You can only view 3 videos without an account. Become a Member to access all videos on the website.
Gluteus Maximus Manual Muscle Testing (MMT) for an Active Population
The Gluteus Maximus Manual Muscle Test (MMT) for an Active Population is a comprehensive assessment technique used to determine the health and strength of the gluteus maximus muscles (buttocks) in an active individual. This test involves manually testing the strength of the gluteus maximus in various positions, as well as its flexibility and ability to tolerate pressure. This test can give an indication of any imbalances or weaknesses in the muscle, as well as assess the readiness
Transcript
00:00:0500:00:06
This is Brent of the Brookbush Institute,
00:00:0500:00:06
...blank
00:00:0600:00:08
today we're talking about gluteus
00:00:0800:00:10
maximus manual muscle testing for an
00:00:1000:00:12
active population. So we're going to go
00:00:1200:00:14
ahead and set that Kendall scale aside,
00:00:1400:00:16
with the one through five the pluses and
00:00:1600:00:18
minuses, and can the person move against
00:00:1800:00:20
gravity and through a full range of
00:00:2000:00:24
motion and resist manual pressure from
00:00:2400:00:25
the practitioner. We're going to set all
00:00:2500:00:27
of that aside. We're going to replace it
00:00:2700:00:31
with a simpler scale -strong, weak with
00:00:3100:00:36
compensation, or with pain. But we're
00:00:3600:00:38
going to make the test more provocative.
00:00:3800:00:40
I'm going to talk about some stuff today
00:00:4000:00:42
guys about range of motion as well as
00:00:4200:00:44
overactive synergists, and how to inhibit
00:00:4400:00:48
them so that this test becomes much more
00:00:4800:00:50
provocative for those individuals who
00:00:5000:00:52
are leading an active lifestyle. They go
00:00:5200:00:55
to the gym, or they play sports, or maybe
00:00:5500:00:57
even a professional athlete. Alright so
00:00:5700:00:59
I think we need to find a little bit
00:00:5900:01:02
more congruence between what we see in
00:01:0200:01:05
movement assessment, versus what we see
00:01:0500:01:08
in these manual muscle tests; and like I
00:01:0800:01:10
said that probably has to do with how
00:01:1000:01:12
provocative is the manual muscle test
00:01:1200:01:13
itself. I'm going to have my friend
00:01:1300:01:15
Melissa come out, she's going to help me
00:01:1500:01:18
demonstrate. So she's going to lie prone,
00:01:1800:01:21
first thing we need to talk about is
00:01:2100:01:24
what are all of the synergists for an
00:01:2400:01:26
inhibited glute, and what we end up with
00:01:2600:01:30
is this deep longitudinal subsystem
00:01:3000:01:33
dominance. When the glute max becomes
00:01:3300:01:35
inhibited, so she'll start using her
00:01:3500:01:39
erector spinae, her biceps femoris and her
00:01:3900:01:42
adductor Magnus the posterior head, to do
00:01:4200:01:45
an extension type pattern; which
00:01:4500:01:46
unfortunately becomes lumbar extension
00:01:4600:01:50
as well as hip extension, to try to make
00:01:5000:01:52
up for the fact that the glute is not
00:01:5200:01:55
doing what it's supposed to do. What we
00:01:5500:01:57
need to figure out during this test is
00:01:5700:02:00
how to ensure that when I get a strong
00:02:0000:02:04
extension from my patient or client, that
00:02:0400:02:06
it's not this compensation pattern and
00:02:0600:02:11
that it is in fact a strong glute max. So
00:02:1100:02:12
I'm going to use some techniques to
00:02:1200:02:15
reciprocally inhibit those overactive
00:02:1500:02:17
synergists, and make sure that all I
00:02:1700:02:19
leave behind is the glute. So starting
00:02:1900:02:20
with her erector spinae, we're going to
00:02:2000:02:23
draw in and maybe even have her make a
00:02:2300:02:25
six-pack. Let's go ahead and have her
00:02:2500:02:27
contract her rectus abdominis a little bit.
