I have to admit, sometimes we all get carried away with exercise selection that we overlook some of the most basic, yet highly effective exercises. I know I fall victim to this at times!
Strengthening the gluteus medius is often an important part of our rehabilitation and performance programs. Like I always preach regarding both shoulder rehabilitation and core exercises, there is a difference between the role and function of a muscle. The gluteus medius has more than just a role to abduct and rotate the leg, it has a function to dynamically stabilize the pelvis and lower extremity.
But realistically, weak muscles can’t stabilize, so we still need to focus on exercises to work on activating and strengthing the gluteus medius in addition to working on dynamic stabiliztion.
Two of the most popular posts on this website have discussed Assessing and Treating Dysfunction of the Gluteus Medius and The Best Exercises for the Gluteus Maximus and Gluteus Medius. In these posts, I discussed a bunch of great gluteus medius exercises. I even posted specifically about the clamshell exercise.
All of these exercises discussed are great, but there is a very simple exercise that is really effective for strengthening the gluteus medius.
A Simple and Effective Gluteus Medius Exercise
OK, get ready for this… the simple and effective exercise for the gluteus medius is… sidelying hip abduction! I know what you are think, wow that is really boring. I agree, it is boring! But it is effective. There are many other gluteus medius exercises that work well and have other qualities that make them important to consider, but it is hard to argue about sidelying hip abduction.
Here is a good video demonstration. Note that the leg is straight, the hip is not flexed or rotated, that is key:
Some of the past articles that I reference in the links above have stated that sidelying hip abduction has great EMG activity of the gluteus medius. A new study in the Journal of Athletic Training agrees with these past studies. The authors concluded that simple hip abduction straight leg raise was superior at eliciting gluteus medius EMG to the clamshell exercise and externally rotating the leg during the abduction straight leg raise.
The study also notes that the sidelying hip abduction exercise does a better job at enhancing the ratio of activity of gluteus medius and TFL.
Reducing the TFL component to hip exercises is often desired especially in those with anterior pelvic tilt, who tend to exhibit too much TFL activity and compensatory contraction to rotate the hip internally. This is one of the reasons that sidelying hip abduction is probably even better than band walking for the gluteus medius because people tend to flex their hips while band walking, firing their TFL
Clinical Implications
There are two take home messages here for me:
- Sometimes taking a step back and performing a simple, or “boring” exercise may be indicated.
- The sidelying hip abduction straight leg raise should be included in many of our patients’ and clients’ programs, especially when trying to maximize the gluteus medius to TFL ratio of muscle activity. This would be something I would add to an active warm-up or corrective exercise component to a program, much like the clamshell exercise.
