Glute Myths That Keep You Weak

[0:00] Today we’re tackling the most misunderstood muscles in your entire body: your glutes. Have you ever been told that your butt’s asleep? Or maybe that you’ve got gluteal amnesia? Yeah. Well, it turns out that your butt didn’t forget — it just got blamed for everything. Kathy: We’re busting myths, explaining the real science, and yes, showing you how to wake that booty up. No donkey kicks required. Jason: All right, this is the PTCH. What happens when a chiropractor and a physical therapist get together to make a health and wellness podcast?

[0:30] Kathy: But chiropractors and physical therapists don’t like each other. Jason: Oh, think again. Kathy: I’m Dr. Kathy Lynch, physical therapist who likes to help people move and get stronger. Jason: I’m Dr. Jason Young, an evidence-based chiropractor who uses humor just as much as adjustments to help people get better. Kathy: Welcome to the PTCH Podcast. Jason: Remember, there’s no I in PTCH. Jason: Okay, welcome back. Welcome back. Kathy: Here we are. Jason: Welcome, Kath. Kathy: Hey. Jason: Yes. What a — what a great episode that we have planned today, right? Highly anticipated. Just want to

[1:00] remind everybody this is a family podcast. So even though it’s called Booty Call, it’s safe for children to watch this. It could even be educational. Kathy: Yeah, we’re just calling your booty to wake up. Jason: That’s right. Get that booty up. So Kathy: I just want to point out really quickly my t-shirt that I was gifted here. Very nice. Jason: So yes, this is a — I think it’s a phoenix. I believe this is from the Harvard of chiropractic schools, the University of Western States. Kathy: I have heard of that place.

[1:30] Jason: There it is. So that’s my alma mater. I was gifted this shirt. So thank you very much to Lily and Alex. You know who you are. So Kathy: well, I gifted my t-shirt to myself. Jason: Hey, there we go. From Encore Physical Therapy. Kathy: I hear that the physical therapy is so good that you’re going to want more. Jason: Very good. I love it. All right. Well, as a chiropractor and a physical therapist, we need to talk about a subject that is very near and dear to our butts.

[2:04] Kathy: No, today we’re talking about glutes, right? Jason: Are we going to be able to get through this episode without just dying? Kathy: Probably not. Probably not. And that’s okay, right? Let’s give the people what they need to hear. Jason: Okay, Kathy. Kathy: tell us about the glutes, because whenever I think some people think about it, they’re thinking butts are just fat and it’s just — yeah. So Jason: tell me about butt. Kathy: See, are we in middle school?

[2:34] Jason: Not anymore. Kathy: Okay. The glutes. And we call them the glutes because there’s three of them. Jason: Okay. Yes. Yes. Not just the glute. No, Kathy: the glutes. Jason: The glutes. Kathy: And they’re actually some of the most powerful muscles in your body. You got your glute maximus. Jason: Yes. Kathy: Which is the glute that’s kind of right at your back pocket of your jeans. Jason: Right. Those are the big ones. Kathy: Those are the big dogs. Jason: The gluteus maximus. Kathy: The maximus. Jason: Which would have been my gladiator name.

[3:06] Kathy: Yes. Jason: Yeah. Could you imagine how it would be if your life was ended by somebody named Gluteus Maximus? Gluteus maximus. Kathy: Well, if I’m going to die, it’d be to the gluteus maximus. Jason: All right. Kathy: And then you got the gluteus medius and the gluteus minimus. Jason: Okay. Kathy: And I call them the side glutes. Jason: Yes. Kathy: Because they are on the side of your hips. Jason: Okay. Kathy: Yeah. No disrespect to them. Jason: No. Kathy: ‘Cause they’re not like a side chick. Jason: No. Kathy: It’s like a side glute. Right.

[3:36] Jason: Right. Right. They’re critical. They are critical muscles. The medius and the minimus. Okay. I feel bad for the minimus. Kathy: Well, they’re named just based on size, but they’re still important. Jason: Try living without a gluteus minimus. Kathy: Yeah. Try it. Jason: Try it. Kathy: Mm-hm. Jason: Yeah. Kathy: Okay. So Jason: what do they do? Kathy: Okay. Jason: Like what are they for? Kathy: So let’s talk about the glute max. Jason: We already spoke about the donkey kick.

[4:06] Kathy: Yes. So if you are a donkey or you want to do a donkey kick, that’s what your glute max does. Jason: Okay. So that’s that straight back — Kathy: kicks your leg back. Jason: So it’s going to propel you uphill. Kathy: Mm-hm. Jason: On that treadmill. Kathy: Okay. Jason: Upstairs. Yes. Kathy: It’s the powerful one that’s pushing you Jason: up the stairs. Kathy: It is. Jason: Okay. Um, and so I think that people — do you ever get people who come in and they’re like they don’t know the

[4:36] difference between flexion and extension? Kathy: Oh, absolutely. Jason: Right. And they’ll point at their glutes and be like, “I think there’s a problem with my hip flexors.” Right. And Kathy: hip flexors apparently, according to some people, are literally everywhere on your body. Right. Oh, my hip flexor. Um, so glutes do hip extension. That’s the movement that you’re talking about. Jason: Yeah. Good clarification. If I’m bending my knee forward, that’s flexion. If I’m going the opposite direction — which I can’t, ‘cause I’m sitting in this chair — that’s extension. Kathy: And I’ve seen your hip extension.

