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Optimal gluteal activation and muscle symmetry are paramount to proper hip function. When the hip muscles do not work the way we need them to, there will be increased spinal motion and potential back problems. For example, many of our back-pain clients are unable to stand on one leg and flex their opposite knee past 90 degrees without leaning forward. In these cases, the body has borrowed the necessary motion from the lumbar spine because it's not getting it at the hip. Much of the client's pain results from low-back hypermobility and the accompanying microtraumatic tissue injury that takes place during daily forward-bending tasks. Damage occurs as lumbar ligaments, discs, and intervertebral joints are forced to overwork to compensate for tight hamstrings. Many massage therapists assume the problem is gluteus maximus tightness and begin digging with elbows, fists, or hands, only to discover no improvement when a test for hip flexion is repeated. In these clients, chronically tight and synergistic-dominant hamstrings have become the primary hip extensors due to neurologically weakened gluteals. This hamstring substitution pattern is obvious when the client squats, as the force vector traversing through the femur allows the knees to buckle inward and the ankles to pronate. "Often, neural and mechanical inhibition from tight or shortened hip flexors cause the glutes to shut down and develop muscle amnesia, but there could be inhibitory consequences from prolonged sitting as well. It seems reasonable that sustained compression may reduce vascular circulation and interfere with nerve function. Pain from low-back or SI joint neuropathy can also inhibit gluteal contractility. This may lead to a vicious cycle where gluteal inhibition negatively impacts posture and poor posture further inhibits the glutes, resulting in a downward spiral in gluteal function. Bottom line? Work the glutes! From an MT's perspective, how important are the glutes to the whole body's health? M&B columnist and educator Erik Dalton shares his perspective The Glutes: Digital extra

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