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They found single limb squat to produce the second most EMG activity and lateral band walk the third. Fredericson, who’s written quite widely on ITB problems and their treatments did a study on runners in 2000. So hip abduction, one of the roles of Gluteus Medius, is weaker on the side runners have ITBS.
Thanks to Stuart Palma (a nice bloke despite being a Liverpool fan!) we also have another article to add to the mix. It gives us an indication of specificity – sidelying abduction appears to be able to activate the muscle we are targeting without working the muscles we are not targeting.
So we’ve seen 3 exercises, all in sidelying, that produce high levels of Gluteus Medius activation, at least comparable to, and in some cases higher than weight bearing exercise. Wall press was compared to Pelvic Drop and Wall Squat and achieved the highest MVIC of 76%. Pelvic Drop – picture below reproduced from Bolgla 2005 who found reasonable activation of Glute Medius on pelvic drop of 57% of MVIC and was similar to Boren et al 2011 (58%). For pelvic drop the standing leg (right in this case) stays straight and you lower your other leg by lowering the pelvis on that side. The aim of this blog was not to prove sidelying exercises are more effective but only to show that they create good levels of glutes activation and have a role in rehab. The other advantage of sidelying work is that it can often be done without aggravating symptoms if done correctly. Selecting exercises for yourself or a client is very individual and should be based on addressing specific weaknesses. I have heard that barefoot running requiring 50% more Gluteus Medius strength for an effective running stride. Have been suffering from a chronic glut strain probably pirofomis and needed to strengthen my med gluts, am starting to feel some relief after applying the clam variations plus glut stretches and my itb seems stronger too.
Anyway, the crux of it is that she advocates closed chain work such as the ones mentioned in your article, and abduction work done on a pilates reformer. There remains the question of whether we can, or should aim to make muscles work in isolation.
It turns out women are not the only ones obsessed with having the perfect glutes (buttocks). According to Huffington post and Cosmopolitan, men find the butt being one of the most desired and attractive body parts in a women.
Further more, based on their online surveys, men said woman's butt turns them on the most.
Surprisingly, science and evidenced base studies revealed one exercise beat and ranked higher than the gluteal workout staple, squats! While different exercises are proven to have varying effectiveness, as proven in the case above, how you perform the exercise also dictates how well you work the target muscles. Those two feet exercises tend to further strengthen the dominant leg, while weaker leg gets neglected and under trained. Done by physical therapists to fire up the glutes and hamstrings this is one move that needs including in every butt workout! Sitting on the floor with your back against a bench, and a weight across your lap, squeeze the glutes and lift your hips off the floor so that your hips are level with your shoulders. Beginners can regress this move by either omitting the weight or doing the move lying on the floor.
Straight legs will emphasize more in the hamstrings and glutes, but if you have flexibility issues you can bend your knees a little while you work on your range of movement. Take the work out of the back by pushing the hips back and keeping the back straight throughout the movement. You can do this exercise as part of your dynamic warm-up or in your exercise routine as we did here. Surprisingly according to the researchers from the ACE study, the most effective glute exercise is not squat. Their study found that the quadruped hip extension activates both the gluteus maximus and the gluteus medius more than any of other exercises tested in the study, including squats. He adds, although testing was done without any weight, if weight was used, they could possibly see even greater buttocks activation. Add resistances to challenge the glutes further, and ensure your abs are engaged throughout the movement! It is essential not to disregard these muscles because they play a vital role in making the most of the strength in your legs, supporting your spinal column and supporting your hips. Basically, simply by enhancing your glutes you improve your posture, which is beneficial for running, high intensity sports and far more. The following 5 exercise are the best ones to assist you develop up the gluteus minimus, gluteus medius, and gluteus maximus. Start in a lying position, with the knees bent, and the feet planted securely on the floor. You need to not raise it greater than the torso in order to prevent injury to the spinal column. You start in the exact same position as in the previous workout, however the right leg should be opened towards the side so that your hip is opened and the right thigh is parallel to the floor.


