Desk jobs, cars, lifts; the adversary to stronger gluteal muscles.
The gluteals act as the powerhouse of the body, providing a base of stability from which power is generated and transferred. Underlying that, the gluteals also play a large role in optimising lower limb function to assist in preventing injuries. Over several posts, I will discuss the roles of the glutes, their effect on lower limb biomechanics, reasons for why they need to be strengthened and exercises to help wake up your booty.
Part I will outline the function of glutes, their influence on biomechanics and their role in preventing overload injuries.
The Gluteal Complex is comprised of gluteus maximus, gluteus medius and gluteus minimis, all which work in unison. Working alone, gluteus maximus acts to create powerful hip extension and hip external rotation. During walking, glute max will help with extension of the hip, deceleration of the swing leg and assist in maintaining an upright trunk. On the other hand, glute medius and minimus have similar actions. Its most important action is to abduct (bring leg to side away from midline) the thigh. It also is able to internally and externally rotate the hip, due to 2 different muscle fibres, anterior and posterior. Functionally, they prevent hip adduction (leg towards midline) and knee valgus, which will be discussed further down. In saying that, the most important function of the gluteals is as a whole. The complex provides stability to the hips, pelvis and trunk and allows for optimal and sound movement. Any disruption to the gluteal stability will result in biomechanical faults and injuries further down the line.
#1 Gluteal Strength to reduce the susceptibility of overloading injuries
Gluteus medius and minimus are the principle muscles, which provide hip stability to optimise lower limb biomechanics. It is believed that weakness, primarily in these 2 muscles leads to internal rotation of the hip, adduction of the femur and valgus collapse at the knee, particularly in single legged positions, as shown below.
One of the most commonly caused overload injuries from reduced gluteal strength is Patella femoral pain syndrome (PFPS). It is primarily caused by excessive joint compressive and kneecap mal-tracking from prolonged suboptimal (valgus collapse) loading whilst running.
“ A study by Loyd et al. in 2003 measured the gluteal strength of 15 subjects with patellafemoral pain. On average, all 15 subjects demonstrated a 26% reduction in hip abduction strength and 36% reduction in hip external rotation strength when compared to their control group of subjects without patella femoral pain”
Iliotibial band syndrome (ITBS) is also another common knee injury caused by poor glute medius and minimus function. It is thought that the internal rotation and adduction of the femur results in a valgus position of the knee, leading to lengthening of the iliotibial band during prolonged running, causing it to tighten and irritate.
“A 2014 study by Noehren et al. examined the knee adduction and hip internal rotation angles of 17 ITBS subjects and compared them to subjects with no ITB pain. The study showed that there was a 20% increase in knee adduction and a 14% increase in hip internal rotation which was attributed to glute deficits”
A study regarding the effectiveness of hip and gluteal strengthening on knee joint pain (in particular PFPS), was performed by Ferber et al. in 2011. Following a 3-week hip abduction strengthening program the group with noticeable PFPS pain had a 32.69% improvement in isometric muscle strength and a 43.10% reduction in pain scores.
By William Chin
- Ferber R, Kendall KD, Farr L (2011) Changes in Knee Biomechanics After a Hip-Abductor Strengthening Protocol for Runners with Patellofemoral Pain Sydnrome. Journal of Athletic Training 46(2): 142-149
- Fredericson M, Cookingham C, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA (2000) Hip Abductor Weakness in Distance Runners with Iliotibial Band Syndrom. Clinical Journal of Sports Medicine 10: 169-175
- Ireland ML, Wilson JD, Ballantyne BT, Davis IM (2003) Hip Strength in Femails With and Without Patellofemoral Pain. Journal of Orthopaedic & Sports Physical Therapy 33(11): 671-676
- Noehren B, Schmitz A, Hempel R,Westlake C, Black W (2014) Assessment of Strength, Flexibility, and Running Mechanics in Men With Iliotibial Band Syndrome. Journal of Orthopaedic & Sports Physical Therapy 44(3): 217-222