Muscle Knockout: Muscles you won’t miss until they’re gone

Muscle Knockout: Muscles you won’t miss until they’re gone

Introduction to the Muscle KO Series

The purpose of this series is to provide readers with an understanding of how stabilizing groups of muscles work. The more a client knows about how muscles work, the more they can learn from their trainers. This series aims to provide some of that fundamental knowledge.

During the final block of medical anatomy, my classmates and I learned the muscles of the arms and legs. It quickly became difficult to remember exactly what muscle did what and in the company of which other muscles. I found the most effective way to learn how muscles work is to learn about disorders that target specific muscle groups and see what symptoms present in patients.

This article focuses on the insanely interesting (to me) gluteus medius and gluteus minimus, which are knocked out in the Trendelenburg gait. Trendelenburg gait is an irregular walking pattern in which the hips sway excessively side to side due to lack of hip stability.

Key Terms:

Abduction: raising the leg to the side, away from the midline

Internal Rotation: twisting the thigh so the kneecap points towards the midline

Gluteus Medius and Gluteus Minimus at Prevail

Many at Prevail Conditioning train their gluteus medius and gluteus minimus whether they know it or not. They are primary stabilizers for walking and all single leg exercises. Many warm-ups include banded movements, like clamshells, that target the gluteus medius and gluteus maximus. Lateral band walks and single leg banded hip extension with external rotations also target the abduction and stabilizing roles of the gluteus medius and gluteus minimus.



The gluteus medius and gluteus minimus lie deep to the gluteus maximus. Their function is to abduct and internally rotate the thigh. The gluteus medius is particularly important because it is the strongest abductor of the hip muscles. Both muscles begin at the outside 12hipof the hip and descend to the lateral, posterior side of the femur (see figure).

In life, the gluteus medius and gluteus minimus contract together whenever a step is taken. When one leg lifts to take a step, both muscles contract to keep the body balanced on the planted foot. Similarly, when one balances on one foot, the gluteus medius and gluteus minimus contract to keep the hip level.

Trendelenburg Gait

Trendelenburg gait occurs when the gluteus medius and gluteus minimus are weakened, 123hipmeaning abduction at the hip will be weakened. Now when a step is taken, the weight of the raised leg causes that hip to drop. The body then loses stability and leans towards the raised leg. To keep from falling, the lumbar spine bends towards the planted leg (see figure and video).

In the video above, we can see that whenever the patient plants with her left foot, her left hip lurches outward, showing a weakness in the gluteus medius and gluteus minimus. This is a common pattern in runners where it can lead to knee and lower back injuries as the hip tilts from side to side every step (Davis et al, 2016).


The gluteus medius and gluteus minimus are essential to every step we take. They are the primary hip abductors and critical to athletes’ stability in all single leg exercises.


Washington University Musculoskeletal Atlas

Stanford Medicine 25

Davis IS, Futrell E. Gait Retraining: Altering the Fingerprint of Gait. Physical medicine and rehabilitation clinics of North America. 2016;27(1):339-355. doi:10.1016/j.pmr.2015.09.002.

Souza RB. An Evidence-Based Videotaped Running Biomechanics Analysis. Physical medicine and rehabilitation clinics of North America. 2016;27(1):217-236. doi:10.1016/j.pmr.2015.08.006.

University of Pittsburgh School of Medicine Anatomy Course

Tyler Paras12tyler

B.S. – Cellular Molecular Biology (Westmont)

M.D. Candidate – University of Pittsburgh School of Medicine

Tyler was born and raised in Santa Barbara, California and began training at Prevail in October 2016. While at Westmont he graduated summa cum laude, led a student-run homeless outreach program, and volunteered with Hospice of Santa Barbara.

After Tyler’s mother was diagnosed with rheumatoid arthritis (RA), he became interested in the cellular mechanisms behind the disease. He conducted his Major Honors project at Westmont on the role of the microbiome in inflammatory arthritis and conducted summers of research at Harvard Medical School studying the role of macrophages in RA. His research has resulted in seven presentations, three at national medical conferences.

Do You Bruise Easily

Why do some people bruise more easily when they use the vibrating foam roller compared to others?

Even though it is difficult to know exactly what is going on with a particular athlete at a given time, there are some governing principles that can explain the phenomena of bruising that occurs without the inclusion of acute trauma.

In the Western Medical model, bruising is the result of blood moving outside of the vessels in a given area of the body. Normally, this occurs as a result of acute trauma that physically damages the smaller vessels and causes a breach in the vessel wall that allows for blood to seep out and pool in the interstitial spaces around tissues. This blood is darker in color since it does not circulate very well, which creates the typical appearance of a bruise. Normally the body repairs the breach in the vessel wall by depositing clotting factors that rebuild the broken tissue and then reabsorbs the excess blood over time.

