Hey, this is Dr. Gangemi and in this Sock Doc video I want to talk about a couple really important neglected muscles that help to support and stabilize your entire lower leg as well as your knee and even your hip when it comes to moving freely and with a nice strong base of support as well as helping you move forward efficiently and effectively when you run.
So the first one I want to talk about is your glute medius. Most people know their glutes as their glute max, their butt muscle. But the glute medius is actually super important to stabilize your hip and even your knee when you’re standing on one leg. And since essentially running is a series of balancing from right leg to left leg and back and forth, the glute medius is really important when it comes to keeping your body really strong in this base of support. And if you stand like I am right now and put your hand right on the side of this front bone here of your pelvis and then you come down and touch over your greater trochanter which is your hip ball and socket joint there, and if you move your hip like this, your leg like this you can feel it.
Basically right in between that area is your glute medius. So your glute max is back here giving you power to push yourself forward and squat and all those things. But your glute medius is going to help to stabilize your leg as you stand on it so I can feel it contract as I come on one leg like this, as I stand on that same leg as well as ABduct. Bring your leg out like this and internally rotate your hip. So if you do this, if you bring your leg out and turn it in as in this motion, your lower leg, your whole leg essentially even your foot, you’ll feel your glute medius contract really well. And that’s how you can isolate it to the best of your ability.
If it’s sore on one side and not on the other, if you notice that, you know, as you bring this one up on one side it’s a little bit more weak then look for a trigger point in that area that you might be able to release and give you more range of motion or more support and stability on that side. Or especially if you’re having pain in the hip or in the knee then look for trigger points in the glute medius like I’ve taught you in other videos. Work it out in there. Hold it. Work it out in a circular motion or even just deep pressure for just 20 or 30 seconds in the glute medius.
So it’s deep in there. You’ve really got to dig deep in this one and see if that frees up some of the support and helps with any lateral knee pain. Because it works with your tensor fasciae latae which we talked about in the Iliotibial band syndrome video to support the outside of your knee. So even though your knee’s down here obviously think glute medius up here. Short little muscle, big time important for support.
The other important muscle that is often neglected which I talked about in the Achilles tendonitis video especially is your soleus. Your soleus is one of your two calf muscles coming from the back of your lower leg and eventually making up the tendon insertion behind your heel bone, your calcaneus as your Achilles tendon. So your soleus is more down here below the meaty part of your gastroc and where your calf sort of thins out. And you’re going to look for any trigger points in there by pushing up and in with your thumbs to see if there’s any tenderness in here.
Now your soleus pretty much plantar flexes your foot like so. So if you notice any problems with stability or even knee pain or pushing off and powering you forward whether it’s up a hill or up stairs, think calf but especially think soleus. And I want you to look for trigger points in there and as I’ve mentioned before, pretty much stay off the Achilles tendon if your Achilles tendon is a little bit sore. Go a little bit more up towards the soleus and look for trigger points in there to relieve anything in the Achilles.
But even more importantly I see a lot of soleus problems, calf problems causing knee pain. So if you notice that if you do a little bit of a light knee bend like this and your knee hurts anywhere but especially over the patella tendon in the front of your knee or your knee feels weak and unstable, don’t just necessarily look around the knee like I’ve addressed in the knee video. A lot of times it can be there, but actually you might have a problem in the soleus way down here or even in the glute medius way up here. So we’re thinking now way above in the hip and way below towards the lower leg and the ankle.
Your soleus is a highly aerobic type muscle. It’s anywhere from 60 to 90 percent or more aerobic muscle fibers. These are the slow Type I, highly oxygenated red muscle fibers that basically help support your or developed through aerobic metabolism. So the more you’re overtraining or the more you’re stressed out and training too hard and using anaerobic type energy systems, the more you can throw off that balance between aerobic and anaerobic that I talk a lot about on the Sock Doc site. And then you can end up with an Achilles tendonitis issue, knee pain, or all coming from a soleus issue on either the right side or the left side of the body. So think about your training and think about overall stress in your life whether aerobic metabolism and soleus issues.