[5:06] Jason: Yes. Kathy: And you can’t actually. Jason: I’m legendary. Kathy: No. Hey, there are things that you have to sacrifice if you’re going to be the sit-and-reach champion, which is flexion. Jason: That’s right. Kathy: Maybe sometimes you got to sacrifice a little bit of extension. Jason: Extension. Yeah. Kathy: Okay. You go ahead and talk about the medius and the minimus. Jason: May I? All right, here we go. So the gluteus medius — also known as the side glutes. So if the maximus does extension, the medius

[5:36] actually does more of the side-to-side. So if you’re thinking about somebody’s pelvis, the medius goes kind of along the sides, comes into your IT band — your iliotibial band — that goes all the way down the side of your leg, tucks under your knee, and those muscles’ main job is to stabilize your pelvis. Now, the gluteus minimus in particular is a stabilizer. The gluteus medius is kind of a hybrid, right? Because it does a little bit of

[6:06] extension. It does something called abduction, where you’re moving your leg away from the midline, but one of its main jobs is to stabilize the pelvis. So if you’re walking, right, and you want to — you got a little shake with those fries. Exactly. Right. Yeah. So if you have some shake with those fries, it’s probably because your glute medius is not stabilized very well. Correct. Yes. That might be one of the reasons. Thank you for helping me keep it appropriate

[6:37] here today. Yeah. So that’s the main thing that the medius and minimus do — some pelvic control and posture. And we’ll talk a little bit later about hip rotation. Yes. And why it’s critical to have those muscles strong. Okay. Yeah. Yeah. So I think it’s pretty safe to say that glutes, whether we realize it or not — and most people aren’t thinking about this all day — they’re involved in just about every movement. Whether it’s walking or

[7:09] lifting, even throwing. You know, if you’re an athlete and you’re going to throw a ball, or you’re going to swing a bat or anything like that, your glutes are going to be involved. Mhm. So they’re important to know about, but nobody wants to talk about it because, you know, booty booty booty. So I think this is probably a good time to get into some of the myths, because Kathy, what are some of the things — like you have clients who come in and maybe they’ve seen

[7:41] another professional? It could be that they’ve seen another physical therapist or personal trainer, or, you know, if they’re really lucky, they’ve seen like a YouTube influencer or an Instagram influencer, and these people have told them some things about their glutes. Uh, what are some of the things that you hear? My glutes have turned off. Yes. The glutes — ladies and gentlemen, the glutes have left the building, right? They’re off. Or I’ve even

[8:11] heard the term in some continuing education things where they talk about gluteal amnesia. Yes. To make it sound more mysterious or formal. I don’t know. Right. Well, I — so I think that kind of — well, and I guess we should get to the other ones, like dead butt. Dead butt. Yeah. Or like glute inhibition. Yes. And I think that I think all these things are well-meaning because they’re trying to describe a real

[8:42] phenomenon. Mhm. But the problem is that we get taught about these things in continuing education conferences and stuff, and so we’re given some of these terms like gluteal amnesia, and it’s a way for us as providers to think about — or like some shorthand for — okay, this is the stuff that we need to get going. But then we make the mistake of saying that to patients. Yes. Yes. Words hurt. They do. Right. And I’ve never had the experience of being on the receiving end of

[9:15] being on the receiving end of a gluteal amnesia diagnosis, or anything like that, just because I hadn’t heard about that until I became a provider. But I don’t know — do you think it’s helpful to patients? Do you think it confuses them? Loaded question. Yeah. Um, you know, the hard part when you’re educating patients is you’ve got to be

[9:45] careful about them latching on to certain things. You’ve got to be careful about them believing you — believing, right? Yes. So I feel like sometimes saying those things — dead butt syndrome, gluteal amnesia, your glutes are turned off — they can use it as an excuse for things. But at the same time, sometimes it is a message, basically to get them to do their exercises. Yeah. Like, your glutes are so turned off you might not walk out of here.

[10:17] Yeah. Yeah. Totally. So how does that show up? Like, what do you mean by people latching on to it? Yeah. They believe that their glutes are turned off, and therefore sometimes that becomes kind of a mental block to them getting better, right? Like, “I just can’t get my glutes to turn on,” and they’re trying to feel them turn on. Believe me, if your glutes are turned off —

[10:47] Yeah. you’ve got bigger problems right? Than coming to PT. You’re — you’re a puddle. Yeah. No more stairs, no more hills. No, you’re not getting out of bed. Right. Absolutely. Yeah. Yeah. Well, and I think that when we communicate with patients, one of the responsibilities we have is to not just identify things, but to let people know what it means, right, and what it could mean. So, by that, I’m talking about not everybody would take something

[11:18] like, “Hey, your glutes are off,” as a kind of a stepping stone forward, right? Some people take it as a reason to ask if you would fill out the handicap parking placard so that now they can get into the little mobile scooter at, you know, Fred Meyer and wheel themselves around the store. Right. And that’s one of the challenges

[11:48] whenever you’re communicating with people — the way that we talk about things can actually disable people. Absolutely. Yeah. There’s no doubt about that. So I think that, as far as I’ve seen, this is an area where providers can do so much more because we throw these terms out there and we don’t always tell people what it means. Right. Right. I’ve been guilty of this too. 100%. Like, whenever you told me that you wanted us to talk about this on the

[12:18] show — this was not my — no, I’m just kidding. No, but whenever we talked about this, the first thing that popped into mind was a specific patient that I had who — I think I even used the term — “Oh, bro, your glutes aren’t firing. They aren’t firing the way they should.” And he freaked out. He’s like, oh my gosh. He’s like, “Now all the problems I have in my life are clear. I know why, you know, Jenny Walker said no when I asked her to prom senior year,” you know,

[12:49] and ah, now I know why I can’t get a higher paying job. Just like it was just like — and I was like, “No, what have I — what have I done here? No, let’s walk that back.”

Kathy: So, actually, at first it wasn’t that obvious. What happened was he came back later and he had a different problem. He’s like, “Well, you know, last time I came in, you did tell me that my glutes don’t fire like they should, so I think this is this.” And I was like,

Jason: “What? Why did I say that?”

Kathy: Yeah, I said that. And just every time

[13:20] he’s come back, that’s been the thing. And I’m like, “Yeah, I created a freaking monster.”

Jason: Mhm.

Kathy: Yeah. I turned off his glutes maybe.

Jason: Yeah.

Kathy: By telling him his glutes.

Jason: I think he did.

Kathy: Gave him gluteal amnesia.

Jason: I wish we could be that powerful.

Kathy: Is there gluteal — is there gluteal Alzheimer’s, you think? Is it Alzheimer’s?

Jason: They just get old and they forget that they’re important.