00:02:2700:02:29
So now she can't extend at the spine, I'm
00:02:2900:02:32
left with only hip extension. Her erector
00:02:3200:02:33
spinae are not going to be able to help
00:02:3300:02:36
her out. Now let's take care of the other
00:02:3600:02:38
hip extensors right, so we have adductor
00:02:3800:02:42
Magnus and biceps femoris. Now Kendall has
00:02:4200:02:44
you try to create active insufficiency
00:02:4400:02:46
by shortening this muscle as far as you
00:02:4600:02:48
possibly can. Now I know this is anecdotal
00:02:4800:02:50
but i don't really like this
00:02:5000:02:53
flexed knee thing, you know I think too
00:02:5300:02:54
many times I've heard man I really feel
00:02:5400:02:57
that in my my hamstrings; and if somebody
00:02:5700:03:00
feels it in their hamstrings my guess is
00:03:0000:03:01
is that their hamstrings are working
00:03:0100:03:04
pretty hard, and I want just the glutes.
00:03:0400:03:07
So I'm actually go opposite, i'm going to
00:03:0700:03:09
have Melissa extend her leg, we're even
00:03:0900:03:10
going to have her reinforce a triple
00:03:1000:03:12
extension pattern, so she can point her
00:03:1200:03:14
toe. We're going to make sure she
00:03:1400:03:16
contracts her quad real hard, extends her
00:03:1600:03:18
knee. and I'm hoping that this quad
00:03:1800:03:20
contraction reciprocally inhibits our
00:03:2000:03:23
biceps femoris. Now as far as my adductor
00:03:2300:03:25
Magnus, I'm going to have Melissa move as
00:03:2500:03:27
close to me as she possibly can, all the
00:03:2700:03:29
way to the edge of the table; and I'm
00:03:2900:03:33
going to have her abduct against my thigh here. So
00:03:3300:03:35
now that she's abducted, I know her
00:03:3500:03:38
adductor Magnus has to be shut down. So I
00:03:3800:03:41
got her drawn-in, contracted, making her
00:03:4100:03:44
leg as long as possible, she's pushing
00:03:4400:03:46
against my leg; and now i'm gonna say go
00:03:4600:03:48
ahead and try to squeeze your butt, and
00:03:4800:03:52
run your leg kind of against my thigh
00:03:5200:03:54
here. Now that i got her in extension, you
00:03:5400:03:56
guys need to put quite a bit of force
00:03:5600:03:59
through to the point that you know
00:03:5900:04:01
somebody has a really strong glute. What
00:04:0100:04:04
should probably move, is you should be
00:04:0400:04:05
able to push down on their leg and see
00:04:0500:04:08
their whole whole body move as one
00:04:0800:04:09
segment. Not their whole body move is
00:04:0900:04:11
like a compensation pattern like they're
00:04:1100:04:13
doing something weird, but as you push
00:04:1300:04:15
down here, you can almost feel her want to
00:04:1500:04:18
tip this way. The glutes a big strong
00:04:1800:04:20
muscle, I should be able to push down
00:04:2000:04:25
really really really hard and she should
00:04:2500:04:27
be able to hold it. Now
00:04:2700:04:29
what are the common things you guys are
00:04:2900:04:30
going to see when somebody doesn't have
00:04:3000:04:34
a strong glute max, well you could see
00:04:3400:04:36
weakness. I could set her up into this
00:04:3600:04:38
whole position get her pushed in, and
00:04:3800:04:40
then like just push her back down to the
00:04:4000:04:44
table with almost no no real force
00:04:4400:04:46
applied. Remember this is a bigger muscle
00:04:4600:04:48
guys, unlike your tibialis
00:04:4800:04:51
posterior -posterior tibialis where I had
00:04:5100:04:53
to be careful how much force I applied,
00:04:5300:04:54
because your posterior tib isn't the
00:04:5400:04:56
biggest muscle in the world. Her glute
00:04:5600:04:58
max I should be able to lean, even though
00:04:5800:05:00
I'm a bigger individual than she is, I
00:05:0000:05:01
should have be able to lean and she should be able to
00:05:0100:05:03
hold me up. If I can just kind of lean
00:05:0300:05:07
over without much added force and push
00:05:0700:05:08
her right back down to the table, I'm
00:05:0800:05:12
going to give that a W for weak. Now I don't
00:05:1200:05:14
get too many weak glutes, I do get some, I
00:05:1400:05:16
do get some weak glutes where you take
00:05:1600:05:18
out all of their synergists and and they
00:05:1800:05:19
really don't know how to get this guy
00:05:1900:05:22
firing. What you'll see a lot of is like
00:05:2200:05:24
different compensations starting to
00:05:2400:05:28
happen. Probably the most common one is
00:05:2800:05:30
is you'll go ahead and have them do this
00:05:3000:05:33
and then as soon as you push, they start
00:05:3300:05:36
arching here. Right you'll see them, can
00:05:3600:05:38
you kind of arch for me as I push down,
00:05:3800:05:40
so they go into an anterior pelvic
00:05:4000:05:41
tilt, like they start doing this thing.
