Question after physio visit

yesimpson

Hi, hopefully someone much wiser than me can help me out.

I'd had a sore hip for a few weeks so I went to visit a sports physio yesterday. I've seen her a few years ago for a old knee injury, which she helped me to sort out wonderfully. The physio said my sciatic nerve was being pinched, and that I had an overly tight illiopsoas muscle (hip flexor) probably caused by my glutes not activating correctly during exercise so the strain has to be borne somewhere else.

She encouraged the muscles clamping around the nerve to release by doing some pretty painful pressure point work, did a similar thing with my hip, then gave me some stretches to do to both lessen the discomfort and try to get the muscles to return to a more normal state of tension. I've got to do these for a month and return if the problem persists. I hope that all makes sense recounted second-hand. The physio said my hips were a bit tighter than she'd like and that generally I could do with some flexibility work.

Two questions.

1. Others who have running as their main sport or form of exercise, what do you do in terms of stretching or to improve mobility? I used to do Pilates but that's more for core strength I believe, would yoga be better?

2. How can I check my glutes are activating properly during resistance training, and everything else for that matter? When I squat/do hip thrusts etc., I try and focus on tightening my glutes to push upward and make the movement smooth rather than rushed, but obviously this approach isn't getting the job done. I don't want to let my butt cop out any more, especially if it risks injury and soreness.

bethberg12

I'm sure others might have answer for you, but honestly, these are great questions to ask her! My husband is a physical therapist, and he teaches this kind of stuff all the time.

Sam_I_Am77

yesimpson wrote: »

Two questions.

1. Others who have running as their main sport or form of exercise, what do you do in terms of stretching or to improve mobility? I used to do Pilates but that's more for core strength I believe, would yoga be better?

2. How can I check my glutes are activating properly during resistance training, and everything else for that matter? When I squat/do hip thrusts etc., I try and focus on tightening my glutes to push upward and make the movement smooth rather than rushed, but obviously this approach isn't getting the job done. I don't want to let my butt cop out any more, especially if it risks injury and soreness.

RE 1: Pilates in the traditional sense is definitely more about strength and core stabilization, but some have distorted what Mr. Pilates originally created. Yoga is definitely a good means of improving flexibility but definitely not the only way. Going through a good mobility workout everyday can help a lot. Look-up "Limber 11" by Joe DeFranco on YouTube. Also look-up Kelly Sterrit's channel, he's another expert on mobility.

RE 2: You don't feel like your glutes are engaging when you do squats? What about hip thrusts?

yesimpson

Sam_I_Am77 wrote: »

yesimpson wrote: »

Two questions.

1. Others who have running as their main sport or form of exercise, what do you do in terms of stretching or to improve mobility? I used to do Pilates but that's more for core strength I believe, would yoga be better?

2. How can I check my glutes are activating properly during resistance training, and everything else for that matter? When I squat/do hip thrusts etc., I try and focus on tightening my glutes to push upward and make the movement smooth rather than rushed, but obviously this approach isn't getting the job done. I don't want to let my butt cop out any more, especially if it risks injury and soreness.

RE 1: Pilates in the traditional sense is definitely more about strength and core stabilization, but some have distorted what Mr. Pilates originally created. Yoga is definitely a good means of improving flexibility but definitely not the only way. Going through a good mobility workout everyday can help a lot. Look-up "Limber 11" by Joe DeFranco on YouTube. Also look-up Kelly Sterrit's channel, he's another expert on mobility.

RE 2: You don't feel like your glutes are engaging when you do squats? What about hip thrusts?

Great for the video recommendations, thank you, I'll have a look at those.

Well, I thought they were engaging - I certainly seem to feel it in my glutes whilst doing both exercises, and I get DOMS there the day or so after. The shape of my butt has definitely improved since I started doing weighted lower body exercises, so I took that as reassurance I was doing a good job. But whilst doing some tests with me, the physio said my glute activation was poor, and that could have indirectly caused the hip flexor strain because the glutes aren't doing their share of the work. Now I'm not sure how else I'd know they were being properly activated.

@bethberg12 you are 100% right, I should've asked her, but these questions only popped up as I was driving home. I will phone her to ask or to schedule another appointment if necessary.

Sam_I_Am77

yesimpson wrote: »

But whilst doing some tests with me, the physio said my glute activation was poor, and that could have indirectly caused the hip flexor strain because the glutes aren't doing their share of the work. Now I'm not sure how else I'd know they were being properly activated.