Kathy: Yeah.

Jason: Yeah. You hit 13 and your glutes are turned off.

Kathy: Yep. All right. Well, maybe now is a good

[13:52] time for you to tell us what actually is this. Like, is it dangerous? Is it important? Like, what does it mean to have dead butt syndrome?

Jason: So, you know, usually when a therapist or chiropractor or, you know, personal trainer tells you that your glutes are turned off, perhaps what they’re saying

[14:23] is that they may not be as strong as they need to be. Perhaps they’re not activating in the proper sequence.

Kathy: Mhm.

Jason: Perhaps other muscles are taking over because your glutes are not that strong. So that’s pretty much what is probably going on at that point.

Kathy: Yeah. And

[14:54] well, let’s get to the muscle strength thing. So, I think in the context of physical therapy too, like I had a patient — I think yesterday — who came in and they told me, “I already did PT and it didn’t work,” which is one of your favorite phrases, right? And they told me that it didn’t work because they felt like they were already strong. They’re already strong enough, right?

Jason: That’s a really good point. And so,

[15:25] another term that kind of gets passed around where it’s like, oh yeah, we need to strengthen this, and people assume that maybe they don’t have strength. So, how does that kind of fit into the context of this? Like, what do you mean when you say that somebody’s glutes maybe aren’t strong?

Kathy: Mhm. And usually when I’m thinking about it, the glute max, the glute medius — the glute medius is notoriously weak on people.

Jason: Mhm.

Kathy: And that’s because — and I think about

[15:56] this, and I’ll actually talk to my patients about this — because as we reach adulthood, we don’t do a lot of lateral movement. We don’t move side to side. Everything we do is forward and back. And I think about Friends — the way Phoebe used to run. And I’ll actually show that to my patients, like if you run in a zigzag pattern like we used to do as kids. Yeah. Your glute medius is getting the workout, but as adults, we’re just very serious. I must

[16:28] walk in this straight line. I must back up in a straight line.

Jason: I shouldn’t move side to side.

Kathy: Yeah. Well, and that’s a good point. And there’s even a lot of these exercise systems —

Jason: Yeah.

Kathy: — and we’ve talked about this before — where people become sagittal warriors, right? Where they’re just moving forward and back. So, like CrossFit is one that’s like that.

Jason: Or even like running. If somebody is like, “Oh, yeah, I just love running. I just want to be a runner.” You know, it’s a very

[16:58] forward — back.

Kathy: Not even back. No, you’re right. Nobody’s like, “I’m going to go back pedaling. I’ll be back in 20 minutes. I’m just going to go back pedal with the dog.” Yeah, that’s a really good point.

Jason: Yeah. But there’s a lot of value in different types of movement. So, what would you recommend in terms of sports or exercises people could do — or just even activities? I guess it doesn’t even have to be sports — that would activate some of those lateral glute movements.

[17:29] Kathy: Pickleball.

Jason: Pickleball’s a good one, right? You got to move side to side. Tennis.

Kathy: Pickleball, obviously. Basketball.

Jason: Yes.

Kathy: You know, be careful of those Achilles,

Jason: right? I mean, there’s all kinds of perils out there, right?

Kathy: There is. Well, and like I think about dancing.

Jason: Yes.

Kathy: You know, I think that dancing is underrated as a form of physical activity, everything. Again, as we get older, we do less dancing.

Jason: More dancing. More dancing, everybody. Please.

Kathy: Doctor’s orders.

Jason: Doctor’s orders. Yes. Turn on

[17:59] the electric slide.

Kathy: Salt-N-Pepa.

Jason: Yeah, you know, just — yeah. Go country line dancing, I guess. Absolutely.

Kathy: If that’s how you’re wired,

Jason: shout out to country line dancing.

Kathy: Or I think even there’s things like jiu-jitsu, you know, there’s a lot of activities that require really good hip mobility and, so yeah, get out there doing those things.

Jason: Yeah.

Kathy: And obviously I have, you know, bunches of exercises

[18:30] in my head

Jason: that would fire the glutes.

Kathy: Yeah. Well, and there are some that are even kind of fun, you know. What are some of the exercises that people usually associate with? Like, oh no, I’ve got weak booty disease. And maybe they’re just being a little too basic about it. Like there’s one that comes to mind right away.

Jason: Yeah.

Kathy: And it’s squats, right?

Jason: So everybody’s like, “Oh, do some squats. Do some squats.” If you’re a physical therapist, you’re thinking what? Bridges. Is that what you’re thinking?

Kathy: That was my first thought.

[19:00] Like, we’re going to bridge — basic basics, right?

Jason: But let’s talk about how —

Kathy: at home?

Jason: How do you find out if you have dead butt syndrome?

Kathy: Dead butt syndrome. Right.

Jason: And hey, try this at home.

Kathy: Yeah. Right. So, I’m actually thinking about the donkey kick.

Jason: Yeah. Okay.

Kathy: Get on your hands and knees.

Jason: Okay.

Kathy: And then you lift one leg up behind you with your knee bent.

Jason: Mhm. Okay. And then you raise your heel

[19:31] towards the ceiling. Jason: Yeah. Kathy: How many of those can you do before your leg gets too tired? Jason: Yeah. I’m thinking about it. My legs are now tired. Kathy: Yeah. I mean, that’s your glute max. Jason: Yeah. Kathy: Right. Jason: Yeah. And I think that’s a really good one. I even tell people sometimes — Kathy: Well, and you could do it like from hands and knees. Another one that I think is a little more telling, because sometimes from the hands and knees you can kind of get a little momentum. Jason: A really good point. Kathy: So, sometimes I tell people just lie

[20:01] flat on the floor so they’re down prone. Bend your knee and try and lift and put your shoe up on the ceiling. You’re not going to do it. Okay. Jason: Unless you got weird legs, and then I’m not talking to you. Kathy: Yeah. If you extend through your back, you have to see a professional, Jason: right? Kathy: Shameless plug. So, I think if you — and what I tell people is you should be able to lift that shoe up towards the ceiling Jason: and then you should be able to like slide a tennis ball underneath your

[20:32] underneath your knee. Jason: Yeah. Kathy: And that will tell you that you have the beginning of good glute activation. Jason: Yeah. And then the other piece of that too is when you do that, whether it’s a donkey kick or you’re just kind of doing that shoe on the ceiling exercise, what’s happening in your glute? Is that thing shaking? Kathy: Right? Jason: Because if it’s shaking, that means that you got some training to do. Kathy: Or are you feeling that in your butt or are you feeling it in the back of your leg? Are you using your hamstring?

