 and welcome back to Movement Matters. I'm your host, Christine Linders, physical therapist and board-certified orthopedic clinical specialist. Today, we're going to learn how to get some out. Oh, what it's now you think. What I'm talking about is getting more rear end, more buns. Let's learn how in video number one. All right, let's talk glutes. There are many incredible functions of the gluteus muscles. So here's where they live. The gluteus muscles live from this region deep inside your buns and deep inside your hip. And there's many little ones that control the rotation of your thigh bone, as well as several larger ones, including your gluteus maximus, this one, and your gluteus medius, which runs here. I talk about the gluteus medius because the gluteus medius primarily moves your leg out to the side, but also back and also rotates here and twists your leg like that. So gluteus maximus has the same three functions, except for the gluteus maximus primarily extends your hip as well as does a little bit of rotation and a little bit out to the side. In order to have a healthy hip, knee, ankle, and low back, you need your gluteus maximus and your gluteus medius to function well. I talk a lot about the gluteus medius because the gluteus medius stabilizes your pelvis on your leg here. If your gluteus medius is not functioning well, your hip can drop, causing back pain and hip wear and tear that can lead to labral tears and arthritis. If your gluteus medius isn't strong enough or functioning well, your femur can rotate in like that. And so when you do a single leg squat, which is the same thing involved in walking, up and downstairs, your knee can rotate in like that and then it can cause wear and tear at your knee joint leading to ligament tears and painful arthritis, but also if your gluteus medius is not strong enough and this bone rules in, so does your shin bone, your arch can be wobbly and you won't get the stability from your foot and ankle when you walk, which can cause you to be off balance. So let's look more how to strengthen these powerful muscles. So what do you do to bring your glutes in? You have to bring your butt to the party then. But first, before we do that, let me bring my guest Joan Lenders to the party. My mom, thank you so much for joining us on Movement Matters Joan. Sure, my pleasure. This is great. So when I told my mom that I was gonna be talking about getting some more, bringing your buns to the party, she said, you know what? I've been thinking about that lately as a senior citizen, right mom? And now you're noticing it's getting a little bit more flabby back there and you were wondering what you could do because sitting on those sit bones, those ischial tuberosities, is it so comfortable? So I said I would quote you on that and I decided to bring on the show. So tell us about that. Like what are your concerns as you are aging? Well, for example, I had gone to a fight in drum corps over the weekend and there were a mix of people, but in my crowd there were also men seniors and women seniors. And no matter who, we wanted to sit on our folded jacket or our folded sweater because those bleachers are hard as stone. And we were getting uncomfortable after a while and if you're shifting side to side, then you're gonna get a kink in your back and you're not gonna be very comfortable all the way around. Yeah, that's a great point. I didn't even realize that when I was designing the show I didn't even think about having more buns and more meat on your rear end as a comfort thing as you age, but it's true. Even myself with my back injuries, when I hurt it, it's just my right foot went away because the nerve was so aggravated, the muscle lost. And then I hurt my left knee and in not being able to walk or limping a little bit, my left bun got smaller and I was noticing the same thing in myself. I've got a little less cushion back there. And so, yeah, less cushion. So that's awesome. Let's go to video number two where we show a little bit about how to start strengthening your glutes. There are several ways to strengthen your glutes. This one is very functional because you're on your feet and most of the day we are on our feet. So you will put a band around your ankles. I think you can see. You can put it around your feet too or above your knees if you have knee problems. You're gonna get yourself in a little bit of squat. Suck your stomach in to protect your back and then you will keep your feet pointing straight and you will wide step to the side out and in. You never wanna come all the way together though to slack the band. So you kinda do this, I call it a crab walk because you kinda keep your feet wide. You'll get a burn right here behind your hip muscle. If you have a long hallway, it's great to go up and down, but if you don't like I have here, you can stand in one spot, you can step out and come back, out and come back and you're 10, 15, 20 times to the right, but never go together, out and come back, out and come back. You'll start to feel the burn here. That's a great way to functionally strengthen your gluteus medius. So Joe, is that an exercise? Wait, what'd you say? That looks great. I should be able to do that, yes. I was just about to ask you if you'd tried that exercise before. Have you done that one before? Yes, on one of your visits here, you had me do just that, exactly walking to the left and then back to the right. And so it's