Hey friends in this video I'm going to show you how to easily correct the root cause of
most glute problems. Now before you think that this is going to be a quick fix video,
I am going to show you a couple strategies that will show you a specific exercise. But I want you
to take away from this video the progressions that you need to take yourself through in
order to fix the root of most hip problems. This is more of a teaching video than it is
a show you how to do something video. But it really is the way to fix the
root of most hip problems including hip arthritis, labrum tears, hip tendinitis,
hip bursitis, IT band syndrome, sprained hips, groin pool, hamstring pools, and so much more.
My name is Dr. David Middaugh. And I'm a specialist physical therapist at El Paso manual
physical therapy and this channel is dedicated to helping people stay healthy, active and mobile,
while avoiding unnecessary surgery injections and painkillers. Please consider subscribing to this
channel so that you don't miss out on any of the helpful videos that we post every single week.
If you're looking for more specific help for like, say, a hip labral tear, hip arthritis problems or
a bursitis problem in your hip, go look in the description below this video and find links to
playlists for other videos that we've created that specifically address things like what I mentioned,
let me tie them all together for you. Because oftentimes, people that have had hip
arthritis have dealt with IT band syndrome in the past or hip bursitis in the past,
or they've had a history of pull hamstrings or pulled groin muscles,
all relating to the hip. Oftentimes they have knee pain as well or back pain in addition to the
hip problem. And the root problem of all these issues is something called a muscle imbalance.
A muscle imbalance is very mysterious in the healthcare field in the in the medical industry,
and people throw it out there sometimes every once in a while
you'll hear a physician or a surgeon talk about it. But it's so confusing because it's ambiguous.
It's like there's so many muscles in the body. How do you know which one is out of balance
with the other ones, and how do they all relate in balance each other out,
even physical therapists don't have a great handle on this topic. And this isn't something
that you can go get an MRI for and identified it on an MRI or an x ray or some other imaging scan.
It's something that's clinically diagnosed by an expert like myself,
I'm a manual physical therapist and I have a different way of looking at the body
compared to like a surgeon who wants to cut open something and fix it or replace it. Or a general
physical therapist who's helping people right after they have surgery. Let me cut to the chase.
The main imbalance that I see all the time and people that have hip arthritis,
labrum tears bursitis. All those things that I mentioned in the past are the main imbalance
here is weak glutes muscles, right in the back of the hip here, these muscles are just a weak.
Now it doesn't matter how big the muscles are, because you may have a big Fannie,
you might have a big backside and look back there and tell yourself I got junk in the trunk.
So I must have muscle back there. But it could be that you just have other tissue there may be
adipose or fat tissue. Or it could be that you do have muscle there and you're not using it
appropriately. When you go do your daily activities or when you go exercise.
And that's putting you in an imbalance. Having an imbalance doesn't always mean
that you don't have muscle in a certain area, it means that you're not using the muscle,
it could mean that you don't have muscle as well. There's many muscles in the glute area there's
a lot the glute Maximus is the most commonly talked about one, but there's minimal glute
medius. There's a bunch of little hip stabilizer muscles here like the piriformis. There's a gym li
muscles, there's a pair of those on each side, the arbitrator muscles internal and external,
and there's a Quadratus Femoris muscle back here. All of these are on the backside of the hip. And
they serve to stabilize the hip joints, as well as move it through extension, moving it backwards in
this direction and rotating it outwards this way. Some of those muscles do have some other functions
like moving the leg outwards like this, and to a small degree a little bit forward and rotated in.
But what I see day in and day out whenever I have a patient with a hip problem in here,
if it's a chronic problem, there was no trauma, there was no accident that just
happened and that's why they're coming in like a car accident, a fall or some bicycle accident or
motorcycle accident. If they've got hip pain that that's developed over months or years,
we see weakness in the glute muscles or improper use of the muscles in the back of the hip.
