Category Archives: Hip

Resisted Upright Side Stepping or Resisted Squat Side Stepping. That is the Question.

21 Monday Sep 2015

Posted by in Hip, Lower Extremity, Patellofemoral Pain

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The Journal of Orthopedic and Sports Physical Therapy published an article in the September 2015 issue about the differences between completed a resisted upright side step verses a resisted squat side step.  I found this article to be very interesting because I use these two exercises in my practice when trying to help patients who have hip abduction weakness and present with a hip drop or a trunk lean while walking.  Here is the synopsis of the article and hopefully it helps you achieve your goals.

The researchers studied the muscle activation of the gluteus maximus, gluteus medius, and tensor fascia lata (TFL).  The subjects were given a theraband and wrapped it around their ankles with about 110% tension in the band.  Pt participant was then instructed to start with their feet 12 inches apart and side step to about 24 inches apart  and back to 12 inches apart for 8 steps in each direction.  The two posture used were upright standing without flexion in the hips and knees and the subject’s preferred squatting position.

The researchers found that the greatest muscle activations of the gluteus maximus, gluteus medius, and TFL were found in the stance limb compared to the moving limb, the muscle activation of the TFL was less and the gluteus muslces was greater in the squatting position compared to the upright position, and their was more hip abduction excursion in the stance limb compared to the moving limb.

So when completing these exercise, it is important to consider which muscles you want to focus on and the functional goal that you would like to improve upon.

Berry JW, Lee TS, Foley HD, Lewis CL. Resisted side stepping: the effect of posture on hip abductor muscle activation. Phys Ther. September 2015; 45(9):675-682.

Which Gluteus Medius and Maximus Exercises are Most Beneficial?

13 Thursday Nov 2014

Posted by in Hip

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Weakness in the gluteus muscles tends to be a cornerstone of many injuries in the lower extremities and back.  It is important to strengthen those muscles to take pressure off of joints and correct an individual’s biomechanics.  But what exercises are the most efficient in accomplishing this?

I found an article that assessed 12 common gluteus maximus and medius muscle exercises.  They wanted to figure out which exercise(s) will be most beneficial for those muscles.  They found that the Side-lying Hip Abduction Exercise activated the gluteus medius muscle the most out of all the other exercises and the Single Limb Squat and Single Limb Deadlift activated the gluteus maximus more than all other exercises.

Side-lying Hip Abduction

(Keep the knee extended and the hip in a neutral position while lifting the leg up to about 30 degrees)

Side-lying hip abduction

 

Single Limb Squat

(Stand on one leg and slowly lower by bending the hip, knee, and ankle until the opposite hand touches the foot that is on the ground without rotating the trunk)

Single Limb Squat

Single Limb Deadlift

(Stand on one leg with the knee flexed to 30 degrees and slowly flex the hip and trunk until the opposite hand touches the foot on the ground without rotating the trunk)

Single Leg Deadlift

(Click the link below for access to the article)

Gluteal Muscle Activation During Common Therapeutic Exercises

Study Design: Experimental Laboratory Study

Purpose:  To quantify and compare gluteal muscle activation across 12 common strengthening exercises of varying difficulty.

Methods: The study consisted of examining 21 subjects who were physically active (exercising 60 minutes at least 3 times a week), no pain, no history of ACL injury, and no history of lower extremity surgery.  They used surface EMG electrodes to measure gluteus medius and gluteus maximus muscle activation.  The subjects completed 8 repetitions of each of the 12 exercises in random order.  The exercises consisted of 3 non-weight bearing (clams with hips at 30 degrees, clams with hips at 60 degrees, and side-lying hip abductions) and 9 weight bearing (single limb squats, single limb deadlifts, lateral band walks, forward lunges, side lunges, lunges with rotation, forward hops, side hops, and hops with rotation).

Results:  The Side-lying Hip Abduction Exercise produced significantly greater gluteus medius activation than the 2 clam exercises, lunges, and hip exercises.  The Single Limb Squats and Single Limb Deadlifts had significantly greater gluteus maximus activation (also, equal activation of gluteus medius and gluteus maximus muscles) than the lateral band walks, clams, and hop exercises.

Limitations: Some of the limitations consisted of the potential for cross-talk between muscles during the surface EMG assessment.  Also, the dynamic movement of the hop exercises could cause EMG activity variability.  Finally, there were no non-weight bearing hip extension exercises assessed.