So next I want to talk about a few little exercises you can do to help support and basically stabilize these muscles. And one real simple that you can do is basically just stand on one leg. I’ve shown this before with some ankle mobility and stability exercises but this one’s great for your glute medius here.
And if you’re really good at it the next thing you can do to take it up a notch is close your eyes as I am right now. And notice how I’m still staying pretty straight, little bit wobbly, but I’m not falling over like some people do. I should be able to do that for a minute and then even you can turn your head like this. And again I shouldn’t fall. I can turn it up and down and do all these different things and even do it with my eyes closed like I am right now. And there I go. So a little something to work on.
Do the same thing with my other leg. Left, right. And you can try both sides and see how you do and basically keep on bringing up the complexity of the exercise. So first with your eyes open, then your eyes closed, then turn your head, turn your head with your eyes closed, and see how well you can work that. You’ll really feel it in your glute medius and your soleus.
The other exercise you can do we’ve talked about before is a deep squat. That’s keeping your heels down, your back as straight as possible, shoulders behind your knees. If you tend to come forward like this you don’t want to go as low. If you’re having trouble getting that low you can put something underneath your heels like a book or a board to help keep your back straight.
Obviously if you have any pain in your knees don’t go down as deep, but you want to go as low as possible while keeping your shoulders behind your knees, as tall as possible with your heels on the ground. And ideally you should be able to come down this far, all the way, so you bottom out. And this is great for mobility of your ankles, your knees, and your hips.
So the last exercise I want to show you if you can do the single leg balances pretty well and if you can do the squat pretty well then I want you to try what’s called a single leg Romanian, some people call it a single leg Romanian deadlift, but an SLR. This one is great for the stability of your entire basically posterior chain. So your glute max, your glute medius, your hamstring, your calf, as well as it’s really good for balance. But it takes a little bit of work.
And what you’re going to do here is you’re going to stand on one leg. I’ll stand on my left first, then I’m going to contract the right glute first. And I want to bring my body down like a pendulum in a way, everything in line rather than sort of throwing my leg up and my torso down at the same time. And ideally I want to, so I’m balancing here on my left leg and I’m contracting this right and I want to bring it down like that. And bring this leg as straight up and flat as possible, okay?
So I can really feel this calf and this hamstring contracting and even the glute max and this glute max is staying straight. So I don’t need to hang out here that long. It’s harder the longer you do it. On the other side, so now I’m on my right leg and I’m staying flat like this, contracting that glute and I’m coming down like this nice and straight but I’m touching the floor. And again, keep your arms and your torso straight, your hips straight, and I should be pretty flat up like that. So do a few of those on each side until you’re basically going up and down and then you can do them with them with a weight a kettlebell if you choose to once you get good at these and you’re coming up and down like so. Up and down.
So you’ll feel that really well. It’s great to develop these muscles. You’ll be a much more efficient runner, much more efficient athlete regardless of what your sport is. And then if you notice some fatigue in there you can always check out the soleus, check out the glute medius or any other instability you might have in the area per the other videos that I’ve shown. Thanks for watching.
In this video I discuss two often overlooked muscles that are key for leg stability, balance, and performance – the gluteus medius and the soleus. Watch and learn how to identify a glute medius or soleus problem and what you can do to improve any dysfunction. I also show three great exercises, from easy to advanced, to help improve leg stability.
How long should you hold the squat?
How many Romanian Deadlifts?
How many times a week?
Sock Doc says
Ideally once you get good at the squat you should be comfortably up to several minutes. You can even add weight (kettlebell) but don’t “bottom out” and tuck your tailbone so much if you do.
SLRs – do 10 on each side and once they’re relatively easy then add weight.
Times per week would depend on your overall training schedule and goals. But even for good movement I’d be doing all three exercises at least 2X a week. Squatting should be done daily.
Hey doc great video! Is it ok to be doing these exercises while building up the aerobic base? Because my heart rate goes up when I do squats. Is it ok to be doing a lot of squats daily even if my heart rate goes up? And how long and how many sets of the squats do you recommend?
