Troubleshooting the Hips and Abs: Part 2

This post is a followup as we continue to investigate your trouble spots. Last time we focused on the abs or more specifically the problematic pooch below the belly button. This time we are looking at the hips and surrounding musculature, namely the glutes (or butt).

Heart Bottom SyndromeIf your biggest concern is an accumulation of fat, then you have to investigate your hormones. Like the pooch, If you are doing everything you should, but still are not getting the results you want, you have to look deeper and discover the internal hidden stressors.

What is most often seen or felt are glutes that are really soft (lack of muscular development) and often very flat (men and flatness are very common). Paul Chek calls this the Heart Bottom Syndrome (image Left).

What you should notice in a dysfunctional bottom is where the weight tends to accumulate, which is right below the waist not as much on the hips. The waist appears top-heavy, similar to an image of a heart. Compare that to the healthy functional glutes on the right. Do you see the difference in the images below?

Overweight Backsidefemale-sprinter-glute-shotDuring pregnancy or with the presence of low back pain the hips will stop working normally. There is a change in the center of gravity and the pelvis begins to rotate anteriorly (image your pelvis is a bowl of water and the water is being poured out the front).

With an anterior pelvic tilt, the hip is unable to fully extend so your legs can no longer move through a full range of motion. To compensate, your legs from the hips, externally rotate outward. Now, when you walk or run, what should be a sagittal plane movement (forward – backward) becomes more a frontal plane movement (side to side).

Pregnancy

This changes how the gluteal muscles act around the hip. When your legs are externally rotated, the large glute muscles (gluteus maximus), shortens and can’t fully extend the hips so it weakens and atrophies from disuse (the flattening).

On the other hand, the smaller muscle (gluteus medius) that rests just above your gluteus maximus start to overwork. Glute medius is primarily a pelvic stabilizer, keeping it level when you stand on one leg or transition from one leg to the other as in walking or running. The change in role for glute medius from stabilizer to prime mover causes it to become much stronger and bigger (hence the heart or top-heavy appearance of the backside).

At the same time this is happening, the lower back muscles become shorter and tighter.  This lifts the back of the pelvis up and pushes the front down further reinforcing the anterior pelvic tilt.

The rotation of the pelvis forward stretches your hamstrings (as the back of the pelvis lifts) and it will feel chronically tight. They feel tight because they are under so much tension, not because they are short. This is the worst time to do a lot, if not any hamstring stretching as you will only make the imbalances worse.

On its own, this is bad enough. But it gets better. The changes in pelvic position and related musculature/connective tissue alters abdominal or core function. The typical response is a lost of stability at the hips. While the pelvis orientation rotates the femur outward, when the hip is placed under load, such as walking, running or squatting/lunging, the instability allows the femur to then rotate inward or cave due to gravity. Essentially, the lower torso falls into a modified fatal position to stabilize itself.

The foot is planted in these movements so it does not move. Due to the femur rotating inward, all the torsional stress is then placed onto the knee. Very common side-effects, especially in women are non-impact ACL injuries, Chondramalacia and IT Band issues .

It gets even more fun. While the knee is caving, the ankle has no choice but to follow and rolls inward (pronates) and the arch will flatten (Plantar fasciitis). Consider all the runners that have chronic low back, hip, knee, ankle or foot problems. It suddenly begins making sense when you consider mechanics and length/tension imbalances.

Combining poor mechanics with repetitive movement patterns is a recipe for pain and injury regardless of your sport or level of daily activity.

What Can Be Done?

Keep in mind that if you have had a C-Section, lower back surgery or a hysterectomy, there is most likely some degree of scar tissue present that will impede progress. Corrective soft tissue work may be required to break up the scar tissue to allow for optimal recovery.

The function of your hips/glutes are intimately attached to the function of the Inner Unit. This is where you need to start, with a comprehensive assessment.

If you are not assessing you are guessing! 

The assessment will allow for a better understanding of which muscles are short/tight, which are long/loose and weak and which are on vacation not responding appropriately at all. Once the imbalances are known, then a plan can be created and implemented.

At its most basic, it is important to stretch the short/tight muscles (foam roll first) and also strengthen the long, loose and weak muscles.

Before making them stronger, you have to realize that these muscles have essentially been on vacation. You have to literally wake them up and reestablish a connection between the muscles and your brain.

Whatever you do, stay away from any machine, especially those that coddle you with padding, support and fixed movements. Machines get in the way as core stability is not required and core stability and function is the foundation for all movement.

Going over specific exercises in this article is challenging as each individual case is going to be different and each individual may require unique cueing and direction to reestablish the neuro-muscular connection. Most likely you will have to follow progressions allowing for individual variations:

  1. Floor Exercises (both supine – face up, prone – face down and horse-stance)
  2. Swiss Ball Body-Weight Work
  3. Kneeling / Half-Kneeling
  4. Standing – Both Feet
  5. Standing – Single Leg
  6. Standing – Unstable surfaces

You also need to train in different planes of motion including Sagittal (forward and backward), Frontal (side to side), Transverse (Rotational) and lastly multi-plane (combination of two or all planes). The multi-plane aspect is vital to gain long lasting results and reduce the risk of injury. Multi-plane movements are also why machines are practically worthless; they do not require stabilization from the Inner Unit, and restrict you to single plane movement patterns typically sagittal. Machines train unnatural movement patterns and do not cross over into day to day activities. This also applies to most cardiovascular exercise machines such as Ellipticals.

The result of an appropriate training program is that you become proficient not only in the Primal Patterns® (Squat, Lunge, Bend, Twist, Push, Pull and Gait) but also in the complex movements that are required at home, at work and on the field.

If you execute an appropriate exercise program and reduce stressors, especially correcting internal dysfunction, there is no reason why you can’t or should not have a strong, tight and flat abdominal wall with tight shapely glutes/hips. As an added bonus, correcting hidden internal stressors will greatly enhance overall health. The only real question is how bad do you want it and what are you willing to do for it?

I hope this information answered more question than it created. If you do have specific questions, don’t hesitate to contact me.

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