December 16, 2015

Pain is a Great Motivator

My PT made me realize the gluteus maximus (GM) muscle on my hemiplegic (paralyzed) side was as soft as unkneaded bread dough.  This buttock muscle is called a hip extensor because it extends the leg behind the body.  Only ballerinas and runners use the GM in this way. 

I am worried about this weak muscle because the GM helps other hip muscles keep the pelvis from wobbling as we swing our leg forward to take a step (1).  If the GM does not help stabilize the pelvis, low back muscles have to do it.  With my history of back pain, my GM has to get stronger.

I am also worried about the violent snapping of my hemiplegic knee when I walk.  For the past three months this knee has been painful and slightly swollen at the end of the day.  I recently learned the GM also slows the leg's forward motion when we swing our leg to take a step (1).  So the GM helps hamstring muscles (back of thigh) stop the knee from snapping into a fully straight position before we step onto that leg.  A recent x-ray shows I do not have arthritis in this knee yet.  I do not want knee replacement surgery so my GM needs to get stronger. 

To strengthen my GM my PT asked me to clench the two halves of my buttock together.  I could not feel where the muscle on my hemiplegic side was.  The inability to locate a muscle happened repeatedly after my stroke.  I had forgotten how depressing this is.  Thankfully, lots of repetition gave me sensory awareness so now I clench my buttock 12 times a day before I swallow 12 pills.

1. Wilson J, Ferris E, Heckler A, Taylor, C (2005). A structured review of the role of gluteus
     maximus in rehabilitation. New Zealand Journal of Physiotherapy, 33(3) 95-100.


  1. I've been focusing on my glutes this past week, too. My PT made me aware of the three layers of the muscle (inner, middle, outer) and how I overuse and rely only on the outer layer. I've been working on "finding" in my mind the middle layer. Have made good progress in a few days of focussing on it repeatedly.

    For the knee-snapping, I bought one of those knee-braces with the arms that prevent hyper-extension. I use it rarely, but it gives me the extra support I need when I'm tired and less able to rely on my muscles instead of my joints.

    1. Can you share the brace brand or name? My knee does the same thing.

  2. What blows my mind is that a stroke can be so selective when it takes away function. Thankfully the exercises my current PT gave me have reduced my knee snapping enough that my knee pain is now minimal and intermittent. Hallelujah!

  3. That is an awesome read, usually i do not read stuff about the human body and its functions but it really got me interested as i always thought the butt muscle was just that a butt muscle. Turns out you learn something every day of your life, thank you for sharing, keep up the informative blog posts. Thank you again.

    Agnes Lawson @ Pain Relief Experts