[21:03] Jason: Oh, yes. Yes. Or your lower back. Right. Is this causing you a spasm or a cramp? So any of those things I think are good indicators that somebody has some weakness. And — Kathy: well, let’s not call it weakness. Let’s talk about opportunity for improvement. Jason: Opportunity for — Kathy: because some people are just comfortable with weakness. They’re like, “Yeah, Jason: I’m weak. I’m weak. Kathy: Yes, Jason: I’m weak. Kathy: Weak.” Jason: Get me the scooter at the grocery store. Not to belittle anybody who needs the scooter, but

[21:33] but there’s some people that — I mean I just bring that up because there’s some people who are stealing those scooters, Kathy: you know, when you need it. Jason: Yeah. Well, when somebody who legitimately needs it needs it Kathy: and there’s somebody who’s been told that their booty’s asleep that’s driving around — and driving around in that thing is actually making the problem worse rather than — Jason: because Kathy: Yeah. Because how is it caused? It’s caused by doing what we’re doing right now. Jason: Sitting. Kathy: Yeah. So, Jason: yeah. Kathy: And it’s not like a little bit of

[22:03] sitting, but we’re talking a lot of sitting. Jason: Yeah. So, and in our society, that’s what we do. We have a lot of jobs. We’re sitting in front of a computer, and that’s just the way life is these days, right? And so, a couple things happen. Your hip flexors, which are actually on the front of your hips. Kathy: Yes. Jason: They’re not up here. Kathy: We’ve identified. Jason: Okay. They can get shortened. Kathy: Mhm. Jason: And when you’re sitting in flexion like we do, your glutes can get lengthened and

[22:36] weak. Kathy: Yeah. They get stretched out. Jason: Yep. Yeah. Well, and like what I like to demonstrate to people if they’re wondering about why does it matter if my muscles are lengthened? When people do that curl exercise, right, with the bar, people will start down here. Kathy: Yeah. Jason: They do that first rep and they never come all the way back. They can’t get it all the way back. Kathy: Yeah. Because it’s just like this is not easy, right? So they come up here and then they come halfway, right? Jason: For those of us not watching — Kathy: Oh, Jason: Jason is showing the bicep curl.

[23:07] Kathy: Yeah, the bicep curl. And they’re not starting all the way down by their pockets. Jason: No, they get about maybe 7/8 of the way down. And the reason is because we have more power there. Kathy: Yes. If we brought it all the way to the bottom of that, that’s a weak position for that muscle because it’s at full length. And so when we have muscles that are lengthened, like all the way out, then that’s typically a weaker starting point. Now, the irony about that is sometimes if a muscle becomes shortened

[23:37] too, it can also become very weak. Jason: Yeah, that’s typically not the case with glutes. Like, oh no, for my work, I’ve just been sitting there with my glutes extended the whole time. Kathy: Yeah, that’s how you get fired. Jason: People — Kathy: you’re freaking everybody out in the break room. Jason: So, oh my gosh. So, other ways that somebody might be able to identify if they’re experiencing

[24:07] some glute weakness. Kathy: Yeah. So, let’s talk about the glute medius. And this is one of my favorite tests to do for people. So you lay on your side. Jason: Mhm. Kathy: And your legs — your bottom leg on the floor. I usually let them bend their knee. The bottom leg, and then the top leg is straight. So your knee is straight, and bring your heel back a little bit behind your butt, behind your glutes. With a straight leg. And then from there, you’re going to raise and lower that leg.

[24:38] Jason: Yeah. So it’s kind of like a leg lift. Kathy: It is like a Suzanne Somers leg lift, but it’s very important that you keep that heel kind of behind your butt when you do it, because otherwise another muscle, the TFL, will substitute. And I see a lot of people who will bring their leg forward, they’ll roll their hips forward because they want to use the TFL to actually lift the leg versus the glute medius, right? So TFL — can we just mention that is such a fun muscle name, the tensor

[25:08] fasciae latae. It sounds delicious. Kathy: It does actually. Jason: And typically if you poke somebody, if you’re like poking around the hip, the TFL — when you get to it, it usually is like it’s kind of sore and it tickles Kathy: because it’s like you never even think about poking there. But Jason: yeah. Kathy: Okay. So, just to clarify, because I think that maybe this might be kind of difficult to visualize, you’re laying there on your side. So, like I don’t want — I want to make sure the leg that I’m lifting, that my knee isn’t coming up towards my chest. I

[25:38] want to move it the other direction. Jason: Yes. Kathy: Kick it back behind you. Jason: Kick it back behind you. Kathy: Keeping the knee straight. Jason: Yes. And so if anybody’s ever wondered, what does a glute medius feel like? They’re about to find out. Kathy: They’re about to feel that. Jason: Mhm. Kathy: And same kind of principles too, like you want to be able to lift it. If you’re lifting it and that thing is shaking. Jason: Yeah. Kathy: Not weakness, opportunity for improvement. Jason: Absolutely. Opportunity for improvement. Kathy: Definitely. And why is that important? Right. Why is the glute medius important? Why are side glutes important? Oh, well, shoot. I I

[26:11] could — I could get into this. Jason: I could rant. Kathy: Yeah, they’re important because this is like part of the reason I have a job. Well, I think it’s important because these muscles — you already mentioned that they’re some of the biggest and strongest muscles that we have. And so they are what we would call like a prime mover or a prime stabilizer. So by “prime” I mean that is their primary job. All the other muscles around there are secondary. They’re there to help.

