From stiff necks to ‘lazy glutes’: why these unloved muscles could prevent injury – and how to train yours
Killer abs, beefy biceps and perky pecs are classic signifiers of strong, well-exercised bodies, but not many people walk into a gym with a goal of building up their teres minor. This more low-key muscle, along with several others, is often underappreciated and weak, even among fitness fans. Neglecting such muscles as the teres minor can cause overuse of other muscles to compensate, or a lack of stability around a joint, which can lead to common painful injuries. And as anyone currently in musculo-skeletal pain knows all too well, it’s preferable to build up these forgotten muscles before you end up on the physiotherapist’s waiting list with an agonising shoulder, hip or lower back. Here are those elusive muscle groups to look out for.
Rotator cuff
If you get someone with shoulder pain to follow a rotator cuff strengthening programme for 12 weeks, “80% of them, no matter the injury, improve,” says Sarah Ryder, a personal trainer at Bear Fitness in London, who is doing a masters degree in physiotherapy. You may not be familiar with the teres minor, the subscapularis and the rest of this collection of muscles, but the rotator cuff, says Ryder, “should be strengthened no matter who you are, whether you’re active or inactive”.
“They support the stability of your shoulder,” says Matthew Harrison, an NHS physiotherapist in east London. “Boys, typically, will do biceps curls and chest presses to make their biceps or their arms bigger. But it’s those other smaller muscles underneath that they don’t work.” The exercises for the rotator cuff aren’t sexy, and will probably feel awkward rather than powerful, but you won’t regret any of them. It helps to use the wall in rotator cuff exercises, such as the “wall squat with long level elevation”, says Ryder. This involves squatting and raising your arms skywards in unison, to avoid your bigger muscles trying to take over. The most fun among the ones she suggests is the “bow and arrow archery exercise” which involves holding an exercise band out in front of you, then pulling one side back as if you were about to shoot an arrow from a bow.
Neck side flexors
“The neck is not an area that’s traditionally been trained in gyms,” says Mathew Hawkes, clinical director of Hawkes physiotherapy in Stoke-on-Trent, “because most of the exercises invented in the gym were devised by bodybuilders and powerlifters, but not necessarily for functional purposes.” The neck exercises that physios learned were “really token – a few stretches– maybe pushing your head against the pillow. But that isn’t taking your neck to a very high capacity.” Computer work, he says, often means your chin juts forward, leaving your head not counterbalanced, and “creating a cumulative postural strain”.
Ryder agrees that for both sedentary and active people, neck muscles need special attention. She suggests a gentle approach, correcting the jutting chin by, “pushing your chin backwards and then looking left and right. Look straight ahead with your chin in its normal position, then put your knuckles on your chin, and move your head backwards.” It seems subtle, but, as she says, “there are loads of muscles in the neck, they’re really small, so you need to adjust the posture.”
Hawkes, meanwhile, trains his neck in the gym. Seven years after injuring his neck in a car accident, he decided his only hope was to start strength-training it, as he would any other area. “They already do this with competitive sports such as Formula One driving and rugby, mixed martial arts and boxing,” says Hawkes, “as it’s good for prevention of neck problems, but it can also help to minimise concussion.” Hawkes started gradually, “and within a year, my neck problem was fully resolved.” He has developed two exercises: weighted neck side flexions, in which you lie on your side with your head off the ground or bench, pad the top side of your head with a cushion or towel, then hold a weight plate on top, tuck your chin in and slowly lower your head towards the floor and back up. His weighted neck flexions are similar, but involve lying on your back with your head hanging off the end of a bed or bench, with the weight and padding held on to the forehead. Obviously you can start this without weights and slowly build up from there. He suggests three sets of six to 10 reps with three-minute rests in between the sets.
Glutes
Dead butt syndrome, otherwise known as lazy glutes, has become a bit of a buzz concept in the physio world as a cause of problems such as hip and lower-back pain, even among those with Adonis-honed physiques. “Within your glutes you’ve got several different muscles that support your hip,” says Harrison. “Your gluteus maximus, a big one at the bottom, that helps extend the hip. Next to that, your gluteus medius and minimus, that sort of sit on the side of your hip for stability.” The maximus is easier to train in the gym or out running up hills, but the others don’t get much of a look-in if you’re not darting about in lateral (sideways) moves. Which, as Ryder says, we don’t do very often, “unless we’re children, playing tag and whatnot.”
Hawkes does caution, though, that the lazy glutes concept has “become overplayed” when sometimes it isn’t the culprit. “We know back pain inhibits your glutes, so your glutes then are weak, so it can be more of a consequence of the back pain, rather than the cause. Equally, I’ve seen people with strong glutes, where they’re still having injury problems, and I’ve seen elite athletes, where they’ve been told their glutes are weak, and it might have been true and helped their original problem, but then they overtrain their glutes to the point where their glutes start to become a problem. If someone’s got a bursitis on the side of the hip, that can come from overworking the glutes.”