a great exercise. Yeah, I was too glad. And I need to start doing it. That's right. Yes. That's why I do these shows, it's for everybody. It's a little reminder of what you should be doing. Plus I like to give you lots of options of how you can be doing it. So in the videos that I'll show to come, I show a lot of lying down exercises, but some people have trouble laying down through their exercises or the only place they can do it is on their bed and it's a little bit soft. So it might not work as well or it's too much resistance. That exercise where you walk sideways or you just step out is a great exercise because you just need to get the band on your ankles and then you can step out and get the burn. But also we walk all day long. It's a very functional position. So we want our glutes to be able to work while we're walking, while we're going up and downstairs to do the laundry, while we're walking around the block and going up and downhill. So I'm glad to hear you're gonna be able to do that a little bit more. Yes. And if I chose to not do it with the band, is it, do you get some effect by doing that sideways stepping without the band? You do. So when you're doing the step out without the band, I tell people it's not as much of a step out as the push out. So let's say you're stepping to the right. Your left leg, if you push with your left leg to step out instead of just lifting your right leg to step out, if you push out with your left, push out with your left, push off with your left leg, you're gonna change direction. That's gonna strengthen that standing leg. So it's a different thought process without the band because sometimes people just swing their leg out to the side and then it just exercises the right, but you don't get that function of the gluteus medius on the standing leg to stabilize your pelvis. As I explained in that first video, that's a great question. Yeah. Yeah. Now I wanna talk a little bit more, Mom, about the hip strategy. So the hip strategy is something that I have shown people with knee arthritis for years and years. And why we call it a hip strategy is because when you're going up and downstairs, a lot of load gets put on the knee joint and many people have knee arthritis, knee poor alignment. Like I showed in that video where the knee's diving in because your hip is weak. If you are going up and downstairs and you kick your butt back, it feels kinda funny cause you're almost crouching, but it puts all the load in your powerful glute muscles. So you have less pain on the knee. Mom, will you tell us all a little bit about it? You reminded me of that yesterday. Yes. Yes, because when you told me about doing that particular thing, it made a difference, a big difference in shifting the load to go up the stairs. And even to go down, but mainly it's to go up that you feel that great effect. Yeah, it's great. It's great. And one of the things I use my mom often and in the show that she was in previously, I used her for her knee. And to me, she's very identifiable by this one crooked knee that she has. And so when she was younger, I think mom, you were a teenager or something, right? Five more minutes, mom and dad. I wanna play in the yard and you fell and glass went into your knee or something like that. Yeah, in one of the knees, I'm not sure if that was that one, but I do have that. Yeah, so it's a five more minutes, right? So begins the process of a knee injury. I've done it. I hit my knee into a rock and now I have arthritis in that knee. But the point is that over the years, if you walk in an altered fashion, like say your toe turning out, like I explained a little bit in that first video, your leg goes over your foot that's turning out. And so begins the process of your knee no longer being straight, but starting to deviate like this five years, 10 years, 20 years. It's such a long way down the road. All of a sudden you have a crooked knee and you don't know why. I know, mom, you've had bunions and you've had bunion surgery and you've had to walk with your foot out like that. And so that's a contributor. So we don't really know which knee you had the glass in, but I want the viewers to know that altered movement pattern causes that. Yes, and it makes a difference that, you've reminded me that one particular foot would be turned out. You remind me to bring it in, bring it in. So I look down when I'm walking to make sure that I feel and see that it's aligned. That's a great point that I want to explain is when you said bring your foot in, when your foot is turned out like that, that powerful gluteus medius does not get the message from your brain to turn on. As soon as you turn that foot straight and you're walking, it's like a switch. That foot lands, pronates, the shin bone rolls over, the thigh bone rolls in and that gluteus medius gets a message going, oh, I need to fire and turn on and stabilize that leg on the ground. And so that's another huge point about turning your foot in so that your knee doesn't go in, but it's also to turn the switch to get your buns to fire. Yes, okay. All right, I didn't realize that. It works its way up. See, that's another thing. So let's go to video number three where we look at some more exercises. My all-time favorite strengthening exercise for the gluteus medius is lying on your back or the band around your ankles. So here's how you do it. You're laying your back. I've got the band around my