[26:41] Jason: Mhm. Kathy: And so whenever you get your prime movers that, you know, are taking the day off, or they’re not strong — or I think another way that we could look at this besides just strength is coordination. Jason: Yeah. Kathy: Because they’re big muscles. They’ve got a huge cross-section of muscle fibers. Like, most people have — the muscles are big enough and strong enough. I’m just going to backtrack a little bit. Jason: Yeah. Kathy: Because when people think about muscle strength, typically what

[27:11] they’re thinking about is muscle size. Jason: Yeah. Kathy: Right. I want big muscles. Big muscles means that I’m strong. That’s not exactly the story with muscles. So you have a certain number of muscle fibers, and when you go and you do a contraction of that muscle, not all those muscle fibers fire. How many of those muscle fibers fire depends on your nerves, and in some part it depends upon the nutrition there. So do you have enough

[27:41] of the electrolytes and things like that that you need in order to get those muscles to contract. So the first part of strength training is actually neuromuscular. So we are learning to recruit more muscle fibers into a movement by getting the nerves to fire off more of those things. So when people are at the beginning stages of strength training, that’s most of the work that they’re doing is getting more fibers involved,

[28:11] not necessarily building. So when people have the strength, they have the tissue, they have the parts, they just need to be able to turn on the power to it, right? And that’s one of the nice things with training is when you’re training, you’re firing those fibers. And so you’re just kind of waking up — but you already have. That’s why people are saying that the glutes are asleep. Jason: Okay. All right. Got it. See, and this is why we come up with terms like it’s asleep. Kathy: Yes. Jason: It’s not really asleep, but I think

[28:42] hopefully that’s a clearer picture of what we’re trying to accomplish. Now, you asked me a question. I don’t remember what it was. Oh — Kathy: why are the glute medii important? Jason: Yeah. Yeah. Yeah. Yeah. Yeah. Yeah, because well, you start developing other problems whenever you are not firing enough of those muscle fibers, or when you’re not coordinated about how you fire it. So, for example, while you’re walking — and we talked about like kind of shaking your hips — there’s something called a Trendelenburg sign. Kathy: Mhm.

[29:13] Jason: Now, the Trendelenburg sign is if you stand on one leg and the leg that you’re standing on kind of juts out to the side — like you can’t stay straight up and down, but like you shoot out your hip like you’re sexy. Kathy: Okay. Jason: Bam. Right. You stand on the one leg and pop, right? And then all of a sudden, like, people are offering to buy you lunch or something like that. That’s called a Trendelenburg sign. And it’s a sign that your glute medius is not coordinated — we’ll say not coordinated, there’s an opportunity to train and get stronger. Kathy: Um, and sometimes people will have this on just one side,

[29:43] right? So if you’ve got a bum hip, stand on that one leg. Jason: Mhm. Kathy: And see what happens with your hip. Does it jut out to the side, right? If that’s the case, then it’s time to train those glute medii. Jason: Yeah. Are you able to keep your hips level when you stand on one leg? That’s another way. And you know the glute medius in my daily life is important too because it controls the

[30:16] femur, which is your leg bone. Kathy: Yes. Jason: Which is connected to your knee bone — Kathy: which is the knee bone. Jason: Okay. I wanted to do a song. Kathy: So you know, a lot of people that have knee pain — the reason they have knee pain is because they have gluteal amnesia. Jason: Yes. Oh no. Here we go again. Yeah. Kathy: No, but seriously, yeah, usually when people come in and they have knee pain, you know, I’m looking at two

[30:47] things. I’m looking at the ankle. Obviously, I’m looking at the knee, but we were taught in PT school that the knee is just the victim between the ankle and the hip. Jason: Oh jeez, that’s a cool way of thinking about it. Kathy: I know. Jason: Yeah. I’ve got knee victimology and gluteal amnesia. Kathy: I like that though. Yeah, it’s true. So a lot of times it’s the — I’ll see that there’s a weak glute medius, or you know, glute max,

[31:19] but usually glute medius, and then we just try to get that. The other thing — as you were talking I was thinking about — “waking it up” is a better way to say it — is kind of: is it neurally available? Jason: Oh, I like that. Kathy: Yeah. Yes. Jason: Yeah. So when I need it, is it available? Kathy: Is it available to me? Yeah. Can my brain — do I have a pathway from my brain to my glute medius? Jason: Well, maybe not because I don’t go sideways anymore,

[31:49] Kathy: Right. You know, so maybe that’s the part why the glute is asleep. The brain’s sleeping on the glute.

Jason: Well, and so I’m saying this as somebody who has problems with mine, right? So I’ve got this bum hip. It bothers me and I frequently will notice that my glute medius is not available. Right? And the less available it is, the more other problems I have. So like I’ll get some hip pain. Like I’ll start to get some popping in my knee like when I’m just walking.

[32:19] My knee doesn’t hurt. I got good knees and stuff like that. I’ll maybe get some cramping in my foot. And so I’m very aware of how that affects me all up and down the chain. Now, did you know that chiropractors — we see a lot of back pain?

Kathy: No.

Jason: Oh, yes. That’s how I’m, you know, feeding my kids and paying the mortgage — is back pain. And when glutes aren’t working like they should, that’s a major cause of back pain.

Kathy: Yeah. And because, although they’re

[32:52] trying to stabilize and move, help us walk and everything like that, they also have an important postural role too. So like when we’re thinking about the idea that these are hip extensors, what happens is if you were to turn off all the hip extensors in your body, your body would fold forward. Okay.

Jason: Yes. And so you don’t see that a lot outside of fentanyl culture.

Kathy: Okay, probably not the best thing to say

[33:22] in this episode, but it’s out there.

Jason: But, so you need something that’s going to help keep you up. And if your glutes are not neurologically available, then the things that are going to take their place are those secondary extensors. So that’s going to be the small muscles that are in your lower back.

Kathy: Yeah, and it’s going to be your hamstrings.

Jason: And so when you have people that have really tight hamstrings, one of the first places you got to look

[33:52] is what’s going on with their glutes. Because are those hamstrings being overworked trying to keep them from folding in half forward?