And as a result of that you have a relative strength or dominance of the muscles on the
front of the hip. It could be the quad muscles in the front of the thigh which one of those
acts like a hip flexor it's called the rectus femoris muscle and there's also
some AB Ducktor muscles AB Ducktor muscles that are kind of on the side of the hip but more on
the Front like the front pocket area, right about here that are technically hip muscles.
But they act to do more internal rotation and flexion, which is going to move that ball
and socket inappropriately and cause that hip problem or use the muscles and appropriately.
Now the medical diagnosis that I rarely ever mentioned on this channel,
because it's just over the top for a lot of people, even people in the healthcare field.
It's called hip anterior glide, medial rotation syndrome. And this is a syndrome that was coined
by Shirley Starman, I'll put a link to her book in the description below. Fantastic, brilliant mind.
And she developed some other syndromes, too, that I use all the time, I think they're just
brilliant. I was taught them by my mentors, and it really explains a lot and gets to the root of
the problem like like hip pain like this. Because when we're talking about going to
the doctor, and they do an MRI on you, and they tell you, you have a hip labrum tear,
or you you get an x ray, and they tell you that you have arthritis on your hip and your hip is
bone on bone. Well, it doesn't just get like that automatically. Because you always have to
ask the question, well, why isn't my other hip as bad, it's walked just as much as this hip,
it's lived just as long as this hip, it's not that this hip is older than that hip, or
you have to just ask those questions. And you can't assume that
it's just age, or time or how active you've been. There's other things at play here. So naturally,
if you have a hip problem, then we can, by the power of induction, we can assume that
you probably have weak glute muscles without having tested your glutes. If you were here in
the clinic, we'd be testing your glutes, so that we have certainty that that's what's going on.
But we see it so much that I can confidently make a video about this. And you can probably make the
assumption that you have weak muscles, then it's a matter of strengthening your glute muscles next.
Now you might be at a certain level where you can't do a whole lot of glute strengthening,
maybe at a level where you just need to turn on the muscles. The number one problem that people
face after they start to work on their glute muscle strength is the problem of
CO contracting. In other words, when you try to fire your glute muscle,
other muscles fire that are not your glute muscle. So it looks something like this, if I'm standing
up, and I'm going to tighten up this glute muscle right here, I don't want to fire the front of my
hip and thigh over here. But if that's you, if that happens to you stand up and try this out
and squeeze your glutes as hard as you can and you feel your quads starting to work here.
You bet you've identified a muscle imbalance in you because if you're trying to fire
your butt muscles, if you're trying to tighten and squeeze and make those muscles
work, but the front of your thighs work, those are the opposite muscle groups,
and they should not be working together, you should be able to fire the glutes independently
from the quads. And if you can't do that effectively, especially at a maximal contraction
through the glutes, then think about what you're doing throughout the day, every time you go to
walk or stand up, or you do things around the house, your chores, or you go exercise,
you're probably firing your quads and your hip flexors, when you shouldn't be with that sets up
is the muscles to be used inappropriately. So you might be overusing your quads and
your hip flexors. But because of the line of pull, just knowing the mechanics of the body,
and I'll make it really simple for you, you don't have to have a degree in any medical profession to
understand this, the glutes are on the backside of this bone right here. And the wrap around and
attached to the outside of this bone right here. They go directly this way, some go this way. Some
come from up here, but they all kind of come from this direction and go this way. hip flexors are on
the front of the hip right here they're on. On the opposite side of the bone. There's a couple that
are on the front here, but they're basically on the front side of this bone right here.
So if you have stronger muscles in the front of your hip here,
the end, the ones in the back are weaker, what's going to happen to your ball and socket joint,
it's going to start to drift forward, and it's not going to seat into the socket very
well. It's not going to sit in the socket very well. Ideally, with every joint you should have
maximum congruency. In other words that the joint fits into the other end of the joint.
Well, it's the shapes should align. And a ball and socket joint like the hip is a very
congruent joint. Not all joints are congruent, but this is a pretty congruent joint.