ankles, as you can see. You are going to pull your toes up. Pull your toes up, you're gonna press your knees down, squeeze your glutes, that locks out your pelvis so you don't wiggle this way and hurt your back, it stabilizes your spine and you're gonna slide both your legs apart. Where people make a mistake if they like to bend their knee, that uses the front hip flexor muscle and the TFL up here. You wanna use the gluteus medius which is right back here behind your hip bone. You wanna slide out, push down, push down and slide out. You're gonna do 10 to 15 times moving both apart to kinda set your pelvis, stabilize your spine. Then you're gonna, I'm gonna show you here, squeeze your buns and slide your leg out. Slide your leg out. Again, you don't wanna lift because then it works the front muscle. You wanna push down, slide your right leg out 10 to 15 times. Then slide your left leg out 10 to 15 times. Another great exercise that works your gluteus maximus and your gluteus medius, more your maximus, is now you put the band above your knees. You're gonna open your knees apart. Open your knees apart, suck your stomach in and lift your buns all the way up. Squeeze your glutes and then come down. Suck your stomach in, open the band, lift your glutes all the way up, squeeze. Squeeze, you should have no back pain when you do this, zero back pain. Make sure you're sucking your stomach in, make sure you're not rounding on the way up. You come up one unit here, all the way up, all the way up. Now, one exercise I like that's helped me a lot with my back is to come up and then pulse 10 times out and out and keeping your stomach sucked in and keeping your buns tight 10 times, then come down. Reset, suck your stomach in, lift all the way up, open and close your knees. You can also suck your stomach in, lift up, open, come down a little bit, up and open. Squeeze your buns and open. Squeeze your buns and open, make sure you suck your stomach in. To work your gluteus maximus, get more cushion. Okay, Joan, what do you think of those exercises? Oh, I really like, well, I'm gonna try those, you know, the laying down with the knees bent, but I really like doing the ones around the ankle and I do 30 times. And I think that really has helped me, you know, build or at least stabilize my muscles that I have. You know, you get kind of squishy when you're, as you get older. I should go. No, I don't know. I don't know. No, you don't know. That's the one where you keep your legs straight and you slide them in. Yeah. Yeah. That's my favorite. That's one of my favorites. I've been using that on myself for years. I suffered sciatica from a tailbone injury, snowboarding while I was doing Ironman triathlons and I was trying to find a way to isolate my gluteus medius as a physical therapist. And that exercise is so difficult to do and easy at the same time, right mom? Because you're gonna pull your, my cues, toes up, lock out your knees. That's for anybody that has a knee pain. You don't want your knees to be mobile because then you feel like, ooh, that hurts my knee. That means you're not locking out your knees. You lock out your knees and it also works your quad muscle. Push your legs down into the floor, into the bed, that engage gluteus maximus and your deepest low back muscles, the ones that stabilize your spine. So for back pain patients that are gonna be doing this exercise to strengthen your glutes, sucking your stomach in, but more importantly, pushing your legs down to engage those stabilizing back muscles and squeezing your buns to stabilize your pelvis because you're doing this exercise because your glutes are weak and you don't want your pelvis to tilt while you're doing it. So when I say toes up, lock your knees out. Buns tight, press down and slide. That's what makes it so hard is a lot of people like to do, including you mom, including me when I was trying to figure out how to isolate this muscle to get what I needed. It's a great exercise, but you gotta push down to do it. As soon as you unlock your knee or lift, it's not the right muscle. It's a different muscle. I had made the mistake of not paying attention to toes up and my knee was hurting. And so you reviewed me and that was where I was at fault. Yeah, well, it's hard. It's like fourth up, toes up, buns tight, press down, slide. And so I'm constantly talking, wait, toes up, wait, press down. Don't lift, don't lift. I will say don't lift even though I don't like to give that cue in their mind of lift. I'll say don't lift because sometimes pushing down doesn't make sense. What do you mean push down, but don't lift makes sense. Don't lift, I can see your knee coming up. Push down, don't lift. And so everybody watching today, please do that exercise. I do it many times a week. My mom is doing it, my patients are doing it. It's excellent. It is, it's excellent. Yeah. And then the second one that gets your gluteus maximus where I have the bridge, not everyone can do the bridge because of back pain. Now that one I've kind of integrated into my routine over the past couple of months. I didn't used to be able to do it. My back was a little funny with that one, but it is helping my back so much to get up in the bridge. And I think what people need to pay attention to is when you suck your stomach in to lift your buns up into that bridge to do the leg openers, you can't be midway. Like you can't just lift it up a couple of