Pain is a Great Motivator

Rebecca Dutton
Home After a Stroke

December 16, 2015

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.

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Pain is a Great Motivator

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