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Gluteus medius exercises for improving movement dysfunction, posture, knee pain, back pain, and performance. Great clamshell, leg raise & side-stepping variations.

Gluteus Medius Exercises (Activation)

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I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

Brookbush is the most efficient Personal Training Certification I have ever come across. All the lessons are well thought out and very straight to the point.

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Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

Totally loving the convenience and affordability of this program with my crazy lifestyle! I feel like I am getting a quality education without a massive cost! My favorite part is the videos I can watch in the courses. I learn so much better that way. Once I really spent more time on the site, I figured out how to maneuver around a lot better! I enjoy the sense of humor, as well as the easy explanation, and short tests. And if I am really tired, I can have the computer read me the lessons. 😁

Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

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This course describes gluteus medius exercises, commonly referred to as gluteus medius activation. Performing hip abduction exercises, with the addition of hip extension, hip external rotation, and tibial internal rotation can improve recruitment (isolation) of this important muscle. The gluteus medius is the primary abductor and frontal plane stabilizer of the hip. It is common to include these exercises in a program designed to address 

; however, these exercises may also be recommended to reduce an asymmetrical weight shift, knee varus, feet turn out, and feet flatten (pes planus). Addressing these signs has been correlated with improving and reducing the risk of low back pain, hip pain, knee pain, ankle pain and foot pain, and improving sports performance. Movement professionals (personal trainers, physical therapists, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) should consider adding these exercises to their repertoire with the intent of improving patient/client outcomes from their integrated exercise programs and therapeutic (rehabilitation) interventions.

Resisted side-lying leg lift with a stability ball

Last, it is important to integrate the increase in gluteal muscle activity into functional exercise. The Brookbush Institute accomplishes this with anterior oblique subsystem and the posterior oblique subsystem integration. Some example movements for these purposes include:

A side lying leg lift is one gluteus medius exercise for activation that has advanced progressions

Course Description: Gluteus Medius Exercises (Activation) 

Gluteus Medius Exercises (Activation) Study Guide

Study Guide: Gluteus Medius Exercises (Activation)

Introduction

Glute Medius In Postural Dysfunction And Movement Impairment

 have a propensity to become inhibited and under-active (relatively weak during activity). This reduces our ability to eccentrically decelerate hip internal rotation, hip adduction, and maintain pelvic alignment during daily activity and sport. This impaired function may result in dyskinesis (movement dysfunction) of the hip, knee, low back, and ankle, and is often paired with over-activity of the 

, piriformis, tibial external rotators, and/or the

. Gluteus medius inhibition may reduce performance, increase the risk of future injury and dysfunction, and is correlated with pain and dysfunction of the lumbopelvic hip complex and lower extremity.

Signs of Under-Activity and a Maladaptive Increase in Length

The knee is compromised when the glute medius does not activate or is in a lengthened state. This is seen by a knee caving inward or internally rotated (knee valgus)

Signs Of Under-Activity & Length In Weak Gluteus Medius Muscles

Introduction to Gluteus Medius Exercises

Overactive Synergists

Muscles that commonly become synergistically dominant when the gluteus medius is inhibited – release and stretch prior to activation, and cue 

 motion to reciprocally inhibit these muscles during activation exercise.

 (inhibit w/ hip extension and neutral foot position - limit tibial external rotation)

Piriformis (inhibit by preventing horizontal abduction - limiting hip flexion to 60° or less during activation)

Quadratus Lumborum (inhibit w/ neutral spine - no lateral flexion or hip hike)

The TFL, a hip flexor muscle, becomes synergistically dominant (shortened or overactive) when the gluteus medius doesn&rsquo;t properly activate

Optimizing Motion (Best Practice)

Optimal neuromuscular activity (tone) and function are not only affected by the strength of an individual's muscles but optimal length and activity of their functional antagonists and mobility of the joints they cross. It is recommended that the appropriate release, lengthening, and joint mobilization techniques are done prior to the activation and integration techniques discussed below.

Research Corner

There is a considerable amount of research on the relationship between movement impairment and gluteus medius inhibition and weakness, as well as activation and strengthening of the gluteus medius and its effect on the quality of human movement. Starting with impairment, a reduction in gluteus medius activity has been correlated with pain in all lower extremity joints, including the lumbar spine, hip, knee, and ankle (Achilles tendinopathy) (5-10). Even in the absence of pain, gluteus medius weakness has been strongly correlated with functional valgus and potentially a risk of ACL injury (11-17).

Research regarding activation/strengthening has compared gluteus medius activity to activity of the 

 during commonly performed rehab/corrective exercise, suggesting that hip extension results in a relative decrease in 

 activity (1-2). Specifically, clams and 

 may be effective for targeting the gluteus medius and incorporate the superior fibers of the 

, a commonly used exercise for targeting the glute complex, is likely more effective when done from a quarter squat position and a slight forward lean (athletic posture) (4).

A miniband or looped resistance band offers progressions and exercise variety for activation of the gluteus medius

Most pertinent to practice, greater gluteus medius strength has been correlated with better landing mechanics, running mechanics, and squat mechanics (11-16), and in a study by Bell et al., a corrective intervention including exercises similar to those recommended below, improved movement quality (14).

