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Tuesday, June 6, 2023

Electromyographic Analysis of Gluteus Maximus, Gluteus Medius and Tensor Fascia Latae During Therapeutic Exercises With and Without Elastic Resistance

Brent Brookbush

Brent Brookbush


Research Review: Electromyographic Analysis of Gluteus Maximus, Gluteus Medius, and Tensor Fascia Latae During Therapeutic Exercises With and Without Elastic Resistance

By Jason Gonzales, MS, NASM PES & CES, NASE CSS Level II, Ironman U Coach

Edited by Brent Brookbush DPT, PT, COMT, MS, PES, CES, CSCS, ACSM H/FS

Original Citation:

Bishop, B. N., Greenstein, J., Etnoyer‐Slaski, J. L., Sterling, H., & Topp, R. (2018). Electromyographic analysis of gluteus maximus, gluteus medius, and tensor fascia latae during therapeutic exercises with and without elastic resistance. International Journal of Sports Physical Therapy, 13(4), 668. ARTICLE


Research has demonstrated that a decrease in gluteus maximus and gluteus medius activity, and an increase in tensor fascia latae (TFL) activity, is correlated with lumbar spine, sacroiliac joint and lower extremity dysfunction (1 - 16). Several additional studies have compared various exercises with the intent of maximizing gluteus maximus and gluteus medius activity, while minimizing the recruitment of synergists (17 - 22). In this 2018 study by researcher in San Diego, CA, electromyographic analysis of gluteus maximus , gluteus medius and TFL activity was compared for thirteen commonly recommended gluteus maximus /medius activation exercises. The findings suggest that the clam exercise had the lowest TFL activity relative to glute activity, while the standing hip extension with resistance on the moving leg had the highest TFL activity relative to glute activity.

Study Summary

Study DesignRepeated measures cohort study
Level of EvidenceIII - Comparative/Observational Research
Participant CharacteristicsDemographics:
  • Age: 27.18 ± 7.33 years
  • Gender: 5 male and 6 female
  • Number of participants: 11
  • Healthy, physically active adults

Inclusion Criteria:

  • No history of hip, back or lower extremity injury/surgery in the past year

Exclusion Criteria:

  • N/A
  • Participants performed a 5 minute warm up on stationary bike without resistance.
  • Manual muscle testing was performed to determine maximal voluntary isometric contraction (MVIC) for each muscle tested.
    • 3 repetitions held for 5 seconds each.
    • Highest average peak value recorded as MVIC.

  • Dominate leg determined by asking participants which leg they used to kick a soccer ball.
  • Surface electrodes were positioned on the dominate side muscles as recommended by Rainoldi et al. (23)
  • Surface electromyography (EMG) was used to quantify the normalized EMG activity of the gluteus maximus, gluteus medius and tensor fascia latae while performing 13 exercises.
  • The order in which the exercises were performed was randomized to minimize the effect of fatigue.
  • Three of the exercises were performed with and without elastic resistance.
    • Green resistance bands were used with males.
    • Red resistance bands were used with females.

  • Band placement was determined as recommended by Cambridge et al. (22).
Data Collection and AnalysisData Collection
  • Surface EMG was performed using a Noraxon Myosystem 1400A (Noraxon USA, Inc, Scottsdale, AZ)
    • Sampling frequency 1000 Hz.
    • Visual onset and offset EMG signal amplitude used to select.

  • EMG signals were smoothed, rectified, and analyzed using a root-mean-square algorithm of 100 ms to determine the peak activation for the gluteus maximus, gluteus medius and tensor fascia latae Elastic resistance provided by either green or red resistance bands (TheraBand®, Performance Health, Akron, OH)
  • The equation used to determine the GTA Index  was GTA Index= {[(GMED/TFL) x GMED)] +[(Gmax/TFL) x GMAX]}/2 in accordance with Selkowitz et al. (26).
Outcome Measures
  • EMG signal amplitude was used to select the middle three of five repetitions of each of the 13 trials
  • The gluteal-to-TFL muscle activation (GTA) index (26) was used to rate exercises
  • Repeated analysis of variance (R-ANOVA) was calculated to determine differences in muscle activation of GMAX, GMED, and TFL.
  • The significant main effect (p<0.05) was detected by R-ANOVA.
ResultsExercises ranked highest on the GTA Index:
  • The clams with resistance (99.54)
  • Clams without resistance (87.89)
  • Running man GMAX exercise on the stability trainer without resistance (70.55)

Exercises that ranked lowest on the GTA index:

  • Quadruped hip extension without resistance (28.29)
  • Standing hip extension with resistance on stance leg (23.94)
  • Standing hip extension with resistance on movement leg (19.60)

Muscle activation differentiation

  • Clam exercise with and without resistance produced significantly higher GTA index scores and mean percent activation score compared to the other exercises.
  • All comparable exercises with and without resistance showed improved mean percent activation in both the GMAX and GMED with the exception of the quadruped hip extension. The quadruped hip extension only showed higher activation for the GMAX.