If you bruise easily without first experiencing acute trauma (like using a vibrating foam roller) that could indicate that your body is not able to tolerate the combination of pressure and vibration which could push blood out of vessels if they are too deficient to maintain their integrity. This could be caused by a nutritional deficiency, like for example Vitamin K, which is used in the synthesis of platelets in the blood, or perhaps a genetic condition, which leaves the vessels prone to hemorrhaging. Another angle to consider is the presence of a blood thinning medication in that individual, which could make them more prone to bleeding episodes.

In the perspective of Traditional East Asian Medicine, people who bleed easily have a deficiency of digestive Qi, called “Spleen Qi.” Spleen Qi, among other functions, is responsible for helping the vessels hold blood in its proper place. Spleen Qi is responsible for many “holding” functions in the body, including keeping organs in place, maintaining posture, and preventing prolapses. People who are Spleen Qi deficient will experience a varying degree of symptoms which could include: fatigue, lack of appetite, low quantity/quality of blood, excessive bruising, muscle weakness, and digestive difficulties to name a few. What is particularly interesting is that Spleen Qi is responsible for nourishing the muscle of the body, especially in the extremities. Aggressive foam rolling after a tough workout could promote bruising in some people because some of the Spleen Qi is already exhausted from exercise and the remaining amount cannot do enough to keep the blood in the vessels.

The answer in both cases is to ensure that an adequate nutrition plan is in place to both feed the body and boost the strength of Spleen Qi. This will serve to enhance digestive strength, improve muscular performance, and reduce the likelihood of any excessive bleeding episodes in the future. Beyond an ideal nutrition plan, acupuncture and herbal medicine can further strengthen the Qi of the Spleen and help it perform the functions it needs to, while also improving the levels of energy, quality of blood, regulate appetite, and improve strength.

Traditional East Asian medicine is a huge world of information, but I hope this was helpful in shedding light on some questions that you may have had or observations you have made.

To your health!

Diego Garcia


12345diegoDiego Garcia – Performance Coach


Diego comes from a varied background of fitness and martial arts including resistance training, acrobatics, Capoeira, saber fencing, hand-balancing, and high-intensity interval conditioning. As a coach, Diego acknowledges the mental and spiritual transformation that goes hand-in-hand with athletic training and helps cement positive habits into real personality traits. Whatever your training goals may be, Diego can help you find the safest and most effective path to realizing your fitness dreams.

Meet Our New Trainer Diego Garcia

Diego Garcia

Performance Coach

Diego comes from a varied background of fitness and martial arts including resistance 1235prevailtraining, acrobatics, Capoeira, saber fencing, hand-balancing, and high-intensity interval conditioning.

Diego leads his clients through his own experience and commitment to optimal health and fitness. This is seen through the path of education that Diego has taken in his life. His experience with training and knowledge of Chinese Medicine provide him with a unique point of view and a broader set of tools to further a holistic approach to long-lasting health and fitness.

Training sessions with Diego are built around the needs of the individual. The program evolves as the goals and athleticism the client progress; emphasizing that fitness is not a means to an end, but a lifelong process.

Form and tempo are prioritized over a focus on numbers and quality of movement while reinforcing the mind-muscle connection build the backbone of Diego’s training philosophy. More than anything else, however, is the guidance and acknowledgment of the mental transformation that goes hand-in-hand with athletic training. Whether you are training for strength, health, or a specific athletic endeavor; Diego can facilitate your path to realizing your fitness goals.


Master of Acupuncture and Oriental Medicine (MAcOM) – Oregon College of Oriental Medicine

Bachelor of Science, Food Science and Human Nutrition (BS) – University of Florida

Certified Strength and Conditioning Specialist (CSCS) – National Strength and Conditioning Association

Meet Our New Trainer Aysia Shellmire

Aysia Shellmire

Performance Coach

Aysia was able to see how her workouts contributed to her progress on the court. 12prevailWestmont’s Kinesiology Department helped foster her passion for coaching and sports performance with the guidance of some amazing teachers including Prevail CEO Chris Ecklund and Trainer Alexis Anderson. She began as an intern at Prevail in June of 2017 and debuted as a trainer in September of 2017.

Additionally, Aysia works as an assistant Strength and Conditioning Coach at Cate School in Carpentaria and is in pursuit of her CSCS. She is also still considering the possibility of continuing to play semi-pro basketball overseas.


B.S. Kinesiology (Westmont College)


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