And if your muscles on the backside here aren't doing their job, then when you can start to get is
this kind of a positioning in your hip? Well, you bet that's going to start to cause hip arthritis.
The labrum is on the edge of this bone right here, you're going to start to get a labrum tear.
The most common labrum tears are anterior and superior. So on right here, where I'm pointing to,
that's where you where you will compress it. And then the hip muscles here on the
front are the ones that are often involved in hip tendinitis. The bursa right here on
the side hip bursitis at often involve there. And of course, hip arthritis inside the joint.
If you have a malalignment, a bad alignment of the ball and socket joints,
then you're going to inappropriately rub the joints. And over the course of months and years,
develop hip arthritis, you don't typically feel good weakness, it's not painful. A muscle
imbalances, not something that typically hurts the way that it presents in day to day activities.
If you think you're dealing with a problem right now, and you think back to what life was like for
you, Before, you had the hip problem, you might have had some aches here and there,
nothing that stopped you in your tracks, maybe occasionally, something that stopped
in your tracks, but, but nothing that that was noticeable on an x ray or an MRI, and you probably
were able to rest it off, or maybe take some sort of pain medication and be okay.
That's how muscle imbalances of the hip behave. They're typically painless,
and then your body hits a certain threshold where the labrum starts to tear, the joint
begins to become affected. And now you've got an official labrum tear, or arthritis or bursitis,
or whatever the diagnosis is at that point. But the root problem was always that glute weakness
and the quad and hip flexor dominance. So how do you begin to fix this problem,
you've got to get your glutes working, the number one thing just like we're doing standing a second
ago is to tighten up those glutes and shut off those quads. Now think of a percentage,
like if you can fire 100%, if these muscles can tighten up back here, 100%. Without the quads
working, then that's a good situation to be in. Now you've got great activation of those glutes.
But if you cannot fire those glutes 100% And you feel like your quads are starting to work, then
you've got to back off and hold that a percentage that works for you to only fire your glutes,
you've got to retrain your glute muscles to work without your quads
without the front of your thighs and the front of your hips. For some people,
their back muscles start to fire their hamstrings and the back of the thigh start to fire as well.
You've got to tone it down and simply stand up like I did a second ago
and squeeze your glutes and think about not firing anything else. And as long as that takes you, it
might take you a couple of days, it might take you minutes, it could take you months, weeks, months,
maybe even several months. And that's where you got to be before you move on to any other glute
exercise. You got to master that right there. Now once you feel like you can confidently
fire your glutes without firing everything else. It's an open ballgame. Go find a glute exercise
that strengthens your glutes, you've got to fatigue them and tire them out.
But you need to have confidence you're not going to fire all those other muscles. There's tons of
videos on this channel for firing your glute muscles for strengthening your glute muscles.
We talked about squats, we've talked about deadlifts, lunges on this channel.
You can use machines if you wanted to at the gym, you can look up any YouTube video that's
focused on glutes, but as long as you don't fire those quads on the front of your thighs,
those hip flexors in the front of your hips. And you can make sure to fatigue mostly the glutes
whenever you go do these glute exercises, then you should be helping out your glute muscles and
helping out your hip problem for the long term. You're going to restore the mechanics at the
ball and socket joint, you're going to offload that labor on the cartilage in your hip joint,
you're going to align the congruent see that the shape of the ball and socket,
and you're going to rest those muscles that have been overworking causing the
tendinitis and the bursitis in your hip. So guys, I hope this video was helpful for you.
This is super important strategy to understand and acknowledge because you can't just be aimlessly
searching for a hip pain relief exercise on the internet. You have to understand the why the
How did you get here, because there isn't a magic bullet exercise.
For hip problems you've got to get to the root problem and address that and it's not
an easy fix. It's going to take you time and it really depends on where you're starting from.
So I hope you liked this video. Give us a thumbs up if you if you did if you have any questions,
comment below and friends I hope to see you in the next video. Have a good one. Bye