Dr. Ben Boudreau: This is glute medius, a very important muscle. It has attachments on the iliac crest of the pelvis here, and it inserts on the back of your femur. And predominantly, it’s responsible for lifting the pelvis on the opposite side. And so important for when you’re walking, running or when you’re single leg standing. Notice how my pelvis is even without a proper or strong glute mead. I’d end up doing this. Yeah.

Dr. Clayton Roach: One important thing, too, is that we all know that the glute makes up our butt, right? And there are three muscles in there. The glute maximus, the glute medius and the glute minimus. So the medius is very important because it’s underneath that bigger glute maximus muscle, but super important when stabilizing the hip. And as soon as that one isn’t working well, then a whole bunch of muscles start to come over to try to help out.

Dr. Ben Boudreau: Exactly. And so you must keep your glute medius activated. Now, some position that may shut it off is sleeping at night without a pillow or seated cross-legged. This will turn off your glute medius. You must keep your hips active so that this muscle does not deteriorate over time. And it’s oftentimes involved with back pain.

Psoas

Dr. Ben Boudreau: One of our main hip flexor muscles, the psoas, comprises two muscles. And it can also be called Ilio psoas, made from psoas, which originates from the vertebrae at the bottom and attaches to your femur on the way down. And so very common for people who have to sit all day at work, say you’re a desk worker and working from home or say you’re a bus driver and you’re constantly seated. These are the types of folks that have that hallmark sign that when you get up from that seated position, you need to crawl up your legs to loosen up that muscle.

Dr. Clayton Roach: Seen a lot of those in the clinic. And the problem with that is that when you’re sitting, that muscle is chronically short, right? So when it goes to try to lengthen, when you go to try to stand, it just doesn’t want to do that. And as Ben noted, there are two parts. There’s the iliacus and then there’s the psoas.

Now, here’s one thing you may not know about the psoas because some of you know a lot of stuff about the back, but it attaches to the diaphragm, so when it’s constantly shortened by the fact that you’re sitting all the time, your ability to take a deep breath in is going to be severely impacted by the fact that that psoas is just not spending a lot of time in that length and phase. And it’s always short, right? So the psoas big one with lower back pain.

Quadratus Lumborum

Dr. Clayton Roach: The most common sight and the most common culprit is where the pain is when you have low back pain. The quadratus lumborum.

Dr. Ben Boudreau: Yes. The quadratus lumborum has attachments at the 12th rib. And so your lowest rib in your back as well as through the pelvis and on the iliacus is responsible for you bending from side to side. It’s also a part of the posterior or the back where your core is. And so it’s a huge part of forming that cylinder to stabilize your lower back. Although people might not know that, when you’re eating flank steak, not to gross anybody out, but that is the flank steak. That’s the QL. So you see these little knobs here.

These are called transverse processes, and they’re on every part of the spine. Every vertebra has them. And this is where the QL attaches along the way. So any time there’s a spasm here, the ability of that spasm, the spasm can shift that lumbar spine, which is why it’s so common with people with low back pain. A huge culprit; as you take a deep breath in, it also stabilizes that mid back here so that things can expand on that rib cage because you can see where it attaches to the lower rib. We work on these all the time. Dr. Boudreau, many people are so tender and need that rib cage. One because they’re sitting a lot, right? And that rib cage doesn’t move a whole lot because of the psoas that doesn’t allow you to take a breath in.