When a muscle on one side of a joint (one partner) is contracted, the muscle on the opposite side of the joint (the other partner) is sent a neurological signal to relax or release.
For example, in the upper arm, the biceps muscle and the triceps muscle are partners. When the biceps muscle contracts, the triceps muscle relaxes and vice versa.
So, let’s apply this concept to your pelvis area. When you are seated for long periods of time (as all of us are), the hip flexor muscle on the front of the hip (iliopsoas muscle) is tightened and shortened or contracted and its partner which is the hip extensor muscle (gluteus maximus muscle) is relaxed or turned off.
Your butt muscles are on holidays.
This is a problem I see in almost every single patient regardless of their complaint and regardless of whether they are a sedentary person or an elite athlete!
So that’s the bad news, is there good news? Of course…you can wake up your gluteal region by stretching through the muscles that are tight and contracted as well as strengthening all of the weakened muscles that have been ‘turned off’.
I usually describe this process as ‘re-introducing your brain to your butt’.
By making this ‘re-introduction, you will alleviate the pain associated with Shin Splints as well as other leg and foot pains and you will also gain speed, strength and stability in your run as the gluteal muscles wake up to the job that they are meant to do.
Reactivating your Gluteal Musculature
The first exercises that patients usually focus on when they are making attempts to reactivate and strengthen their gluteal musculature are squats or lunges.
This is a mistake.
If you are struggling with Shin Splints, a huge biomechanical contributor (as described above) is a lack of stability at the pelvis or at the feet which translates to the lower leg muscles, making them work harder which ultimately leads to your painful stubborn shins.
Doing a squat or a lunge with an unstable pelvis or feet will only aggravate the problem further. Instead, gluteal strength needs to be achieved in positions that won’t compromise the leg and lead to further stress at the shins. Only once you have achieved strength and stability gains with the more supported exercises is it appropriate to move on to squats and lunges.
Exercises To Strengthen and Stabilize your Gluteal Musculature
The first exercise I give to my patients is to squeeze their butt muscles or make an isometric contraction (an increase in muscular tension without a change in muscle length) of their glutes in various positions as they go about their day.
Hold the squeeze for 5-10 seconds for a set of 10 while sitting at a red light or standing in a line. If you can make this voluntary connection in a static position, then the contraction will be more likely to be there for you during functional movements like running.
You can start this isometric squeeze of your butt muscles exercise right away, even if you are in a Shin Splint or other repetitive strain injury crisis. You may then want to ease into the other exercises for your glutes as the pain in your shins begins to subside.
The reintroductory squeeze is enough to start with for now. We shall cover some more gluteal stabilization exercises in a future post.
So, What does your Butt have to do with it?
The kinetic chain (anatomy train) that goes from the ground at your feet, up through your ankle, knee and hip and into your core is vital in terms of stability for every person, especially during running gait.
One way to stabilize the foundation of this chain is by choosing proper footwear. Now we know that there should be equal importance placed on the stability and function of the pelvis and the core….and in particular, the gluteal musculature.
If the feet and the pelvis are both strong and stable, all of the musculature in between will be less likely to be injured as it won’t have to work as hard to try and make up for a lack of stability.
Remember that your Gluteus Maximus is your biggest strongest propulsion muscle. The Gluteus Medius is one of your most important muscles for maintaining stability while on one leg. If these muscles function as they should, you will move your body further and faster with more ease and most importantly with less injuries including repetitive strain injuries like Shin Splints.
My patients that have had the most stubborn, resistant cases of Shin Splints or other repetitive strain injuries of the legs who had tried every treatment that they could find only got the relief they needed when they added their core/gluteal strength into the equation and focused on getting stronger and more stable.
So begin right this minute by re-introducing your brain to your butt and start squeezing those glutes!!
Dr. Peggy Malone is a Chiropractor and an Athlete who helps other athletes to overcome injury and get back to their sport. She also inspires patients from all walks of life to take control of their health to be as happy and as healthy as they can be.
A former varsity Basketball and Rugby player, she has since entered the world of endurance athletics where she has completed 2 Ironman Triathlons, 3 Marathons, several Half Marathons and many other Triathlons, Road Races and Off-Road Adventure races of varying distances.
Her own athletic endeavors and injuries have given her valuable insight into working with athletes in her practice for both the care of injuries as well as for the improvement of athletic performance.