All pictures are reproduced from research articles freely available on the web and will be referenced and linked.
2009 used an EMG study to determine which exercises produced most activation of Gluteus Medius. 2011 but I’ve modified them with some instructions to clarify (thanks to Debra for the suggestion).
2009 used the slightly different technique shown above, they also reported good activation of both Glute Med and Max. In the picture below the right Gluteus Medius is being exercised by pushing the left knee, hip and ankle against the wall and maintaining a contraction for 5 seconds. In Bolgla’s study it scored the highest of 6 exercises which also included sidelying abduction. 2009 (abstract only) studied the effect of doing exercises on a balance cushion and found an increase in Gluteus Medius activity (compared to balancing on normal floor) although it should be noted this difference wasn’t thought to be statistically significant. 2011 looked at the effect of using resistance band to pull the knee more medially (towards the other knee) during weightbearing exercises. For people with painful ITBS or irritable patellofemoral pain a range of weightbearing exercises can make symptoms worse.
Take sidelying abduction, some people can do 40-50 with good form and minimal glutes fatigue.
Assuming we are working endurance roughly speaking people usually start at around 10-15 reps 3 sets in a session with a rest of 1-2 minutes between each set. Di recente dopo la corsa con dolore mi sono fermato 1 settimana e poi, quando non avevo piu dolori, ho provato a seguire il protocollo stretching e potenziamento ITB e glutei ma sento indolenzimento e poi dolore alla ITB. I am physio working in orthopeadics for 20 years now-primarily private clinic with a mixed client list. I am a final year medical student with an interest in sports medicine and a BSc in sports science. I just wanted to add a couple of points having just come from Dr Grimaldi’s Hip and Pelvis course. Did she say if she had evidence that weight-bearing exercise improved recruitment of deeper stabilising muscles? As with squats and lunges it’s a love-hate relationship but for a great butt they are a must.
Distefano PhD from the University of North Carolina, Chapel Hill, NC has shown that the side-lying hip abduction activates the gluteus medius more than squats, lunges and deadlifts. The feet should be in a parallel position to the knees, a bit more than a hip’s width. Then, advance with one leg and you should bend the knee at 90 degrees, and hold for 5 seconds.
Lift the leg to the ceiling, so it is just above the butt while tightening the abs and glutes. Hold a bit in this position then return the knee towards the floor, but do not permit it to touch the ground. It’s fair to question this, EMG change is all good in theory but what about in practice? 2012 compared 3 sidelying exercises sidelying abduction, the clam, and sidelying abduction with external rotation in healthy runners. Their top 3 exercises for Glute Medius were side plank abduction with dominant leg down, side plank abduction with dominant leg up and single leg squat (in that order).
The link above also includes detailed descriptions of this exercise and its progressions (it’s all in the appendix at the end of the article).
We were given this by one of their team at a Strength and Conditioning lecture but sadly can’t reproduce it online. Single Limb Squat as above showed good Gluteus Medius and Gluteus Maximus contraction with 81% of MVIC for Gluteus Medius and 71% for Gluteus Maximus. Lateral Band Walk shown below, also showed good Gluteus Medius activation (although less than side lying abduction). The idea behind this is that the medial pull of the band should increase activation of Gluteus Medius.
I’ve barely scratched the surface of research in this area and I acknowledge there is more research out there, undoubtedly with different findings.
There is little point asking them to do this as an exercise as it probably won’t overload the glutes to achieve strength changes. If you find sidelying exercises are getting you results without causing symptoms then great. Then progress up towards 25 reps, you’re aiming to fatigue the muscle so there will be lots of individual variation in the reps needed to do that.
Dall’ecografia fatta un anno fa emerge solo un modesto ispessimento della bandelletta ileo tibiale, il resto e tutto OK!
I am Physio in Kenya and articles like yours are very enlightening to some of us in Africa where research materials and exposure is very limited. Non functional glute exercises have helped me rehabilitate my patellar tendinopathy, it has been a very long road and I can back up your claims about functional exer use aggravating symptoms. She isn’t a big fan of open chain abductor exercises because they tend to upregulate the superficial system, including more superficial medial part of glut med, which can increase compressive joint loading at the expense of deeper muscles (glut min, ant and post glut med) which control the joint position and retract the joint capsule.


