No nerve in foot -> poor glute activation. Help?

ClosetBayesian

I had foot surgery back in January - bunion repaired, big toe re-broken and pinned, and had a compressed nerve removed. The swelling around my big toe has finally gone down enough that the first part of the toe touches the ground most of the time when I'm standing still. Because the nerve is gone, I cannot feel toes 2 through 4. The little toe is fine. I probably overpronate on that foot, even with orthotics, if for no other reason than habit from the ten months of post-surgery swelling - that, and it's hard to force your weight to travel over your toes when you can't feel them.

Lately I've noticed some hamstring tightening on that side. When you walk normally, the glute engages in the last part of the stride, as you push off from the toes. Mine does not. My hamstring is all sorts of engaged, but not my glute. Hence the hamstring tightening/fatigue.

I have tried every exercise on Bret Contreras's website; even a plain ol' glute bridge will get my hamstring going. Single-leg exercises are right out - hamstring activation, every time, but no glute.

Ideas that do not involve the gym, anyone? I am working on consciously walking on those toes that I can't feel; even then, I can feel the glute engaging maybe 50% of the time. When I consciously try to contract that glute, sometimes I can get the glute to fire, sometimes the hamstring fires instead - I can't even consciously squeeze the correct muscle reliably. What can I do to engage that glute?

(No gym: I am trying to fit in 80+ hours of work per week into 55-ish hours per week at the office - we are hellaciously short staffed at work, and there is quite literally no one else who can do my job or the jobs of the multiple people we need to hire whose work has landed on my plate because I'm the only one who knows how to do those jobs. I am also four months away from defending my dissertation, and am woefully behind on that. As it is right now, I only see my youngest child for about an hour per day during the week - and sometimes not even that much - because there is only about an hour overlap between when he's awake and when I'm home. I completely and utterly refuse to compromise any more time with my family than I already am because of work being so chaotic. So no gym. /end rant)

healthynFitforLife

Have you tried doing standing leg lifts (specifically, lifting your leg 'backward' and slightly to the side while standing on the other leg, slightly bent)? It takes me about 30 reps or so to start feeling my glute engage but it works. Also, have you tried foam rolling your hamstring so that it loosens up a bit?

jemhh

Have you tried glute bridges with your heels dug in and toes up off the ground?

777Gemma888

Eeesh! I cannot imagine how you're feeling trying to mitigate your work schedule, Dissertation viva, your family and healing post surgery, which has only compounded matters for you.

My suggestions are:

1. Strength training - Lower abdominals and glutes focussed.
2. Deep tissue massage
3. Infra red light therapy
4. See a Sports Medicine Specialist to ascertain if you qualify for an ultrasound guided tetonomy for pinpoint treatment.

Good luck!

Elise4270

I had a glute activation problem up til a few weeks ago. Post surgery, long time problem. Bridges, donkey kicks, knee lifts, nothing helped.

The one thing that helped was standing on one leg on a balance pad for 30 seconds, alternating legs for 5 reps. Two fingers are allowed to hang on to something.

If you use a gym, they prob have a bosu that does the same thing. I bought a foam pad on EBay for half the retail price, 30$.

Good luck!

ClosetBayesian

Tried glute bridges; mediocre at best glute activation on the post-op side, but great hamstring activation. No time in my 55-hour+ workweek for PT/sports med, unfortunately; sounds lovely, though. Will try standing on one foot more - that did work a few months ago to get the medial gluteus going, but hasn't worked as well lately. I find I also have trouble lifting the opposite (non-surgery side) knee up much past waist level without manually pulling my leg up - probably some pelvic imbalance/instability going on, too.

777Gemma888

Oh wow! How about Isometric glutes and ab exercises?

Feel better soon!

canadianlbs

i've been trying to deal with a lazy left glute for a few weeks; may or may not be related to the fact that i broke that big toe in my teens and never have been able to raise it independently. i can manipulate small objects with the right one; on the left i can't even move the other toes independently of the big one, never mind one another.

so fwiw here are some of my own diy experiments and experiences (disclaimer: i'm not a physio and never even aspired to be one).

- hip circles are my hell and my go-to. i do 10 in each direction from quadruped position at least once a day, and i do them from a one-legged stand throughout the day too. i may be fooling myself, but i like the standing position better because you have to have some degree of hip stability for them or you fall over. so it's much harder for my body to compensate for stiff hips by passing the movement upchain into my pelvis.
- the theraband-around-knees thing has helped me. side stepping seems to force my glute medius into operation and the forward-backward walk does improve external rotation on my femurs.
- your psoas might be over-active on the weak side and contributing to the shut-down of that glute plus the corresponding psoas on the 'strong' side. you might want to look into dialling that down via massage, but be cautious. it's a hellishly sensitive muscle. the 'strong' side glute might be over-active as well.
- kelly starrett had a thing out there about using a lacrosse ball under the heel to release hamstrings. i don't like the guy much, but i seem to remember that that one was effective. i know hamstring isn't your problem, directly. but sometimes stunning an overactive muscle keeps it from barging in on work you're trying to get a different muscle to do.

in my case these may all just be fixing the symptoms instead of the cause, but they ahve been helpful anyway. in the meantime i'm trying to make sure i keep physical rom in those toes even if the muscles can't necessarily drive that themselves. i figure there's no point in making it so even if i did get the muscle/nerves back, they can't do their job because the joint itself has jammed up.

ClosetBayesian

Rear leg lifts engage my hamstring, not the glute; same with glute bridges- I feel the glute on one side, the hamstring n the other. I can activate the gluteus medius with clam exercises, but the muscle doesn't stay engaged when I go to do something else. I'm not great even at an isometric contraction - when I go to contract what I think is that glute, I just as frequently contract the part of my hamstring that is just below the glute, even after stretching/rolling that part of the hamstring beforehand. I have thera-bands on order; they should be here tomorrow.

Cherimoose

ClosetBayesian wrote: »

I have tried every exercise on Bret Contreras's website; even a plain ol' glute bridge will get my hamstring going.

When a muscle is overpowering another muscle, you have to first deactivate the overactive one, which is best done with frequent stretching. Frequent is the key, because the effects of stretching don't last long. Try a 30+ second hamstring stretch every 15 minutes. Do the same with hip flexors, especially if you sit a lot, since they counteract the glutes. Use a reminder app if you forget to stretch.

When you sit, try to keep your knees as straight as possible, since this stretches the hams.

To activate the glutes, simply stand up and squeeze your butt cheeks together. You should be able to palpate when they contract. Probably shouldn't do this in public.

Finally, walk in zero-heel shoes. Most shoes have a raised heel, which activates the hamstrings. It also worsens bunions, encourages overpronation, etc.