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The body is made up of approximately 620 skeletal muscles that control all of our movements from blinking to giving a thumb's up sign. Some of these muscles form groups that work collectively to accomplish a goal. Think about the act of kicking your leg out while sitting down – there are four muscles that work together to elevate your foot. One of the cornerstone principles of the body is balance and symmetry not only from right to left, but also through the three planes of motion (forward and back, or sagittal, side to side, or frontal, and clockwise and counter clockwise, or transverse). This means that for each muscle group, there are opposing groups that check and balance each movement through the three planes of motion. If one muscle group dominates the other, the body will be pulled in an asymmetrical motion which can lead to pain and dysfunction. In this article, we will look a simple motion, the act of getting up from a chair, and how a small muscle imbalance can lead to problems.

Most of life is in front of us – driving, computer work, studying, walking, etc. Often, the only movement that we make backwards is sitting. This sequence leads to over development of the front muscles, and weakness or inhibition of the back or buttock muscles. The gluteals, or buttocks, are designed to be one of the most powerful muscle groups in the body and are supposed to play a key role in sitting and standing, going up and down stairs, squatting, and basic walking.

The loss of gluteal function and strength leads to compensations during those movements that would otherwise be controlled by the glutes. These compensations require other areas of the body to be overused, which will result in early wearing down of the knees, hips, and low back. Let's go back to the motion of getting up from a chair. Normally, the body is able to use the glutes as well as quadriceps to elevate from the seated position to standing (there are many other muscles involved, but we will focus on these two for now). With decreased strength and inhibition of the gluteals, one may lean further forward, push more with the hands, bring the knees further forward, shift weight onto one leg more, or any other compensatory movement to stand up. This additional pressure on the knees from the quadriceps being overworked as well as shifting and leaning putting pressure on the hips and low back will lead to pain and early breakdown with repeated compensatory movements.

Movement specialists can often identify these compensatory patterns and correct with exercise before pain wears the person down.

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     -      Dr. Kathryn Gollotto, DO - Orthopedic Reconstruction Specialists