Kathy: Same thing with if you chronically have a really tight lower back.

Jason: Yeah.

Kathy: You got to think, is my lower back trying to do what my glutes are supposed to be doing?

Jason: Mhm. And so I think there’s a lot of people — well, let me get to a scientific study. This is a really good study. Oh, I should have written down the reference to it, but I just have the description written

[34:22] down. So it was a pretty large systematic review done in 2019. It looked at 24 different studies. Okay. And this involves over 2,000 people. So this is a pretty good size study. And there was some clear trends that came up in this review, and that said that people with lower back pain are more likely to have weaker glute muscles and also more trigger points or knots in the lower back and also the hamstring

[34:53] compared to people without back pain.

Kathy: Okay, which this might seem like, well, duh, right?

Jason: But also duh duh.

Kathy: So yeah, do you find that you have a bunch of knots and stuff like that in your lower back? Well, it could be because your glutes need some more training.

Jason: You mean not the core?

Kathy: No, not just the core, right? So it’s a really good place to start if you have some chronic lower back pain to work on the glutes. And it’s a really good place from the

[35:23] standpoint of it’s free, right? So, oh my gosh, I had a patient today who came in — this is like a total tangent, but

Kathy: okay.

Jason: Came limping into my clinic, right? With a hip problem. And then said to me, “Well, I see that every time I come in, it’s just like cha-ching, cha-ching, cha-ching.” I was like, what?

Kathy: Okay.

[35:53] Jason: So, yeah — “I see that you’re just getting paid a bunch of money every time I come in here.”

Kathy: Oh, yeah. That’s how it works.

Jason: And I was like, “Did you think I was doing this for free?” He’s like, “Well, no, but it’s like, wow.” And I was like, “Oh my goodness.” So he has one of the worst paying insurances that you could have. You probably know which one I’m thinking of. And so, man, it just like — it hurt my feelings. So I was like, “Dude, you came hobbling in here.” So for guys like that, if you don’t want me to make any money,

[36:23] just train your glutes.

Kathy: There you go. It’s a great place to start. Like if you — there’s some people that they just don’t want to get checked out. They don’t want any help. Help yourself. Start with glutes. I think it’s a good place. It’s why I tell people

Jason: body weight squats are magical, right? It’s a good way to start with that.

Kathy: Okay. All right. Is a really good place to start.

Jason: Yeah. Okay. I feel like I just went off on a rant there.

Kathy: You nailed it.

Jason: Okay.

Kathy: Yeah. So I remember you were saying before that you had some information

[36:55] about surface EMG studies.

Jason: Yes.

Kathy: So, first of all, what’s a surface EMG — or I don’t know if it was surface EMG, but an EMG study.

Jason: Yes. And that EMG — let me, I got the reference right here, so I want to give them a shout out.

Kathy: Shout out Paula.

Jason: This is from the Journal of Medicine and Science in Sports and Exercise.

Kathy: That sounds important.

[37:26] Jason: Collins et al. Gluteal muscle forces during hip-focused injury prevention and rehab exercises. Wow. It’s exactly what we’re talking about.

Kathy: What? It’s like they knew we were going to make this episode.

Jason: So if you’re looking to find the peak gluteal muscle force — the perfect exercise — so for the glute max, we are looking at the exercise that

[37:58] creates the peak glute max force. We’re looking at the split squat.

Kathy: Split squat.

Jason: Yes.

Kathy: Yep.

Jason: The — American split squat. The American and not the Romanian.

Kathy: The Bulgarian split squat.

Jason: That’s right.

Kathy: Man, some people have real feelings about that exercise. So, and that’s the one where —

Jason: So, are you talking about the split squat?

Kathy: Oh, just a regular split squat.

Jason: Yeah, the regular split squat. Rear — probably rear elevated.

Kathy: I’ve got one foot in front of the other

[38:28] Jason: foot and I’m just doing a squat, or do you want that back foot up on like a bench or table or something like that?

Kathy: Either way.

Jason: Okay.

Kathy: Yep.

Jason: Mhm.

Kathy: Mhm.

Jason: I agree. I think it’s a great exercise. I mean, at Helix Training, we can show you how to do a split squat.

Kathy: I think it’s one of the best places you can do one.

Jason: Yes.

Kathy: Shameless plug.

Jason: Yeah. Okay. So, I didn’t answer — what’s a surface EMG? Basically,

Kathy: they put electrodes onto muscles and then they measure the force through

[39:00] biofeedback.

Jason: Okay.

Kathy: Computers,

Jason: machines,

Kathy: machines, robots.

Jason: Yeah. They can measure how much the muscle is being activated during these exercises. So,

Kathy: okay. So, if you want to activate the glute medius, do you have a guess for this one?

Jason: Clamshells.

Kathy: I just say that because PTs love clamshells.

Jason: They do the clamshells. Okay.

[39:31] Actually, the side plank.

Kathy: Side plank? Oh, side plank.

Jason: Side plank. So — the leg — I would have guessed like a side lunge or something like that, but side plank is the one.

Kathy: Mhm.

Jason: Side plank with the leg that’s on the floor.

Kathy: Okay.

Jason: Not knee bent.

Kathy: Not knee bent.

Jason: You have your leg straight. You are kind of up on an elbow.

Kathy: Yep.

Jason: And you’re lifting your hip

Kathy: up off of the floor.

Jason: That’s right.

Kathy: So that you are like one big, like, 45-ish degree plank of human being.

Jason: Yes. And again, you got to be pushing

[40:02] your — you can’t be having all your weight on your arm.

Kathy: Yeah. You got to be pushing that leg into the floor to get the glute

Jason: to activate.

Kathy: Okay,

Jason: so that’s your glute medius. And then glute minimus. The best exercise for that is actually a single leg RDL, which is basically a single leg — you’re bending over. If you’re standing on one leg, you bend over at the hips.

Kathy: Yes.

Jason: Whether it’s weighted or not

[40:32] weighted, you’re going to get —

Kathy: touch your toe. Try to get down as low as you can. So, that actually comes in number three for the glute medius activation too.