But for the vast majority of us, who aren’t in danger of having overworked gluteus medius and minimus muscles, finding sports where you duck around laterally would help, or making like Jane Fonda in one of Ryder’s favourite moves: “You lie on the side and lift your leg up or down. It usually needs a lot more stimulus than your body weight, so I try to get people to hold it. Once you are over an injury – you need to first be able to do the movement – try an isometric hold, and have someone push down on you. If you have kids, try to get them to push your leg down while you try to hold it up.” You can up the intensity by propping yourself up on your elbow and raising your hips off the ground, as Ryder makes look easy on her Instagram account. Another go-to move for these muscles is the clamshell. Lie on your side, legs bent, then raise and lower the top one, which, says Harrison, “does that rotation movement”. But most importantly, he says, “Find an activity that you enjoy and is multi-directional, to encourage a range of muscles to work together.”
Erector spinae
These muscles run down the back, supporting the spine, and neglecting them can lead to lower back pain. To avoid this, Hawkes recommends the Jefferson curl, which involves standing with a barbell in both hands, arms straight at your sides, and slowly rounding your back to lower it as far as you can, before curling back up again. “It actively rounds the spine against load, training the body to cope better with the movements you apply in real life. By rounding the spine, gradually adding weight, that makes the spine more mobile, strong, resilient, and minimises the risk of that area being injured.” This is in terms of both heavy lifting but also general movement (or lack thereof). “Back pain,” says Hawkes, “is the number one cause of disability. People think: ‘I go to the gym, why am I getting injured?’ And it’s because they’re not training all the things they could train.”
Wrists
Forearms are often left out of traditional training, but a little work here can prevent overuse injuries such as tennis and golfer’s elbows. “A few years ago, I started to develop some golfer’s elbow from my job,” says Hawkes. “So I started to do more strengthening for my wrists and forearms, and within one month that feeling was gone, because I built their capacity up to tolerate the workload of my job.” He recommends exercising the wrist radial deviator muscles by resting an arm on a table, holding a weight in your hand, thumb-side up, and slowly raising and lowering said hand.
Shins
Around a joint, says Hawkes, there are antagonist and agonist muscles, which need to be working in synchronicity and balance; and so as your calf muscles build, so must your shin muscles. “Shin muscles are small compared with the calf,” says Hawkes, “but there are quite a few of them and they do a lot of supporting roles in the foot. Some of the muscles go under the tendons, run under the foot and support the arches. But most people say: what is there to train there? And that’s the misconception.” Not exercising them, he says, can lead to knee and foot pain. And yet, he says, “you wouldn’t see tibialis raises being done in any gym.” Stand with your back against a wall, feet hip-width apart. Keeping your legs straight, raise your toes toward your shins and slowly lower them down again. Move your feet further away from the wall to make it harder.
Ryder points out that the tibialis anterior’s opposing muscle, the soleus in the calf, is often short in women, which can be caused by wearing heels, but it takes 80% of your load when running and often gets injured. To confidently run without injury, you should be able do 25 single leg heel raises – “which is actually really challenging”. A single leg heel raise means standing with your weight on one foot and rising up on to your toes, then holding for a few seconds before slowly lowering the heel. One of many variations for added intensity is doing it with your heel hanging over the edge of a step.
Lower trapezius
This muscle in the upper back is an important target if you have shoulder issues, says Hawkes. Generally, he says, “it isn’t trained through its fullest of functions. One of its roles is to rotate your shoulder blade upward so it helps with [the arm’s] overhead position. If you’re lacking good lower trapezius activity, you’re going to struggle with overhead ability and are more likely to have compensatory issues like the upper trapezius working harder.” To combat this, he developed an exercise called the bent overhead shoulder raise. Stand leaning forwards, hinged at the hips, with your legs slightly bent and a straight back as parallel to the floor as possible, and holding a dumbbell in each hand. “You’re squeezing your shoulder blades down and together as you lift your arms up in front of you and above your head. So you’re trying to activate your lower trapezius while elevating your shoulder.” Other common moves for this area, such as the reverse fly or a row, he says, “tend to train the other muscles in that area as well and they aren’t always the ones you’re looking to train, because they’re already overworking.”
Grip
Grip strength is correlated to longevity, but how many of us are regularly exercising our hands? “Our hands could obviously lose strength as we age,” says Ryder, who recently read that ideally we should be able to dead hang for up to 90 seconds in our 30s, and be able to carry a heavy shopping bag in our 70s. But “most people can’t hang at all,” she says. Pull-up machines in the gym can take some of your weight off, she says. “And that’s where I always get people to start, working on their grip strength so they can hang from the bar. The easiest way to improve this is doing a farmer’s carry, which is when you hold a weight by your side – as if you are holding a briefcase or suitcase as you walk. Those are brilliant for helping grip strength.”
