Name: Gluteus Medius Manual Muscle Testing (MMT) for an Active Population
Uploaded: 2023-04-26T01:01:42.000Z
Duration: 9 min 14 s
Description: This video goes over the foundational knowledge and practice of Gluteus Medius Manual Muscle Testing (MMT) for active people to safely assess their body's ability to move effectively. Learn how to accurately assess your glutes!

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https://stream.mux.com/AYPK007VGcJRgVnLUkUzpflPCl2L5BbKIv01537u00r00Vg.m3u8

This video goes over the foundational knowledge and practice of Gluteus Medius Manual Muscle Testing (MMT) for active people to safely assess their body's ability to move effectively. Learn how to accurately assess your glutes!

Introduction to Gluteus Medius Manual Muscle Testing

Setting Up the Test Position for Gluteus Medius

Conducting the Gluteus Medius Test and Identifying Compensations

Assessing Strength and Weakness in the Gluteus Medius

Understanding Compensation Patterns and Muscle Synergists

Reassessing Gluteus Medius After Activation Exercises

Gluteus Medius Manual Muscle Testing (MMT) for an Active Population

This is Brent of the Brookbush Institute, today we're talking about gluteus medius manual muscle testing for an active population. So since we're testing for an active population I'm actually going to go ahead and set that Kendall scale aside, that one through five with pluses and minuses, where we test can the person move against gravity through a full range of motion. Can they resist a little bit of external resistance from the manual practitioner. We're going to go ahead and replace that scale with strong, weak with compensation or with pain, and although that sounds simpler we're also going to make the test itself more provocative, so that we can see if it is in fact the gluteus medius that is weak, strong, or whether this particular movement pattern is being overrun by those overactive synergists. I'm going to have my friend Melissa come out, she's going to help me demonstrate. Now first things first we want to set up, actually just like we set up for the Kendall manual muscle testing for gluteus medius. We want to make sure she has a nice neutral spine, the one thing I see on this test a little bit, and even gluteus medius activation which isn't great, is sometimes I see people prop their head up right; as soon as you prop your head up your spine is kind of curved this way, we have a shorter quadratus lumborum on this side, we have shorter erector spinae on the side that we're testing that could lead to compensation and reinforcing patterns I don't really want to reinforce. So let's go ahead and have her lay her head down, make sure she's neutral all the way across. The next thing I'm going to do is I'm going to stabilize her pelvis with my webspace from index finger to thumb, by going just over the top of her iliac crest. So I don't want to try to control her from here, I'm going to try to control her from the top of her iliac crest. I think you get a lot more sensory feedback into your fingers as well, you know as we're watching for anterior pelvic tilt or posterior pelvic tilt, or her like rotation of the pelvis. I'm going to go ahead and have her straighten her leg back. Good, and in the in the traditional manual muscle test you'd have the person abduct and then you push down into adduction right, problem with that is is that doesn't just test our gluteus medius, there's other abductors, if she's up here and I just keep putting her up here to make her very tired, she's also going to start trying to use her TFL and gluteus minimus, but I want to test gluteus medius. I know that's a very important muscle. I know it's a muscle that has a propensity to get under active. I want to make sure that's what I'm testing. So how am I going to do that, I'm going to make sure her pelvis is stacked, that she's not rolling back. I'm going to have her go ahead and abduct, and then she's going to have to extend a little bit for me, and you guys as soon as you try to put somebody in this position, you're going to see your first two most common compensations; either they try to go into an anterior pelvic tilt, alright so their pelvis rotates this way, or as I pull them up and back, rather than coming back into abduction and extension of the femur relative to their pelvis, they're just going to roll their pelvis back, so they're leg went in the same direction but they're actually in abduction and flexion, we don't want that either. Those are both big compensation patterns, and big hints that something's not right with their gluteus medius. Let's try this one more time, I'm going to go ahead and pull her up and back into extension, really stabilize her pelvis so I can get her her leg in the position I'm looking for, and we might just start by having her hold this position without resistance. All right you guys can even slide your thumb down since it's right here and see kind of palpate their