Jason: Okay.

Kathy: Yeah. So those are your top three exercises for the three glutes as far as peak gluteal muscle forces, according to Collings et al.

Jason: Mhm. Well, I did a little bit of reading

Kathy: and I came across one more, and now this is going to be like apocryphal because I

[41:03] don’t have the reference.

Jason: Okay.

Kathy: And so, I also heard that hip thrusts —

Jason: Yo, hip thrusts are very good, too.

Kathy: Yeah,

Jason: hip thrust is on here.

Kathy: Let me see if I can see where the hip thrust is. It just wasn’t top, you know.

Jason: Because this is a family show, I’m going to explain what a hip thrust is while you look that up.

Kathy: Okay. So, with a hip thrust, you want to be horizontal. Like, I think ideally if you have your back on a bench — like the bench press bench — so you have your shoulder

[41:34] blades there,

Jason: feet are on the ground, you can dip your glutes down towards the ground, and then you are thrusting up so that you’re making kind of a tabletop, moving your hips up against gravity,

Kathy: towards the ceiling.

Jason: Yeah. You got to squeeze your booty meat in order to get it up there. And you can even do that with weight. So you can do it with a barbell on there. You can do it with some weight and you can really lift, and

[42:04] I think that’s another one that does a good job of activating the glutes.

Kathy: Yeah, that one came in number three for glute max activation.

Jason: Oh, right. Yes.

Kathy: The single leg RDL gets glute max. Single leg RDL is like top two for all three — for all three glutes.

Jason: Yeah.

Kathy: So, if I’m limited on time, that single leg RDL seems —

Jason: you’re going to knock it out. You’re going to get all three muscles.

Kathy: Love it. Okay.

Jason: Yeah.

Kathy: Cool. And then — yeah. So, I think the thing that’s great about

[42:34] glutes is they’re so useful. I think the number one principle is get off of them.

Jason: Get off of them.

Kathy: You’re suffocating them. Okay. That’s why they fall asleep.

Jason: That’s right.

Kathy: It’s like when your arm falls asleep and you lay on it.

Jason: Yeah. You’re squishing them to death,

Kathy: right? So, just get off of it first of all.

Jason: Blood flowing to them.

Kathy: And really, that’s huge. So, even if you’re going for a walk or doing jumping — like literally any exercise —

Jason: not compressing your glutes is really

[43:04] step one to having healthier glutes. And so, just to review, we talked about — sounds like the single leg

Kathy: RDL is a champ because it’s hitting all of them.

Jason: Hits them all.

Kathy: Doing some squats.

Jason: Yeah, squats are always great.

Kathy: Hip thrust.

Jason: Hip thrust.

Kathy: Side planks.

Jason: And

Kathy: then just anything that creates some lateral movement, too. So dancing, pickleball,

Jason: just all those kinds of things.

[43:36] And what are we promising the people here? That they’ll never have back pain again.

Kathy: I think that’s fair. Oh, no. Yeah. No, I’m just kidding.

Jason: No promises.

Kathy: No.

Jason: No. I think — I don’t think there’s any guarantees, but it’s just smart. If that’s where you find yourself, that’s a great place to start.

Kathy: Yeah.

Jason: So, especially if you don’t want your healthcare provider to get paid any money,

Kathy: right? Just listen to this free podcast.

Jason: Look at this. Cha-ching, cha-ching, right?

[44:06] Kathy: They actually paid you to treat me.

Jason: Yeah. So, well, we probably got to wrap up soon because the Rolls-Royce is coming to get me.

Kathy: Absolutely. Yeah. The driver — I don’t want to keep the driver waiting.

Jason: I don’t know what that is. I’ve never been able to — yeah.

Kathy: No, that was interesting.

Jason: Yeah. Maybe when I had a flat top I could, but anyway.

Kathy: You want to play a game?

Jason: Sure.

Kathy: Of course you want to play a game. All right. Let me get over to the game. Now, this is fun. I have play-tested — oh yes, I’ve play-tested. You’re surprised that we’re playing a game?

[44:37] Jason: I’m surprised. I don’t know what the game is. Kathy: You don’t know what the game is? I’ve play-tested this with several people, including my family. We’re going to call this game — we’re going to literally call this “Booty Call.” All right. Jason: So these are kind of trivia questions, but all the answers involve some sort of synonym for glutes. Kathy: Oh, man. Right. Like, can you think of, like — Jason: like “bud”? Okay. So there’s going to be

[45:08] a word in there for each of these. Okay. Jason: Mm-hm. Kathy: All right. And I’ve got several of these. If you get 12 points, then, you know, free teddy bears for somebody. I don’t know. We have to really come up with a good prize. Jason: Absolutely. Yeah. Okay. Wait till we get some swag, baby. Kathy: We’re working on it. Jason: Here we go. All right. So we’re going to start you out with an easy one. Ready? When you deliberately make fun of somebody, they are this — Jason: butthead.

[45:38] Kathy: The butt of the joke. Jason: The butt of the joke. Kathy: Yes. Okay. Jason: Oh, you’re seeing deep into my soul now. Kathy: All right. Pirates fight over this treasure. Jason: Oh, booty. Kathy: Booty. Yes. You might say this before taking a drink. Jason: Bottoms up. Kathy: Very good. Okay. Another name for the blacktop. Jason: It has to do with butt. Kathy: Asphalt.

[46:08] Jason: Oh — Kathy: “Ass”-fault. Jason: All right. Here’s a tricky one. Okay. This two-star flag officer in the Navy is the equivalent of a major general in other branches of the US military. Jason: Two-star — say that again. Two-star what? Kathy: This two-star flag officer in the Navy is the equivalent of a major general in other branches of the US military. Jason: Oh, the rear admiral. Kathy: Yes. Very good. Let’s go. That’s

[46:38] awesome. Jason: Very good. Okay. Kathy: This cut of meat is perfect for beef stew. Jason: The butt roast. Kathy: Rump roast. Yes. Very good. Okay, here’s a tricky one. Okay. If Sir Mix-a-Lot had written a screenplay for a 1985 movie about Marty McFly, it might have been titled this. Jason: Sir Mix-a-Lot. Oh, that’s one of my favorites now. I can’t think about it.