I’m also always a little wary of very specific exercises – is it realistic to expect a patient to be able to target 1 muscle group? Then, place a light dumbbell on the hips and raise them off the floor, while tightening the abs, thighs, and glutes. Tighten up the abs and glutes as you squat downwards, with the back straight and the knees aligned with the toes.
I also agree that sidelying work isn’t functional, but I feel it still has a valuable place in glutes rehab and it shouldn’t be treated as ineffective quackery! They compared a number of exercises including hip clam, single limb squat, single limb deadlift, lateral band walks, multiplanar lunges and multiplanar hops. They found it didn’t increase activation during single limb squat or step up and may result in poorer limb alignment during the exercise.
I also realise that the main measure involved in these studies is surface EMG recording of muscle activity in healthy individuals.
If functional tasks were so good at glutes rehab, we’d all have great glutes just from walking around, climbing stairs and running!
Some people get to 9 or 10 reps and start to fatigue or lose control and they are more likely to benefit from it.
If not try some of the others above and see which ones seem to work your glutes and get results.
That said if you can do more than 30 reps without fatigue maybe you need a harder exercise? We have great sportsmen and women known all over the world, but knowledge to most of us is very basic. It has been a personal goal of mine to progress to single limb squats for a long time but every time I try I increase pain. As you mentioned, much of the work has been carried out by surface EMG, which tends to reflect the activity in the more superficial parts, and there are few fine wire EMG studies to help our understanding. How does this all fit in the biopsychosocial model and the view that it’s not how we move that’s important but how often we do it? They compared muscle activation in Gluteus Medius, Gluteus Maximus, anterior hip flexors and Tensor Fascia Latae with each exercise. Of note too is that they found less activity with side-lying abduction than the previous studies. This measure is only related to Maximal Volitional Isometric Contraction presented in a percentage and has not included people with injuries. For some the issue actually isn’t strength at all, some studies show poor correlation with Glute strength and pelvic position, this is because control of movement can be poor even with good strength. These recommendations are based on those by the American College of Sports Medicine research (abstract only) which I’ve summarised in a table below (click to expand).
I tried the clam progressions and already my “gluts ” are talking to me-excellent!! Also very good point well made that if functional exercise was always so good for glute activation, us highly active people would have no problems!
Then, lower down to the preliminary position, while the hips are still a bit above the floor.
In many exercises they can be progressed by increasing resistance, this one is progressed by a change in position.
In that situation it’s control and form that needs to be addressed and this is where functional weightbearing movements are more important.
Remember too that form and control are very important and you should feel it in your glutes not the side of your knee or front of the thigh. The article demonstrated an increase in glutes activity from Clam 1 being lowest to Clam 4 being the highest.
So we can’t conclude that because sidelying abduction has a higher % of MVIC than single limb squat that it is a better exercise for rehab in return to running.
I think if your control of pelvic position is poor, but Glute strength is good it’s unlikely sidelying work will be of great benefit. Compared to other exercises in the study Clam 4 had a high level of Gluteus Medius activity (77% of MVIC – Maximal Volitional Isometric Contraction) only slightly lower than Single Limb Squat (81% of MVIC). As a result I often start with a shallow knee dip or use this exercise after first rehabbing with sidelying exercises.
Neither can we conclude that certain exercises are better for rehabbing certain conditions as the research above (with the exception of Fredericson et al. Distefano et al 2009 showed lower levels of activity with the clam but didn’t include the same progressions. There is also an issue of control, some patients struggle to even balance on one leg let alone perform a squat.
That said I think the research is a useful indication for strength work – Boren et al suggested that an MVIC of greater than 70% was needed for strength work while ealier research suggested a range of at least 40-60%.
Sidelying and weightbearing exercises have both achieved greater than this range and should be capable of producing strength changes.



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