Sock Doc says
You don’t really do sets of squats in this manner. It’s something you should be doing daily as ideally it becomes a passive “rest” position. Not sure why your HR goes up doing them other than you’re very inefficient at them currently and it’s difficult for you. Eventually as it becomes easier a full squat should lower your HR. So yeah you should be doing theses exercises every week if not balance/squats daily.
Oh ok makes sense. My heart rate usually goes up if I do the squats really fast. So do you think a squat hold for a couple minutes or however long you can hold it would be more beneficial than just sets of squats? And what about squat jumps and lunges?
Sock Doc says
This squat I’m showing is for flexibility/stability. You don’t do it in “sets”. And I won’t comment on other exercises because that’s not the point of the video – and the list could essentially be endless.
the last two months I’ve been up and down with pain that seems to come from my si-joint.. First it flared up by playing soccer with the little children. Going side to side and even as being a goalkeeper in my youth I dived to the right.. after playing I lost some control in my lower leg/feet but it passed. the day after i did some bending gardening work.. And in the evening I was bending to one side and had pain in the muscle of the hip-area.. I rested for a week and started fitnessing in the gym.. Checking my muscle’s.. They did’nt hurt in any way.. Bad girl, good girl exercise.. Back-extension.. No pain with easy-practice.. Two weeks later… almost forgot about it. Did farmerwalks with dumbbells. Gotup to 35 kg…. I felt squeezing in my lowback. Put the ketllebell aside went showering knowing… this is no good.. I was bend to the left again.. later.. In a few days… it got better.. But a nagging pain after sitting stayed for weeks.. After two weeks I started heavy bricklaying in the streets.. Walking with bandwagons with stones.. Went well against my expectations but after a few days…. It was wrong again.. Long story short.. Rest gives relief and feels cured again. but know a month later.. after doing some work again… Not to heavy but bending over still.. I am sensitive and painfull that gets worse with work on the spot where you pointed out where the glute medius is…. My question is.. Is this a si-joint case… Or is it glute medius.. I am sensitive on both sides… I used a little ball and that made me stand straight again..
I’m very sensitive for using that area in working so I think I should not exercise it… What can you make out of this too long story..
If you take the effort to give me directions out of your knowledge.. Thanks very much
Sock Doc says
Even if it’s the glute meds then they’re going to seriously affect your SI joints anyway.
So, anyway. Pure rest is best. Okay, I’ve one week vacation this week. It’s easing down allready. I was wondering if I should go on for looking and working for triggepoints.. Spot 6 between the trochanter and illiac ridge.. on the glute medius/minimus… Or if I should even forget about that for if it is the si-joint… I feel no urge to do anything now.. It’s been like that. It eases down on itself with rest but comes back with weight bearing/while bending over !
But I understand.. It;s not to say. I check it out in the time coming.. Hope rest will do it.
I have an arthritic autoimmune disease called Ankylosing Spondylitis. It is symptomatically (classically) diagnosed with bilateral sacroiliitis, or inflammation in both SI joints. If the SIJ pain persists, I suggest talking to your Dr about seeing a rheumatologist. In fact, it is the ONLY diagnosis for someone who has true inflammation in both SI’s.
There are a lot of other issues with this disease as well, such as morning stiffness/soreness, especially in the spine.
Hope this is helps and isn’t what your problem is.
Corey I gave some more answers to your comments but it got lost with pussing the button as I forgot to fill in my name… I won’t rewrite my answer (pff) but to be short.. I have no stiffness in my spine. I have no symptoms during normal standing daily life.. I have dull sensation only at some time at the position of the joints. Using muscles around the hip don’t give any bother.. Only getting in bending loaded work gives soon backfire in the center of the low back (hips, around si-joints). I hope to get weeks of rest from work.
Great info Sock Doc, thanks.
I have had sciatic pain recently, starting in butt and going down leg..feels like labor contraction in leg! Very painful. It wasnt until i worked out the glute med that i felt complete relief..now i need to strengthen and stabilize so this video is a great push in that direction.