inches. You really need to go all the way up. And the reason why is you gotta get your glute maximus, the big glute muscle to fire, but you need those deep low back muscles, the multifidus to fire as well. And if you're hanging out in the middle there somewhere without that lordosis, that extension in your spine, those muscles may not fire. So if you have pain with that exercise, make sure you're coming up like a salad unit, lift your buns all the way up like there's a door strapped to your back. Right. I can do it on the bed. Yeah. Because the bed will give a little, but that's where I do exercise. Yeah. No, it's great. It's great because you're lifting your buns up so you're pushing your feet down into the bed, lifting your buns up. Your shoulders are stabilizing you. You can use your hands next to you for stability and balance because the bed's softer and you lift and you do your open clam shells. Yeah. Okay. All right. Good. So let's go to video number four where we show a couple of sideline exercises. A few more exercises to work those deep hip rotators as well as your gluteus medias. So you want to put the band above your knees right around your thighs here. You're going to lay on your side with your knees bent and your hips bent. You're going to suck your stomach in. You're going to open your top knee, keeping your feet together. I usually do 10. You can do 20. So let's say we've done 10. You're going to hold your knee open and then lift your foot to parallel. Do not go like this. It can harm your hip. Lift your leg to parallel, horizontal only. You'll do 10. And you're going to straighten your hips and knees. So you're in a straight line, but your knees are bent. And now you're going to open your knees. Open. You're going to do 10 times. And then you're going to hold it open, lift to parallel. Lift to parallel. That's great. That gets those many deep rotators that are inside your hip to stabilize your hip. Then you're going to straighten your legs. Don't put them in front. Make sure you're in a straight line. If anything to the back, suck your stomach in. You can use your hand here for balance. You're going to lift your leg up into the back. You don't want to roll back like this otherwise you're going to end up getting that front muscle by mistake. So you want to go up and back. Up and back now. That gets your gluteus medius. It's a great exercise if you are weak from a disc herniation. You're weak from hip arthritis. You're weak because you had knee surgery and you were on crutches for a period of time or you had foot surgery in your own crutches. So enjoy those deep rotator and gluteus medius exercises. So Joan, have you tried any of those exercises? I did try that one on my side. And like you said, it's important even though I'm on the bed, I have to make sure that I'm straight and that falling forward, falling backward. If I do it on the floor, then it's another problem trying to get up. And so it's easiest on the bed. Yeah, that's good. I think that's important for everybody to hear. The last thing we want to do is have you get hurt getting up and down off the floor. And I remember my dad was fixing something underneath the bathroom door and that bending your knee up and pushing really flared up his knee. He was probably 70 years old, right? And he'd do everything above ground but that's a lot of knee bending and a lot of load. So if you don't need to get down on the floor and you could do it easier, we want to preserve our bodies for as long as we can so we can enjoy our lives, right? Oh, yes, yeah. So to the bed it is. To the bed it is. So I have a question now and it's a common question I get. How can strengthening my buttock muscles help my balance? So how is your balance, Joe? It's a, at times a little titty tater tattery. My feet hurt. So sometimes if I'm stepping wrong, that can send me a little bit but most of the time I just, I do catch, you know, but that's the main thing with balance is that my feet hurt and that can throw me. Yeah, that's actually a good point. Any kind of pain can cause you to lose balance. And I know I've lost my balance plenty of times. I step on a rock. I've had a lot of ankle sprains or walking down the street. I just did it the other day. I stepped on the edge and lost my balance. The important thing is to catch it. And I think that sidestepping exercise that I showed in the beginning is a good one because you're stepping out, stepping out, stepping out. So you're shifting your balance. But I also, I have a video where I show a couple other ways to have your glutes by tensing your glutes, help your balance. So let's go and look at video number five. Another great exercise to strengthen your hip and put all of these exercises into practice while you're walking, doing stairs or to improve your balance if you feel like you've lost your balance is a standing hip hike and a standing high knee march. So the hip hike, basically, you stand and you just lift one side of your hip up. The whole point of that is to strengthen the standing leg. So it's like you're driving this leg down into the ground and raising this leg. If you do 10, 15, 20 of these, you will feel it on your standing leg butt side. And that's for those of you who have that little hip drop because you've had a back injury or you've got hip arthritis or you had surgery on your foot and you weren't crutches. So the hip hike here is one great way to functionally