00:05:4100:05:43
You might even see some hip flexion on
00:05:4300:05:45
this side as they try to figure out a
00:05:4500:05:47
way to pull up. That's probably the most
00:05:4700:05:49
common, and then of course they' get
00:05:4900:05:52
a C for with compensation. And I'm going to
00:05:5200:05:55
start going to, if I saw too much lumbar
00:05:5500:05:58
extension, one of my lumbar extensors
00:05:5800:06:00
that'd be my erector spinae. My erector
00:06:0000:06:03
spinae are probably overactive, maybe I
00:06:0300:06:04
want to try to get some release and
00:06:0400:06:06
lengthening here, and then start working
00:06:0600:06:10
on that glute maximus activation. Some
00:06:1000:06:12
other signs you might see is not being
00:06:1200:06:13
able to hold the abduction against your
00:06:1300:06:16
thigh, or you might see them actually try
00:06:1600:06:19
to bend their knee and recruit their
00:06:1900:06:22
hamstrings. Now another really
00:06:2200:06:24
interesting test to try somebody who's a
00:06:2400:06:27
little bit more advanced, or maybe you
00:06:2700:06:28
want to do something that's a little bit
00:06:2800:06:30
more sensitive pretest post-test. I
00:06:3000:06:31
learned in these
00:06:3100:06:33
Maitland workshops I have been taking for
00:06:3300:06:36
certified orthopedic manual therapists,
00:06:3600:06:38
this little test that they showed us in
00:06:3800:06:40
one of the workshops works really really
00:06:4000:06:43
well. I think it's a a fascinating thing
00:06:4300:06:45
to do in a lab, get a bunch of your your
00:06:4500:06:48
colleagues together and just try doing
00:06:4800:06:50
what i'm about to show you, glute max
00:06:5000:06:53
activation, and then try it again. And
00:06:5300:06:56
here's how it goes, you guys are going to
00:06:5600:06:59
make your your hands like this right,
00:06:5900:07:02
you're going to go biceps femoris, so
00:07:0200:07:04
lateral hamstring. Your thumbs are going
00:07:0400:07:06
to be over the glute max, and then this
00:07:0600:07:08
other pinky is going to be over their
00:07:0800:07:11
erector spinae. What you're going to do
00:07:1100:07:14
is have them go ahead and extend at
00:07:1400:07:18
their hip, and what you're going to try
00:07:1800:07:20
to figure out is the timing of these
00:07:2000:07:23
three things. So what I felt with Melissa
00:07:2300:07:26
which is not great, is biceps femorisM
00:07:2600:07:28
erector spinae and then glutes came in
00:07:2800:07:32
last. What I would like to feel when I
00:07:3200:07:34
asked her to squeeze her glute and extend
00:07:3400:07:38
her hip is glute first, followed by biceps
00:07:3800:07:41
femoris, and then if she gets in further
00:07:4100:07:43
into extension gets her leg up off the
00:07:4300:07:46
table, then her erector spinae has to
00:07:4600:07:49
fire to stabilize her pelvis. Alright so
00:07:4900:07:50
I would do this again, go ahead and
00:07:5000:07:53
squeeze, that was a little bit better
00:07:5300:07:55
just from her hearing me talk, and having
00:07:5500:07:57
good body control. She went biceps
00:07:5700:07:59
femoris, erector spinae and then glute, but
00:07:5900:08:03
it was a little bit more combined. If we
00:08:0300:08:04
had a little bit more time on this video
00:08:0400:08:06
I would have her do a bunch of glute max
00:08:0600:08:08
activation stuff, maybe some hip flexor,
00:08:0800:08:11
hip flexor release and lengthening stuff,
00:08:1100:08:15
and try it again. So now you guys got two
00:08:1500:08:18
tests here, you guys got the glute max
00:08:1800:08:20
manual muscle test. What you're going to
00:08:2000:08:24
do is activate your core, go ahead and
00:08:2400:08:27
activate your quad, push against your
00:08:2700:08:30
thigh for abduction. Have them go into
00:08:3000:08:31
extension, and really squeeze they're
00:08:3100:08:33
glute. They're going to see if you can
00:08:3300:08:35
push them back down to the table, make
00:08:3500:08:37
sure you're watching for both weakness
00:08:3700:08:40
and compensation.
