*I am not a physical therapist or doctor and do not have the expertise to treat injury. If you are injured you should consult your doctor or a physical therapist to discuss a treatment plan. Apparently weak glutes area a fairly common problem among runners (and athletes in general), as I found out the hard way through my own deficiencies. Based on my physical therapy assessment last weak I have a very weak left glute and as a result my left hamstring is carrying the load, so much so that the PT says that my left hamstring is visibly bigger than my right. Yikes! Which is why I'm experiencing tendonitis in the hamstring: it is being loaded in a way that it cannot handle.

My job: to get my butt in gear. Literally. I need to build strength in my glute and retrain my neuromuscular pathways so that my glute muscle "fires" when it should during the running stride.

My PT has me doing that a variety of strengthening exercises and form drills. On the right side I have no problem performing these drills correctly, but on the left I really have to concentrate on "firing" the glute and keeping the hamstring from taking over; it has been doing the job of the glute for so long and under a heavy training load that it is very reluctant to start delegating. Sounds like someone I know...after all it is my hamstring.

My PT took some helpful pictures from our last session so that I could have a bit of a tutorial for my "homework". Here are the moves he has me doing:

Please keep in mind that the cues I talk about here are specific to my body: my weaknesses and imbalances. It is best to do these exercises under the watchful eye of a professional so that you can learn proper form to ensure you're doing the move correctly. If you're not activating the correct muscle while performing the drill then you're really not helping yourself at all.

Leg Raise on All 4's (Glute): On knees and elbows begin by activating the glute and raising the leg primarily with the glute. Keep the knee at a 90 degree angle. Ensure that your core is engaged. I have to be careful not to arch my back so core engagement is key. Lift and lower. 2 sets, 10 repetitions.

Bridge (Glute): I have a hard time performing this one correctly. My back very easily slips into an arched position so I have to consciously tilt my pelvis forward, engage my core and then activate the glute to lift the torso off the ground. Stretching the arms out helps engage the core. Do you see that face? It takes a lot of concentration for me to get this right.

Backward Lunge (Glute): This is basically a lunge to the back. Start with the leg drawn up in front, as if in running and then extend the leg behind you in a lunge. The arms alternate as in running. The key for me is (again) to keep my back from arching by tilting the pelvis forward, engaging the core and firing the glutes. I did this in front of a full length mirror so I could also watch the angle at which my legs went back behind me; the objective was to keep the leg tracking in a straight line vs. crossing the mid-line of the body.

Single Leg "Runs" (Glute/Form): Very similar to the backward lunge: stand on one leg with the knee raised then swing the leg back in a running motion. The arms alternate as well. The focus here for me, is keeping the pelvis from rotating back as the leg swings back. It seems that some of my leg extension is coming from my pelvic rotation=not good. I try to focus on engaging my core and firing the glute to keep the standing leg steady and the hips square. I did this in facing a full length mirror so I could also watch the angle at which my legs went back behind me; the objective was to keep the leg tracking in a straight line vs. crossing the mid-line of the body.

Forward Lean (Form): This one is pretty simple, but is helping to train my body to be in the forward lean vs. leaning back as I often do. Simply stand and bend forward at the ankles until you have to put your foot out to keep from falling forward.

High Knees on Wall (Form): A variation of high knees that incorporates the forward lean. Lean against a wall and lift knees rapidly in a set of three (so as to alternate the starting leg). I focus on keeping the arch out of my back and keeping the glutes engaged.

Butt Kicks (Form): Another running form drill that helps train the neuromuscular pathways. Exaggerate running by kicking the leg all the way back until it touches your butt. I really had to focus on the alignment of my pelvis and the arch of my back. It seems that at this higher speed I lost a lot of the correct form.

Single Leg Crossover (Eccentric hamstring): This exercise is meant to help repair the hamstring by elongating the muscle while it works. To perform the crossover stand on one leg with a dumbbell raised above your head, cross the body with the weight as you lower into a single leg squat. Come back up. My cues for this exercise were to keep my head and torso extended and core engaged.

I've got a lot of work to do to get my left glute up to par. I've already noticed a difference in the way I feel on my runs. I can tell when the glute is "firing" as it should be because I don't feel that "tender" spot where the tendonitis is.

PT Cards. I put all my PT exercises on index cards and pull out 4-6 cards in the morning and then again in the evening and do the exercises listed on the cards.

As for my ITB on my right knee it seems to be resolving itself pretty quickly with stretching and rolling with my trusty PVC pipe. I was able to run 4 miles yesterday without any discomfort. The PT seems pretty confident too that it isn't anything major and will resolve itself with time.

I've got to be honest though I'm not sure what kind of shape I'll be in at the beginning of July, which is really when I need to start training for Reach the Beach and my fall races. I don't know if I'll be able to run the mileage necessary to be part of a four person ultra team, as I had planned. Fingers crossed and glutes squeezed together it'll all work out.

I found these helpful articles on glute weakness:

The Plague of the Mediocre Athlete: No Glutes, No Results

Is Your Butt All That it Could Be?

Have you ever done PT? How long were you in PT? Do you still do your PT exercises? What was the most helpful move you learned?

--Sarah

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