gluteus medius, is that gluteus medius firing, can you feel those fibers firm underneath your thumb contracting hard. Good, tough. Okay, a little bit all right. So now we get into adding a little bit of resistance. So we're going to go up and back, and rather than just pushing straight down, all right let's go ahead and resist those posterior fibers through all planes, by using a pincer or lumbrical grip over her calcaneus. Rather than just pushing her straight down, i'm going to get fancy and go ahead and push her into adduction with a little bit of flexion. So now she has to extend into my hand, and I'm also going to try to internally rotate her leg a little bit. So relax for a second for me. I'm going to try to push her kind of this way. Don't go too far into flexion, but just like you're trying to take her toes and rather than put them right on top of her other toes, you're trying to put her toes right in front of other toes. All right so go ahead and hold up here for me, hold hold hold hold hold, ready to resist. Alright Melissa is doing a very good job acting right now. If she was able to resist that much force guys, the test would be strong, that would be awesome. It would be great to see somebody with a strong gluteus medius, unfortunately i don't see that test result very often. What i usually get is somebody who has a hard time even holding this position right, which then would we just put weak, that's that's a weak gluteus medius. Of all I have to do is like put a couple fingers like this and I can push them over, that's a weak gluteus medius. I think the sign you guys are going to get most commonly though is with compensation, and here's the two big compensations you're going to see; either you're going to go to push down just like we were talking about right, so that down, a little bit forward, a little bit of internal rotation, you're going to go to push like that, and their pelvis is going to try to flip back on you. If their pelvis tries to flip back on you, now what they've done is they have relatively put their femur in flexion, so now they're trying to use those abductors that are also flexors, which is her TFL and gluteus minimus, to try to resist you. The other thing you might see is when you go to push down, you can actually feel her leg slide away from you into flexion. Once again trying to bias the test into flexion, trying to use that TFL and gluteus minimus to try to resist you. So you have weak where you just push down, but then we have the most common thing I see which is this with compensation, and I think you guys got the hint there from both of my examples with the pelvis turning forward, the leg sliding forward, that somehow flexion is involved. Well if we kind of go back to our general human movement science, we go back to those predictive models of dysfunction, we kind of know that inhibition of the gluteus medius is going to lead to synergistic dominance by the TFL and gluteus minimus, and this is not a great thing. TFL and the gluteus minimus are also internal rotators, we know internal rotation at the hip is is related to both hip dysfunction as well as knee dysfunction; and so if we get a sign of with compensation on our provocative gluteus medius test here, we know we've got some work to do. We probably need to calm down the TFL and gluteus minimus with things like release of lengthening techniques, and we know we're going to have some work to do on that gluteus medius to get it active, and to get it taking over the role it's supposed to be taking over, which is the prime mover of abduction. I hope you guys can see from doing this test, alright so I'm going to stabilize her pelvis, up you know abduction and extension here, that this definitely biases the test more towards gluteus medius; and instead of just doing that abduction test where people will often trust very strong, because they can use those overactive synergists, we're basically taking those out. And all of a sudden that's where I think everybody will start saying their movement assessments match their manual muscle tests, because all things being equal shouldn't they match up. All right if I see knees bow in, my gluteus medius should probably test weak in most individuals. And I think doing it this way that's what you'll start to find. I hope you guys enjoy testing the gluteus medius, I think you'll find with a lot of individuals they're not as strong as they think they are, and then start doing some of those gluteus medius activation exercises, and see if this test changes. You could start doing an assessment for gluteus medius, do your activation circuit and then immediately reassess, and I think you guys will start to see how this test can change. I think you'll see how gluteus medius activation exercises can really have a big benefit, and I think you'll see a huge improvement in your outcomes. I look forward to talking to you guys again soon.

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