00:08:4000:08:43
You then have the timing test which
00:08:4300:08:46
should be glute, biceps femoris, erector
00:08:4600:08:49
spinae. Not biceps femoris, erector
00:08:4900:08:51
spinae, glutes which is a very common
00:08:5100:08:54
compensation pattern. One more little
00:08:5400:08:56
geek out molar for you guys, remember
00:08:5600:08:59
that strength is range of motion
00:08:5900:09:04
specific. So Melissa had a lack of hip
00:09:0400:09:08
extension, she had tight hip flexors, is
00:09:0800:09:09
she going to be able to get into
00:09:0900:09:11
extension real well. Is she going to be
00:09:1100:09:12
able to get into extension without
00:09:1200:09:16
compensation, probably not. That's going
00:09:1600:09:18
to have an effect on her test. Realize
00:09:1800:09:20
also that if you lengthen and release
00:09:2000:09:23
her hip flexors, alright she had a tight
00:09:2300:09:25
tfl gluteus minimus I went after that, psoas
00:09:2500:09:27
an iliacus got that out of the way, adductors,
00:09:2700:09:30
anterior adductors got those out
00:09:3000:09:31
of the way; got her all the way back to
00:09:3100:09:33
good hip extension; well she's been
00:09:3300:09:35
missing that ten degrees of hip
00:09:3500:09:36
extension, is she going to be very strong.
00:09:3600:09:38
So another thing you could do with this
00:09:3800:09:42
test is maybe you want to test it see if
00:09:4200:09:44
her glute max is strong, but then go
00:09:4400:09:47
ahead and do her mobility work, test it
00:09:4700:09:49
again. If it was strong before the
00:09:4900:09:52
mobility work but weak after, it might be
00:09:5200:09:54
that she's weak in her new range of
00:09:5400:09:58
motion. Sorry for the last minute and a
00:09:5800:09:59
half of this video guys, i know that's a
00:09:5900:10:00
little bit of an anatomy geek out but
00:10:0000:10:02
i've given you a lot to think about here.
00:10:0200:10:05
We have a manual muscle test with
00:10:0500:10:07
reducing the contribution of overactive
00:10:0700:10:09
synergists. You guys had the sequence tests,
00:10:0900:10:12
hopefully glute max, biceps femoris then
00:10:1200:10:14
erector spinae. And now you have a little
00:10:1400:10:17
range of motion to think about. Make sure
00:10:1700:10:19
that when you're doing this test as they
00:10:1900:10:22
gain range of motion you re-test, so
00:10:2200:10:23
they're not only strong through the
00:10:2300:10:26
range of motion they had, but the new
00:10:2600:10:28
range of motion you're giving them back
00:10:2800:10:30
to get them back to optimal. I hope you
00:10:3000:10:32
guys have enjoyed this video, I look
00:10:3200:10:34
forward to hearing about your results on
00:10:3400:10:37
these tests. Really try to do your pre
00:10:3700:10:39
and post-tests. If you're new to manual
00:10:3900:10:41
muscle testing do the manual muscle test,
00:10:4100:10:43
do some activation techniques, do the
00:10:4300:10:45
manual muscle test again. Start with your
00:10:4500:10:48
colleagues is always a good idea,
00:10:4800:10:49
grab some of your fellow personal
00:10:4900:10:51
trainers, physical therapist, athletic
00:10:5100:10:53
trainers, chiropractors. Get a study group
00:10:5300:10:56
together and practise these, and then by
00:10:5600:10:58
the time you get them to your client and
00:10:5800:11:00
patient, you're already be nice and
00:11:0000:11:01
comfortable. I look forward to hearing
00:11:0100:11:04
from you guys again soon.
Related Videos
Tibial Internal Rotator Manual Muscle Testing (MMT) for an Active Population
Posterior Tibialis Manual Muscle Testing (MMT) for an Active Population
Shoulder External Rotator Manual Muscle Testing (MMT) for an Active Population
Gluteus Maximus Manual Muscle Testing (MMT) for an Active Population
Deep Cervical Flexor Endurance Test
Femoral Nerve Neurodynamic Tests
Lumbar Movement Assessment
Slump Test
Upper Body Movement Assessment
Straight Leg Raise Test and Well Leg Raise Test