[47:09] I don’t know. You got to tell me that one. Kathy: “Baby Got Back to the Future.” Yes. Baby Got Back. Jason: Okay. This is where you might find a hot dog or a hamburger patty. Kathy: Buns. Jason: Buns. Yes. We’re gonna give that one to Scott. I needed that one. Kathy: How about this? This waist pouch, ironically, is often worn in the front instead of the back. Jason: Fanny pack. Kathy: Yes. Chipmunks are known for this distinctive feature on their faces. Jason: Butt cheeks.

[47:40] Kathy: We’ll accept cheeks. Jason: Cheeks. Kathy: This is the name of the last car in a train. Jason: Oh. The tail. The — Kathy: Caboose. Jason: There we go. Good. All right. Super Mario’s girlfriend, who is named for this fruit, which is also a color. Jason: You’re losing me here. Kathy: It’s the flavor of the drink I was drinking before the show. Jason: Peach. Yeah, Peach. Kathy: In the UK, they call this a boot. In the US, we call it this instead.

[48:10] Jason: Oh, the trunk. Kathy: Trunk. Yes. When you’re looking at your phone while driving, this is the kind of impact you’ll have with the car in front of you. Jason: Rear end. Kathy: Yes. Good. Your unemployed cousin who still lives in his mom’s basement might be called this. Jason: Did I say it already? Butthead. Kathy: No, a bum. Jason: A bum. Kathy: Let’s see. This cranium-to-cranium attack may be considered a dirty move in a fight. Jason: Headbutt. Kathy: Yes. This one’s from Taylor. This is how you might respond to an argument.

[48:41] Jason: But — Kathy: Rebuttal. Jason: Rebuttal. Oh, of course. From Taylor. Hey, I think you got at least one for me at least. Oh, okay. Yes, let’s have it. Jason: A football play made famous by the Philadelphia Eagles. Kathy: Oh, that would be the tush push. Jason: Yes. Very good. I like — I was trying to come up with one for “tush” and I couldn’t. That’s the one. Kathy: Wait, one — I got to throw one last one in there. This is related, but the illegal play in which the USC Trojans

[49:11] cheated against the Notre Dame Fighting Irish in a football game — and this is very close to the last question I asked, and it was named after one of their players because they pushed him into one of their running backs. This is just one of those cheating things Trojans do. Jason: Yeah. Oh, well, like I’m just trying to go through the list — the Bush push.

[49:43] Kathy: The Bush push. Oh, yes. Reggie Bush. Jason: Had there not been the Bush push, Kathy: there would not have been a national Jason: championship at USC — or there would have been one at Notre Dame. Kathy: That’s true. Jason: That’s true. Kathy: Yeah. Jason: You okay? Kathy: No. Jason: I’m not bitter. That was like — that was like 2005. I’m not bitter. It’s okay. Hey, we’re only great because sometimes we’re bitter about the right things. Oh, man. Well, this was

[50:13] great. This was a satisfying episode. Okay. Kathy: Not the longest one. Jason: Not the longest one. No, that was the one before this. Kathy: All right. So, takeaways. Yeah. Jason: What are we taking away from this? Kathy: Don’t blame the glutes for everything. And they’re not asleep. Jason: Yeah, they care. The glutes care. Kathy: They do care — care to be strengthened. Jason: Yeah. Well, I really appreciate — I like the way that you said about them being available,

[50:44] right? And that really is what it comes down to — is, are your glutes available? That sounds so bad. Kathy: Can the glutes come out? Jason: Gosh, I know. I just thought of, like, what if some teenage boy pulled up to my house and was like, “Sir, are the glutes available?” And it’s like, great, now I got to go find my shotgun. Kathy: Are Taylor’s glutes available? Jason: I hope Taylor — Kathy: Yeah. Oh my gosh. Taylor can handle

[51:14] herself. So I’d be like, you’re in trouble, bro. No. And I think just one of the most important things is to understand the role of the glutes Kathy: and just don’t blame them for everything. Like, do something about it, right? Yeah. Stop suffocating them. Get up off of them and do something, right? Jason: Okay. So I think that’s it. We’ve run out of things. We actually could talk a lot more about this. I think Kathy: definitely. Jason: it’s an important conversation to have. And if you have questions about

[51:46] Jason: Things like gluteal amnesia, maybe — maybe it’s other like weird diagnoses that you’ve gotten. Feel free to send that in. Like, leave a comment.

Kathy: You can email us somehow.

Jason: Like, you just got to like —

Kathy: You can’t email us, that’s for sure.

Jason: You can DM us.

Kathy: No, just DM us. Yeah, hit us on our Instagram. Hit us in our DMs.

Jason: Slide into our DMs.

Kathy: Yeah, exactly. But yes, we hope that you have enjoyed this episode where we talked about all things booty, and

[52:19] make sure to subscribe.

Jason: Yeah, definitely. To like us.

Kathy: To review us.

Jason: To share us with people.

Kathy: Share us with people who have butts.

Jason: Yeah.

Kathy: They might be interested.

Jason: You know, anybody with a butt.

Kathy: Yes, anybody with a butt or who needs a butt.

Jason: Yes, this would be — this would be a great, a great show for them. So, all right. I think we need to be done.

Kathy: Yeah, we’re done here.

Jason: Yes. Yes. We’re at the tail end of this episode.

[52:49] Kathy: You’re welcome.

Jason: The trailer.

Kathy: Yeah, the caboose. Yes. I got to nip this in the bud. No, that’s not a thing. It’s “nip it in the bud.” I hate it when people say “nip it in the butt.” What does that mean? Why are you nipping butts?

Jason: No, we’re nipping butts anyway.

Kathy: Anyway.

Jason: Oh, there’s one more thing that we got to get to, though.

Kathy: Really?

Jason: Yep.

Kathy: There’s no “I” in PTCH.

[53:25]