The Chiro Playbook

The Root Is the Glutes: Exploring Hidden Triggers of Pain

As a future chiropractic physician, I'm constantly immersing myself in new research and clinical insights-especially those that shed light on how to best serve high-performance athletes. Their bodies are their livelihood, and ensuring peak function is not optional-it's essential Read More...

While diving into some sports chiropractic case studies today, I was reminded of something critical: every patient is different. There is no one-size-fits-all approach to treatment, and trying to force one can compromise a patient’s trust-and even worsen their condition. The beauty (and challenge) of our work lies in discovering the true root cause of pain, even when it’s not where the patient feels it.

Pain Isn’t Always Local: Muscles Work in Teams

Pain often appears in one area but originates somewhere else. That’s why understanding muscle synergyis crucial-how different muscle groups are designed to support one another in movement and stability.

One compelling case study from Dr. John Gibbons, a physician of osteopathic medicine, illustrates this concept. A patient came in with persistent pain in her upper scapula. At first glance, it seemed like a shoulder issue, but deeper investigation revealed a surprising root.

When the Glutes Slack, the Lats Attack

After assessing the patient’s pelvis, Dr. Gibbons found no signs of instability. However, his clinical curiosity led him to evaluate her gluteal activation patterns. What he discovered was significant: the right gluteus maximus was underactive compared to the left.

Now here’s where it gets interesting-when the gluteus maximus doesn’t do its job, other muscles jump in to compensate. In this runner’s case, the left latissimus dorsi, which helps depress the scapula, became overactive. This compensation caused strain and ultimately led to scapular pain during her runs-especially around the 4-mile mark.

The Fix: Strengthen, Lengthen, and Realign

The treatment plan focused on strengthening the gluteus maximus and lengthening the iliopsoas and rectus femoris, which are key hip flexors. Through a combination of in-office adjustments and at-home exercises, the patient restored muscle balance and, most importantly, eliminated her pain. She was able to return to her running routine-pain-free and properly aligned.

The Takeaway: Treat the Whole Athlete

This case is a powerful reminder that effective chiropractic care requires a whole-body approach. With a comprehensive diagnostic and management plan, we can avoid costly mistakes and help our patients get back in the game-safely and efficiently.

Whether you're a fellow student, a practicing provider, or an athlete yourself, remember: the source of pain isn't always where it hurts. Sometimes, the root is the glutes.


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Gibbons, John. “Vital-Glutes.Pdf.” John Gibbons Body Master, 2020. https://www.johngibbonsbodymaster.co.uk/wp-content/uploads/2020/02/Vital-Glutes.pdf.