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Tuesday, June 6, 2023

Which exercises target the gluteal muscles while minimizing activation of the TFL?

Brent Brookbush

Brent Brookbush

DPT, PT, MS, CPT, HMS, IMT

Research Review: Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata?

By Jinny McGivern, DPT, Certified Yoga Instructor

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

Original Citation: Selkowitz, D. M., Beneck, G. J., & Powers, C. M. (2013). Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? electromyographic assessment using fine-wire electrodes. journal of orthopaedic & sports physical therapy, 43(2), 54-64. ABSTRACT

Why is this relevant?: EMG studies provide us with important information about the function of muscles during various movement patterns. Studies comparing exercises and/or techniques are relatively rare, but may provide some of the best evidence for the selection of intervention with the goal of optimal treatment strategies - In essence, these studies have a "high practical value." In order to reduce pain, improve postural dysfunction and improve the efficiency of human movement, it is important to have a repertoire of exercises that promote increased activity of muscles that tend to be under-active and minimize the contribution of overactive synergists . This research study explores the relationship between the muscle activity of tensor fascia latae (TFL) & 2 gluteal muscles, gluteus medius (glut med) & the superior fibers of gluteus maximus (sup glut max) in 11 different exercises.

http://blog.brianschiff.com/wp-content/uploads/2013/06/myers-it-band-proximal-291x300.jpg

Study Summary

Study Design Controlled laboratory study
Level of Evidence Level VI - Evidence from a single descriptive or qualitative study
Subject Demographics
  • Age: 18-50 years      (mean=27.9 +/- 6.2 years)
  • Gender: 10 men, 10 women
  • Characteristics: Healthy volunteers without musculoskeletal conditions of the lower extremity or neurological disorders
Outcome Measures
  • Normalized EMG amplitude of Gluteus Medius (Glut Med), Superior Gluteus Maximus (Sup Glut Max) & Tensor Fascia Latae (TFL) for 11 exercises - normalized by max voluntary contraction (MVC) of each muscle.
  • Gluteal-to-TFL muscle activation index (GTA) for 11 exercises - Activation of  2 gluteal muscles compared to TFL - In order to get a high GTA the exercise had to have high gluteal EMG activity & also be higher than TFL (equation in full article).
  • Details of each exercise included in full research paper.
ResultsThe following exercises had significantly greater EMG activity in Glut Med as compared to TFL: Side-lying Hip Abduction, Bilateral Bridging, Clams, Quadruped Hip Extension (with knee extended & flexed), Sidestep with a band, Squat, Unilateral Bridge. Lunge, Hip Hike & Step up did not show significantly different activity between Glut Med & TFL. The following exercises had significantly greater EMG activity in Sup Glut Max as compared to TFL: same exercises as above except Side-lying Hip Abduction which had significantly lower Sup Glut Max activity as compared to TFL. The Hip Hike exercise also had significantly lower Sup Glut Max activity compared to TFL. Lunge & Step up did not show significantly different activity between Sup Glut Max & TFL.
ConclusionsExercises with GTA index >50: Clam, Sidestep, Unilateral Bridge, Quadruped Hip Extension (with knee extended & flexed) Exercises with GTA index <40: Abduction, Step Up, Bilateral Bridge, Squat, Hip Hike, Lunge
Conclusions of the ResearchersThe researchers recommend that both the GTA activation index & as well as the difference in the levels of EMG activity between TFL and gluteal muscles be considered when determining if an exercise maximizes gluteal activation while minimizing TFL activity. Based on this criteria, 5 exercises demonstrated preferential activation of gluteal muscles over TFL: Clams with a band, Unilateral bridge, Sidestepping with a band, Hip extension with both flexed and extended knee. 

Review & Commentary:

Overall the methodology of this study was very good. The use of wire electrodes as opposed to surface electrodes provides more precise information on the activity of specific muscles. Surface electrodes are susceptible to "crosstalk" from other muscles, thus making them a less precise method of measuring muscle activity. The use of the maximum voluntary contraction to normalize EMG signals recorded during the exercises is an acceptable method of normalizing data for this study because of its observational nature. In the event a comparison was being made between healthy and pathological subjects, it would be more appropriate to normalize data to the muscle activity occurring during a task.

One limitation of this study is that this data was retrieved from healthy, pain free individuals, therefore it remains to be seen if these results can be generalized to other populations. Furthermore, there are limitations to the conclusions that can be drawn from this paper. This research provides information on the activation of muscles during certain exercises. This protocol was not tested on subjects with pathology or dysfunction, so we cannot say with certainty if prescription of these specific exercises with improve pathological conditions such as patellofemoral pain syndrome, even though clinically we have seen this to be the case. Future research should also examine the use of these types of exercises in the improvement of function and performance.

Why is this study important?

This study is important for the process of connecting the dots between the abnormal movement patterns noted in Lower Leg Dysfunction (LLD) and Lumbo Pelvic Hip Complex Dysfunction (LPHCD) and the interventions we use to treat them. The authors of this study note that abnormal hip mechanics & impaired hip muscle performance have been connected to a variety of lower limb dysfunctions such as patellofemoral pain syndrome, iliotibial band syndrome, anterior cruciate ligament injuries, low back pain and hip joint pathology.

How does it affect practice?

This study provides clear recommendations for exercises that activate the gluteal muscles without promoting TFL activation. This essential information allows movement professionals to have greater precision in exercise prescription for rehabilitation and training interventions.

How does it relate to Brookbush Institute Content?

Lower Leg Dysfunction (LLD) & Lumbo Pelvic Hip Complex Dysfunction (LPHCD) implicate an overactive TFL and an under-active Gluteus Medius . This may be observed during the Overhead Squat Assessment  with the signs of dysfunction : "excessive forward lean", "excessive lordosis", "knees bow in", "knees bow out" or "feet turn out" or in the cluster of signs  indicative of LLD, LPHCD or an "Asymmetrical Weight Shift". The TFL is inhibited via hip extension (a major component of the exercises used in this study) and tibial internal rotation (not validated by this study) in all Glut Med activation exercises recommended by the Brookbush Institute.

Articles Related to the Exercises in this Research Study (Videos embedded):

Brookbush Institute Gluteus Medius Activation Exercises:

Gluteus Medius Isolated Activation:

Gluteus Medius Activation Progression (Activation Circuit):

© 2014 Brent Brookbush

Questions, comments, and criticisms are welcome and encouraged.

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