Exercise for lumar segmental control- contract glutes or not?

[mover123]

Hi- gee I went to a physiotherapist yesterday and he showed me an exercise for my lumbar spine- it is like doing a very slow bridge where I lie on my back with knees bent, press down with my feet, then press my knees away (from my head) and very gradually, vertebrea by vertebrea, roll up to somewhere around rib cage level and then roll back down.

That is hard for me because I tend to muscle it and just grip all my muscles etc.

Anyway, I have been practicing quietly at home and have realized that I automatically contract my glutes- not squeeze them together but the upper portions do contract. I don't really notice until I roll back down and these muscles (just on top of my butt) are the last thing to let go.

So now I am wondering, should I be contracting them at all? I really didn't think to ask yesterday. But it seems like contracting them keeps my lumbar spin tense... I tried without any contraction whatsoever (as good as I could do) and **WOW** I suddenly really felt the strain on my back! And I was thnking maybe that is good?


So I don't know which way to do it? These sessions cost a LOT of money and I don't want to wait until next week to find out and I don't think I can phone. And I really want to practice this before next session- it was my only assignment. I feel so stupid with my body- I can't even get this simple little exercise right!

So contract the upper glutes or not?

thanx

Similar Threads:

• My QL is tight because my glutes are weak???
• piriformis / Glutes
• "Per patient" contract work
• FULL TIME PHYSIOTHERAPIST WANTED FOR TEMP OR PERM CONTRACT
• Treatment of spasmodic torticollis in primary segmental dystonia

[gcoe]

Hi mover 123. I don't really know what the PT is trying to get you to do from this exercise. Whether the physio intended this or not the byproduct for you is that you seem to be discovering what you ared doing and so promoting body awareness. That is never a bad thing but whether it will "solve" your back problem I couldn't say.

When a PT is teaching you an exercise and you don't get it - well that is really their problem more than yours and it is their responsibility as ypur clinician to ensure you successfully learn whT they want you to learn. So personally I would go back and say "hey that session i paid for i didn't get itwhat were you trying to do?

In PT there are a number of approaches to managing low back pain and it is usually best to go with one that is backed by research evidence that it works. I couldn't comment on what your PT is doing in this regard. However as you Re pYing you havea right to know. So I would quizz them about what they are aiming to do, whether it is backed by evidence and get them to better explain the therapy.

[mover123]

thank you for replying gcoe!

The PT is getting me to learn how to use my spine with fine-tuned musclar control (fine-tuned is my term...) and my transerve abs. My understanding is that I am just using my large back muscles to move and I have to learn how to use all the little muscles. That's is why I don't really roll my spine one vertebrea at a time.

Yes, I know it is their job to teach me. He did teach me. I even practiced by myself while he went away. Then he came back and asked if I had any questions. I just didn't think about my butt muscles at the time. Really, he said the only thing I should think about is moving my knees away from my body. I just don't know.

I don't want to antagonize him. I will ofcourse ask for clarification next week but in the meantime that is my only homework assignment and I would like to get it right.

I don't have low back pain but he thinks some nerves are being pinched. In any event the exercise is only meant to teach me how to move properly.

Here is a video from youtube that is the same. My PT never used the word Rolfing.
YouTube - Rolfing Pelvic Lift

So, my question is that my upper butt muscles, just above the crack and to either side (sorry for terminology) automatically turn on because I can feel them relax when I finish the roll down.

But I can deliberately keep those upper butt muscles relaxed and if I do my back has to work a lot harder. Maybe all those little muscles that I never use???

So I just don't know- should I keep the upper butt relaxed or not?

thanx

in the video- the PT here does not say either. I would think whatever I do naturally would be correct but then, my natural ways are wrong so who knows!

[gcoe]

Learning to stabilise your spine by contracting your transverse abdominus is an evidence-based treatment and providing your back pain is related to an instability problem this should help you. If he is trying to get you to contract your transverse abdominus then you should be thinking about gently drawing your lower belly in. You need to be shown how to do this and he should have got you to do this in isolation before giving you the exercise you desribed. Once you have some proficiency with contractong your transveres abdominus you can go on to the exercise you described. You contract the transverse muscle before lifting your pelvix then perform the lifting while keeping the muscle contracted. If that is what he taught you and that is what you r doing then you are on the right track!

The working of the glute max is fine. In fact You have to do this in order to lift and lower your pelvis. Nothling wrong with that and this is because you have to extend your hips with your hip extensors ( glute max) when you push through your feet and lift your pelvis. In fact in a lot people with back pain learning to use and strengthen this muscle is a good thing.

Don't worry too much about the rolfing thing. Ida Rolf created an alternative therapy called structural integration or rolfing and it has been been more or less discredited. The fact that the exercise is identical is just coincidental.

Your therapist will probably go on to give you more movemnts to do that getprogressively more demanding, each time learning to maintain the contraction during the movement. This is part of a standard therapy

Hope this helps

[mover123]

Thank you! Yes, it is L4/L5 instability. The action of pressing the feet into the floor activates the transverse abs- we covered that in isolation for about 5 minutes and I understood. & yes, he said it is going to get more complicated later.

I was just practicng when I got the response reply email from your post. It feels nice on my lower back. But I have been practicing now without contracting the glutes- it does stress the back more. I googled rofling and got a paper called " the Plevic Lift Themes and Variations" that talks about rolfing- it said do not contract the glutes.

So then I WILL contract the glutes- but only by what ever happens naturally (which is quite a bit!)

Thank you very much gcoe! That is intersting to know that Rolfing has been discredited- thank you so much for that because i just emailed a person in town who gives rolfing lessons and I was wondering why my PT had not said it was rolfing- I was loosing trust, so a BIG thank you for that!!!! Makes me feel much more confident in my PT. Also, I really like that it is evidence based. I am very conservative. I don't even want chiropractic adjustments for example.

so as far as glutes go- contract naturally but that is not my focus. That is what I will conclude. Thank you!!