I have had alot of heel issues as well and have done one leg stands periodically in an attempt to strengthen my ankle joint…always feel a burning type pain around the very base of calcaneal bone..should i not do this stand, or might that pain indicate weakness and a need for stabilization?
Soleus has been neglected as well..finally got that smoothed out and ready to strengthen..your video is perfect timing!
I recently completed my first half iron distance event. I should have worn a shirt: Powered by sock doc!
Thanks for another great video Steve. I hope your book is coming along well? When I started doing deep squats my heels kept lifting and I was tipping forward. But now I can get deep with my feet flat and hold it – it is quite a relaxing posture. Would there be any benefit or harm with using a kettle bell in the deep squat position, say with the elbows tucked into the knees?
With the SLR’s my body isn’t coming down flat like yours and my right leg tends to collapse inwards – probably explains my right knee pain and shows I need to keep doing these until I improve. Thanks again.
Sock Doc says
Yeah you can do the deep squat weighted but be careful to keep your back real straight and not “tuck your tail”.
A lot of people will not be straight at first with the SLRs – takes time.
And yeah – book is coming along slowly. I’m not a fan of sitting in front of the computer more than I already do!
Thanks for the excellent video. It was very helpful. I have begun barefoot running and occasionally get calf and achilles tendon pain, but I stop as soon as it rears it ugly head.
Upon googling , I can across this
http://www.barefootjosh.com/?p=3553. It mentions overdosing on NSAIDS and keep on training.
Can you please share your thought on this strategy
Sock Doc says
I have plenty of info on this site re NSAIDs.
Hi Steve, as per the comments above, thanks for a great video
I am a 31 yr old minimalist / forefoot runner and I have been training & eating mostly using your principals for a couple of years now with great results
In the last couple of months, I have all of a sudden been getting bilateral calf pain whilst running which seems to be coming from the Soleus which gets worse when going uphill. It sorta feels like cramp.
I have found that trigger point work on the soleus definitely helps but it seems very odd that this should happen on both sides at the same time, usually a mile or two into a run. Seems like it’s maybe more of a systemic issue rather than a mechanical one?
I haven’t changed anything in my approach, form or equipment or increased my training volume or intensity and I really don’t know why this is happening. Starting to get me down a bit.
Any ideas?? Your suggestions would be sincerely appreciated
Sock Doc says
Soleus problems I always think too much lifestyle stress.
Ramila Century says
HI Dr. Gangemi,
I have been following your videos and posts as I am flat footed and having trouble with my ankles. I have been doing arch strengthening exercises, however when I go for a run my lower legs get really fatigue and sometimes painful (mostly left leg) so I have to stop and take rest which makes it feel better than I start running the pain comes back. I also tried doing the deep squats and whenever I do deep squats my keens making cracking noise. Help me out please!!
Sock Doc says
Check out the Knee Video and the other articles/video on the lower leg. Could be from past injuries or other issues related to the lower legs – such as hormonal imbalances.
Hi,I live in iran,tehran.i decide to lose weight.I do TRX for 4 months,but my muscles become bigger and now I want to lose weight.h dont like my legs becuse they become bigger
help me plz
I’m from the UK, I have recently been diagnosed with Hypomobilty, which is causing both knees to not work as efficiently the past few weeks (Never had a problem in the past – always fit and healthy), I’m struggling to bend, kneel, walk down stairs without sounding like a musical band (clicking and popping) and even just standing up still for short periods of time. I’m not in any pain, however my knees feel tight and often feel quite hot, I feel like my muscles around my knee are tight and im conscious of them while trying to stand up straight im aware my knees are slightly bent, and tired!. Im yet to have tests etc, but the condition isnt really spoken about here or understood that well. I obviously cannot squat but I want to strengthen up all of the muscles in my leg without putting any pressure on my knee, what exercises do you feel would be best for this?. Ive been using a exercise bike every other day, doing very shallow squats against a wall and holding my heel a few inches off the floor while sitting up right, would you say this is the best thing to be doing?
I understand if you are not sure on what to suggest, many people aren’t! I need to do all I can to help this, I’m only 28 and i feel 88! Any advice or help will greatly be appreciated.
Thank you so much for your time!