Gluteus medius weakness and chronic low back pain
Hip abductor weakness is often seen clinically in patients with chronic, non-specific low back pain (CNSLBP). The current study aimed to assess differences in gluteus medius, maximus and TFL strength between subjects with CNSLBP and healthy subjects. Manual muscle tests were used to determine strength with the 1-5 strength scale. The authors found a significant difference in strength between the groups, particularly on the affected side in subjects with unilateral pain. There was also a significant correlation between unilateral low back pain and trendelenburg sign.
150 patients with CNSLBP and 75 healthy controls participated. They were assessed with manual muscle testing in 3 different positions to test TFL (side lying with some hip flexion), gluteus medius(side lying with some hip extension and forward pelvic roll and gluteus maximus (prone with knee flexed). The presence of LBP correlated with higher BMI, gluteus medius weakness, low back tenderness, and a positive Trendelenburg sign, particularly on the affected side for those with unilateral LBP.
Although a small study by Kendall et al in 2010 found a reduction in LBP of 48% after 3 weeks of gluteus medius training, future studies should rigorously examine the effect of gluteus medius strengthening in this subgroup of CNSLBP patients and should include assessment via dynamometer.
Is, in your opinion, targeted gluteus medius strengthening an effective intervention for patients with unilateral low back pain?
> From: Cooper et al., Eur Spine J 24 (2015) 0(Epub ahead of print). All rights reserved to Springer-Verlag Berlin Heidelberg 2015.Click here for the Pubmed summary.