The Center of the Universe

Written By: Dr. Michelle Millner, PT, DPT

When I was in physical therapy school, one of my professors had a mantra “The Pelvis is the Center of The Universe”. She was right. The hip, pelvis, and lumbar area are the foundation for human movement. When there is a muscle imbalance in this area the results can present themselves in the form of back pain, hip pain, knee pain just to name a few.

The good news is that targeting muscles of the hip, back and pelvis can prevent and alleviate a lot of those symptoms. The bad news is that many traditional exercises activate the wrong combination of muscles. Many hip exercises like squats and leg lifts will activate a very strong muscle called the tensor fascia latae (TFL). The problem is when the TFL get stronger, it also get shorter which pulls the pelvis forward and puts torque on the lower back. The TFL needs to be opposed by a strong gluteus maximus and gluteus medius. Unfortunately, neither of those muscles get a lot of exercise when we sit at our desks all day, not to mention sitting decreases circulation which further weakens the muscles.

So what are you to do: The answer is to change your exercise program to include exercises that really target the gluteus maximus and gluteus medius. The Journal of Orthopedic Physical Therapy recently published a study that demonstrated that a series of exercises can effectively activate the gluteus maximus and minimus with little activation of the TFL. Here are the top 3 exercises:

1) The clam shell: lying on your side with your hips stacked on top of each other. Keep your feet together while you lift your top knee upward. Key things to remember: a) keep your hips stacked on top of each other by tightening your stomach muscles, do not roll back; b) add a band for resistance

2) The single leg bridge: Lie on your back with one leg bent and one leg straight. Tighten your stomach muscles. Lift your buttock up off the table/floor. Key things to remember: a) your hips should stay level(this is the challenge) b)resistance can be added in the form of time, reps, and/or weights.

3) Hip extension exercises both knee straight and knee bent: Starting on your knees and elbows. Kick one leg back and upward. Key things to remember: a) keep you hip and pelvis level. b) do not arch your back. Your goal is to get maximum squeeze in your gluts, but stay in a straight line.

Remember that form is much more important that number of reps. Quality over quantity. I encourage you to add these exercises to your program even if you are not experiencing back, knee or hip problems. If you experience difficulty or pain during the exercises, I encourage you to contact myself or one of our therapist for a consultation.