Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. This week I’m going to talk about your butt. Sounds funny, but it’s actually a very serious topic! 

When I say “butt”, I’m talking about the gluteus maximus, gluteus medius, and gluteus minimus. The first two (the main focus of the Note) are the most important because you train the gluteus minimus by training the gluteus maximus and gluteus medius

Your butt is important. Keeping the butt muscles strong can actually keep you from serious injury, even death. As your butt muscles shrink (part of the aging process), your body becomes unstable, leading to knee and hip problems later in life. This is one reason why I try to do squats every day (mostly air squats with a few added weights every once in a while). I consider this the most important exercise I do.   

Note: when I squat, I place my feet shoulder width apart and try to go down as low as I can (this requires some hip and knee flexibility).  

Working on your butt muscles is important because they help to stabilize your trunk (along with the other main core muscles such as the abdominal and back muscles). You need to see how strong your butt muscles are. Are they flat or strong? Then work on them. 

Your gluteus maximus is the primary hip extensor. It’s the muscle we should be strengthening the most, yet it’s the most forgotten. The gluteus maximus stabilizes the hip and pelvis, helping you get from a seated position to a standing position. It also helps you climb stairs, which is extremely important as you get older! I often watch patients get up from their seats. If they have to use their arms, then most likely they have a weak butt muscle. The gluteus maximus also helps us keep an upright trunk posterior. It’s an antagonist muscle to the hip flexor, which is usually tight due to excess sitting. Remember…sitting is the new smoking. 

The gluteus medius also weakens as you age. If you start to have hip and knee problems, your physical therapist will usually go to your gluteus medius and find that it’s weak. The gluteus medius is the chief hip abductor (moving your hip in an outward direction) that stabilizes the hip and pelvis during ambulation and standing. Weakness in this area contributes to excessive wear and tear on the hip and knees. Cartilage can wear out faster because of weakness in the gluteus medius. Strengthening these muscles (gluteus medius and gluteus maximus) will help preserve your knees and hips. 

Stability and balance is very important as you get older. You may be otherwise very healthy, but if you’re falling, you are in trouble! Your chances of dying within five years, or even sooner is high. You have to look at stability. Building a strong core also reduces pain. As you get older, you get stiffer. You sit around too much, don’t stretch and don’t drink enough water. This is a sign that you need to work on your core! 

My favorite core exercises: 

  • Squat (the most important exercise for your butt muscles, and it also hits a lot of other things)
  • Bridge
  • Plank (side and front planks)
  • Lunge 
  • Superman 

How many people do you know have had knee or hip replacements? Many of my patients and friends have had at least one of these surgeries. There are a couple of tests I do with patients, if I’m worried about them. 

  1. I’ll watch them go from sitting to standing without using their arms. 
  2. The ten second test. This is where I will have them stand on one leg while looking forward. If they can maintain this for ten seconds or more then they’re usually good. If they can’t maintain standing on one leg for at least ten seconds then their mortality rate over the next five years is pretty high. 

You can try these tests on yourself to see where you’re at. If you don’t do well on one or both of them, then you need to start working on your core.

To sum it up, if you want to age well, think about your core, especially your butt muscles. You want to strengthen your entire core (front and back). A weak core leads to instability, which leads to excess falls as you get older. Note: there is a very high mortality rate after falls, especially if you fracture a hip.  

It’s not about looking better in a swimsuit. It’s about aging well, walking upstairs, being able to go on hikes, and going outside to ride your bike. It’s living your best life. So take care of your butt!  It’s that important. 

FYI:  If you want to see me demonstrate a version of my daily workouts, check out this video