We received a question about treating Superior T4 syndrome using the gluteus medius. James Anderson, MPT, PRC did a great job explaining the rationale behind this:
When I took the Myokinematic Restoration class you said to email you about some information on Superior T4 syndrome. You mentioned working your glute med’s for Superior T4’s.
Please read a handout I put together on Superior T4 syndrome. Click HERE!
The reason I said the glute medius was such a big deal with the T4 patients is because of all the things that must be in place in order for the glute medius to be properly felt during single leg stance. In other words, the Adductor Pull Back must have been well coordinated with proper breathing to clear out the right BC while it approximated the left femur up into the acetabulum. In fact, your Adductor Pull Back should have restored full right HG IR to ensure that the left ZOA has been restored and the right BC has been inhibited. The deliberate left hip approximation is a precursor for left posterior hip capsule stretching, which is often needed prior to the glute medius being able to properly work when doing single leg left AF and FA IR training. Also of note, if the right thigh does not stay positioned ahead of the left thigh during single leg left AF IR training (like the Retro Stairs), then you are probably not maintaining the needed left AF IR state to keep the left glute medius active during single leg stance training.
I hope this helps clarify what I said about the glute medius. And I hope the T4 document is helpful as well. But remember, if the left hip does not do all of the above described items, your left hip comes out of place and the base of your spine will orient towards the right (something you’ll struggle to overcome with just upper half exercises).
-James Anderson, MPT, PRC