Strong Hips, Smart Thinking - Caroline Schlais, PT, DPT, OCS
When strengthening the muscles in your legs many individuals focus on the anterior thigh or quadriceps muscles, the posterior thigh or hamstring muscles, calf muscles and the gluteus maximus or “butt” muscles. Unfortunately, many people do not emphasize strengthening the muscles on the side of your hip. There are two muscles in this region called the gluteus medius and gluteus minimus. The gluteus medius lies directly on top of the gluteus minimus. These muscles connect your thigh bone or femur to your pelvis. The gluteus medius is divided into 3 segments (anterior, middle and posterior) and the gluteus minimus is divided into 2 segments (anterior and posterior).
Dysfunction or weakness of these gluteal muscles has been associated with pain in the low back, hip, knee and ankle. A recent systematic review evaluated which common therapeutic exercises activated the gluteus medius and minimus with sufficient intensity to elicit an increase in strength and muscle size or hypertrophy to decrease a patient’s symptoms and improve his or her quality of life. They also investigated which segments of each muscle were targeted the most with each exercise.
An exercise called the hip hitch or pelvic drop generated high enough activity in all segments of both the gluteus medius and gluteus minimus muscles to elicit an increase in strength and hypertrophy. There are numerous variations of this exercise but during the most basic form of this exercise an individual will lift one foot at least 1-2 cm off of the ground by hitching or lifting the hip upward. The knees of both legs will remain straight or extended. There are a number of other exercises that target these gluteal muscles, but they tend to target specific segments of each muscle. For example, side-lying hip abduction and a single leg bridge generate high activity in the middle segment of the gluteus medius and the posterior segment of the gluteus minimus. Other exercises that can be performed include resisted lateral stepping, single leg squats and lateral step-ups.
If you are having low back, knee, hip or ankle pain you one of the causes may be a lack of gluteus medius or minimus strength. These exercises may also prevent future injury. If you have any questions, please feel free to call our office at Vertical Motion Physical Therapy in Evergreen, Colorado and schedule an appointment with one of our physical therapists.
1. Moore D, Semciw AI, Pizzari T. A Systematic Review and Meta-Analysis of Common Therapeutic Exercises That Generate Highest Muscle Activity in the Gluteus Medius and Gluteus Minimus Segments. Int J Sports Phys Ther. 2020;15(6):856-881. doi:10.26603/ijspt20200856