I would definitely agree with your physio. If one muscle is lacking it can cause over compensation from another and lead to injury. You may want to avoid Squats for right now. A correct Squat heavily engages the Glutes through the ascent of the lift. If they're not engaging your quads and hips are doing more than they should.

Things that can help your glutes.
-Back Raises on a 45-degree bench
-Glute Bridges (really squeeze them glutes, do these as part of your warm-up before you start exercising. Heck, do a set of 12 every morning.
-Front Plank with Rear Hip Extension: Hold for time, shoot for 20-sec's, then 30, etc
-Lying Superman (done as an iso-hold): Hold for time
-Romanian Deadlift
**don't go down too far, get a good hamstring stretch and return
**engage your lats to keep the bar against your body, reduce lower back stress
**If you have lifting straps use them so you can focus on a good lift and not holding the bar

cheshirecatastrophe

For hip and glute strength and flexibility, I do the myrtl exercises:
http://www.njsportsmed.com/files/myrtl_routine.pdf

I was prescribed basically these by a PT for tight hips causing VERY VERY BAD illiotibial band syndrome. They worked tremendously well. I still do them today to help limit injury risk due to running all the miles.

ETA: I also do some cross-training on the elliptical without holding on--it works my core stabilizer muscles and my glutes.

yesimpson

Sam_I_Am77 wrote: »

yesimpson wrote: »

But whilst doing some tests with me, the physio said my glute activation was poor, and that could have indirectly caused the hip flexor strain because the glutes aren't doing their share of the work. Now I'm not sure how else I'd know they were being properly activated.

I would definitely agree with your physio. If one muscle is lacking it can cause over compensation from another and lead to injury. You may want to avoid Squats for right now. A correct Squat heavily engages the Glutes through the ascent of the lift. If they're not engaging your quads and hips are doing more than they should.

Things that can help your glutes.
-Back Raises on a 45-degree bench
-Glute Bridges (really squeeze them glutes, do these as part of your warm-up before you start exercising. Heck, do a set of 12 every morning.
-Front Plank with Rear Hip Extension: Hold for time, shoot for 20-sec's, then 30, etc
-Lying Superman (done as an iso-hold): Hold for time
-Romanian Deadlift
**don't go down too far, get a good hamstring stretch and return
**engage your lats to keep the bar against your body, reduce lower back stress
**If you have lifting straps use them so you can focus on a good lift and not holding the bar

I love squatting, but if taking a break is a good idea I definitely will. Thank you for that list - I'm familiar with most of those so I can make sure I'm doing them more regularly, then maybe in a month or so I should get somebody to check my squat form. Thank you.

yesimpson

cheshirecatastrophe wrote: »

For hip and glute strength and flexibility, I do the myrtl exercises:
http://www.njsportsmed.com/files/myrtl_routine.pdf

I was prescribed basically these by a PT for tight hips causing VERY VERY BAD illiotibial band syndrome. They worked tremendously well. I still do them today to help limit injury risk due to running all the miles.

ETA: I also do some cross-training on the elliptical without holding on--it works my core stabilizer muscles and my glutes.

I remember doing those myrtle exercises when I used to horse-ride! Thank you, they look great.

@chesirecatastrophe and @Sam_I_Am77 Final question I promise: is there a way I can know that my glutes are activating during these exercises, and not that my quads and hips are doing the work?

cheshirecatastrophe

Since glutes are your powerhouse muscle, they are "activating" whether you feel it or not. (Activation is a fancy way of saying "using.") I generally *feel* it much more in my hips since they are weaker, but they are not working alone. I guess on the kickbacks and on the elliptical I can feel it sort of in the sides of my butt.

yesimpson

OK, thank you - I do appreciate your help. Maybe I need to focus on these simpler glute exercises and take a few weeks off squats whilst my hip flexor heals.

Sam_I_Am77

For your first question, if you're talking about the squat; I think this may vary from person to person. If your squat mechanics are good you'll notice it when you sit back and you get to the bottom of the squat (aka the "hole"), you might feel a stretch in your glutes. If not, after a couple sets your should feel your glutes to be a little tight and / or swollen from the movement. As for the other exercises I mentioned above, there should be little question about feeling your glutes activate; you'll probably notice right away. If your glutes have been inactive then you will probably experience some soreness.

Taking 3 to 4 weeks off from squats would not be a bad idea. This will give you time to heal-up and work on your glutes and hamstring separately. It doesn't sound like you compete in squatting or powerlifting so a few weeks off isn't a bad thing.