(See Table 1 for full GTA Index results and rankings.)

Our ConclusionsThe study demonstrates the effectiveness of the clam exercise for GMAX and GMED activation with minimal activation of the TFL.  This adds to the body of research in support of the Brookbush Institute's series of gluteus maximus activation exercises.
Researchers' Conclusions

The clam exercise with and without the elastic resistance was shown to be the most effective at activating the GMAX and GMED with minimal TFL activation.

How this study contributes to the body of research:

This study examined the surface electromyography (EMG) of the gluteus maximus , gluteus medius and tensor fascia latae (TFL)  while executing 13 different exercises with and without resistance. This study included more exercises than many of the previous studies, and further compared the addition of band resistance. This findings of the study may be used to aid in optimizing exercise selection based on glute to TFL  activity ratio, and further demonstrates that band resistance may also improve glute to TFL activity ratio.

How the Findings Apply to Practice:

The data provided by this study can be used to rank the 13 exercises investigated based on glute to TFL ratio (higher values = more glute ). If evaluation/assessment findings during practice suggest that increasing gluteus maximus , gluteus medius  while reducing TFL activity is recommended, selecting “higher ranked” activities may be beneficial. Human movement professionals should be using comparative studies like this to continually refine exercise selection with the intent of optimizing practice.

GTA Index Results (Higher values = More Glute  and less TFL ):

ExerciseGTA Index
1.         Clams with resistance99.54
2.         Clams without resistance87.89
3.         Running Man on the Stability Trainer without resistance70.55
4.         Bridge with resistance48.86
5.         Prone Hip Extension without resistance48.57
6.         Side-lying Hip Abduction without resistance44.75
7.         Bridge without resistance41.59
8.         Quadruped Hip Extension with resistance36.11
9.         Standing Hip Abduction with resistance on movement leg29.59
10.       Standing Hip Abduction with resistance on the stance leg29.34
11.       Quadruped Hip Extension without resistance28.29
12.       Standing Hip Extension with resistance on the stance leg23.94
13.       Standing Hip Extension with resistance on the movement leg19.60

Single Leg Touch Down with Posterior Pull


  • The use of previously validated assessments, measurements, and protocols increase confidence in the study findings.
  • The comparison of 13 exercises was more exercises than most studies investigate, allowing for direct comparison of many commonly recommended exercises.
  • The exercises used in the research study are commonly recommended, use little equipment, and are relatively easy to teach, making the study more replicable and easy to apply to practice.

Weakness and limitations

  • Failing to include exercise experience as an exclusion/inclusion criterion may have resulted in variability in findings, as some participants may have had some experience with a few of the exercises.
  • The methodology did not explicitly detail the instructions used to teach the participants each exercise. It is possible that some exercises had lower GTA values due to failures in form.
  • Inclusion of additional musculature in the EMG data may have provided additional data that has not been provided by previous research.

How the study relates to Brookbush Institute Content?

This study compares exercises, with and without resistance, for gluteus maximus activation and gluteus medius activation while minimizing TFL activity. A decrease in gluteus maximus , gluteus medius  activity and increase in TFL activity is correlated with Lumbo Pelvic Hip Complex Dysfunction (LPHCD) and Lower Extremity Dysfunction (LED) . The Brookbush Institute recommends the inclusion of gluteus maximus activation and gluteus medius activation  exercises when addressing muscle imbalances related to these dysfunctions. The clam shell exercise exhibiting the best glute to TFL  ratio in this study, is the first exercise recommended in these activation progressions. The Brookbush Institute will continue to pursue optimal practices by continually integrating research findings and patient outcomes into an evidence based, systematic, outcomes-driven approach.

Sample Videos:

Gluteus Maximus Activation Circuit:

Gluteus Maximus and Transverse Abdominis Activation:

Gluteus Maximus Reactive Activation:


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© 2019 Brent Brookbush

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