strengthen that muscle so it can learn to stabilize your pelvis while you're on one leg as in walking, going up and down stairs. But also for balance, I like the high knee march. So what the high knee march looks like is you suck your stomach in and you squeeze your bun. You balance on one leg for maybe a 1,000 to 1,000. Then you take a step, squeeze the other bun, lift your leg up, suck your stomach in, squeeze. Hold for two seconds, stand, squeeze. Three seconds, you can do it in place if you want to, if you don't feel safe walking. Squeeze that bun, hold for two seconds, switch. Squeeze that bun, hold for two seconds and start teaching your glutes how to work to stabilize your pelvis while you're on your legs. Well, I've marched in place but not that particular exercise but I could hold onto the back of the chair and just so I'm more steady and do that, yeah. That is a great exercise. I'm gonna do that one too. You should and you should tell on Betsy too because I know she was trying to work on her balance. I think one of the things I like to share with all of my viewers, friends and family is I want everyone to be able to do everything that they wanna do as we age. And I know better than anybody how pain and disability can affect your life because I've pretty much been getting injured since I was 13 years old and finding ways to strengthen my body, finding ways to stretch and move so that I put the least amount of strain. And as you all know by now, I pay incredible detailed attention to the biomechanics of the body. So I wanna turn on this muscle, get that muscle to fire like Joan and I were talking about, turn your foot in, switch that glute medius on. You'll not only have better balance but you'll have less foot or ankle pain. You'll have less knee pain, less back pain. Now that biomechanical process is complicated and I've explained it in many of my previous shows but in that video number one. But I want you guys to really digest my message. We need you to bring your butt in the party. We need to grow your commute, get some glutes so that your foot can have less strain, your knee can have less strain, your head can have less strain and your back as well. And if you're older and you're losing your balance, like you said Joan, hold out to the back of the chair, squeeze your glutes. That's one of my most challenging things with someone who's had hip arthritis or knee pain and their hip is dropping. We strengthen it on our back, we do the bridges, we do all that and then they walk down the hall and their hips dropping, hips dropping. And so I did those little hip lifts because they could do that. It's like, oh wow, I can strengthen it in a functional position. Let's teach the glute what to do. And then the high knee march, extra bun squeeze is that little bit of, okay, now let's make it work during the function that you need it to so your hip doesn't drop and cause you to lose your balance. Yes, because I'm Betsy and I love to do gardening and just walking on grass because it's not a hard surface. It's a challenge sometimes, you know, and if you're not all muscled, it can end in looking at the grass really close. Yeah, we don't want that to happen. We don't want that to happen to your friends, our family, or anyone. We want you to be safe and enjoy and all that. So I have a little bonus video that I did this morning when I was at the beach because I thought, you know what, if you're not injured and you want better buns, let's go to video number six and learn a simple way to get it. And of course, if you have healthy knees and you just want to get more buns for more cushion, this is a great way to do it or just a great workout. You want to get into a lunge or do a squat and I like to put my back leg up on a high surface. So you go somewhere, put your back leg up on a high surface and then you shove your rear back. You don't let your knee go over your foot. Lunge, lunge. I like to do one leg at the same time. I'll show you from the other side. So you like this angle. Don't let your knee go in front of your foot. Shove your rear back. Hulse, pulse, pulse. I like to do three sets of 20 before I start switching legs. So I'll do 20 and then I'll switch to my left. 20, switch to my left and afterward. I will sit back, squat, sit back, see? Sit back. So put your rear back, sit back. Please move back into sit back. Please. You can pulse down here up, down so you get that nice rear burn. If you notice, my chest is coming down. I'm not squatting this way. I'm sitting my rear back, getting tons of stuff and keeping my back straight, sucking my stomach in. Enjoy better buns. That was important to point out, Chris, that you're not, to bend at the right angle. Yeah. Yes, because we, you know, you can wind up doing it incorrectly, but we have to listen to you. That's right. That's right. Life is better when you listen to your physical therapist, right, Mom? It is. This is great. We have to close. Is there anything else you need to add, Mom? Nothing I know of except your videos are excellent. And when I can go on any of your videos and review if I've forgotten exactly how, you know, to do something. So right on, you know. Thank you. I'm there. All right. Well, thank you, Mom, for coming on. And thank you everyone for joining us on thinktecawaii.com. I'm Christine Linders. This is Movement Matters. And I hope you all have a wonderful day. Bring your butt to the party. Aloha.