Research on Gluteus Medius Muscle Exercises

Resisted Side-Lying Leg Raise with Stability Ball

Clam Shells and Side-Lying Leg Raise 

Side-Lying Leg Raise

Resisted Side-Lying Leg Raise

Quick Glute Activation Progression

Best Exercises for Gluteus Medius Isolated Activation

Single-leg Balance and Reach 

Resisted Single-leg Balance and Reach

Single-leg Deadlift Touchdown 

Integrated Stabilization

Resisted Side-stepping

Resisted Side-stepping Progressions

Gluteus Medius Side-hop Progression

Reactive Activations

Subsystem Integration

Illustration of the Posterior Oblique Subsystem with Muscles Labeled

Gluteus Maximus Activation Taping provides the practitioner with the opportunity to reinforce gluteus maximus activation techniques for hours and possibly days after a session. The intent is to use taping as a kinesthetic stimulus via skin receptors, which results in an increase in gluteus maximus activity for the period the tape is on.

Asterisk on the skin over the area where the 

 and gluteus medius meet, roughly 3" inferior to the posterior iliac spine.

Done in side-lying so the top leg is in a position of:

Gluteus Maximus & Gluteus Medius Muscle Taping

Sample Activation Circuit

Female, college soccer player, 21 yo, with a history of knee pain.

Gluteus Medius Manual Muscle Testing (MMT)

: With compensation. As pressure is applied the patient “pulls into flexion.” This may be a sign of synergistic dominance of 

Tensor Fasciae Latae (TFL) and Gluteus Minimus Static Manual Release

Mobility Program: Self-administered Techniques

Tensor Fascia Latae (TFL) Self-administered Release

Gluteus Minimus Self-Administered Static Release

Vastus Lateralis Self-administered Static Release

Adductor Self-Administered Static Release

Lateral Gastrocnemius Dynamic Release (Pin and Stretch)

Adductor Magnus and Inferior Capsule Static Stretch

 Light to Moderate (60 - 85% of 1-RM), focus on form and ROM

 Circuit training, 1 min rest between exercises

5 - 15 minutes (excluding mobility interventions)

Gluteus Medius Activation: Side Lying Leg Raise with Stability Ball

Gluteus Maximus Activation: Prone Hip Extension with Stability Ball

Single Leg Balance with Frontal Plane Reach

The biggest mistake we see clinicians make regarding knee valgus (knees bow in) is failing to address dorsiflexion restriction and ankle inverter activation. It is very challenging to achieve optimal outcomes with hip and/or knee interventions alone.

It has been our experience that performing gluteus medius activation before gluteus maximus activation results in better outcomes.

“It feels” as though gluteus medius activation sets-up better gluteus maximus recruitment.

Dr. Brent Brookbush demonstrating a static ball bridge with trunk rotation working the gluteus medius and core muscles

Case Study and Sample Activation Circuit: Gluteus Medius Exercises

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.

Boren K, Conrey C, Coguic J, Paprocki L, Voight M, Robinson T. Eletromyographic Analysis of Gluteus Medius and Maximus During Rehabilitation Exercises. Int J Sports Phys Ther. 2011 Sep; 6(3): 206–223.

Selkowitz DM, Beneck GJ, Powers CM. (2016) Comparison of electromyographic activity of the superior and inferior portions of the gluteus maximus muscle during common therapeutic exercises. 

Berry, J. W., Lee, T. S., Foley, H. D., & Lewis, C. L. (2015). Resisted Side Stepping: The Effect of Posture on Hip Abductor Muscle Activation. 

Journal of Orthopaedic & Sports Physical Therapy

Cooper, N., Scavo, K., Strickland, K., Tipayamongkol, N., Nicholson, J., Bewyer, D., Sluka, K. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. J Euro Spine. 26 May 2015

Grimaldi, A, Richardson, C, Stanton, W., Durbridge, G, Donnelly, W. and Hides, J. (2009) The association between degenerative hip joint pathology and size of the gluteus medius, gluteus minimus and piriformis muscles. (2009). 

Hungerford, B., Gilleard, W., Hodges, P. (2003) Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine 28(14), 1593-1600

Ireland, ML., Wilson, JD., Ballantyne, BT., Davis, IM. (2003). Hip Strength in Females With and Without Patellofemoral Pain. J Orthop Sports Phys Ther 2003. 33: 671-676

Noehren B, Hamill J, Davis I. Prospective Evidence for a Hip Etiology in Patellofemoral Pain. 

Franettovich, S. M., Honeywill, C. O. N. O. R., Wyndow, N., Crossley, K. M., & Creaby, M. W. (2014). Neuromotor control of gluteal muscles in runners with achilles tendinopathy. 

Medicine and science in sports and exercise

Smith, J. A., Popovich, J. M., & Kulig, K. (2014). The influence of hip strength on lower limb, pelvis, and trunk kinematics and coordination patterns during walking and hopping in healthy women. 

Mauntel, T., Begalle, R., Cram, T., Frank, B., Hirth, C., Blackburn, T., & Padua, D. (2013). The effects of lower extremity muscle activation and passive range of motion on single leg squat performance. 

Journal Of Strength And Conditioning Research / National Strength & Conditioning Association

Padua, D. A., Bell, D. R., & Clark, M. A. (2012). Neuromuscular characteristics of individuals displaying excessive medial knee displacement. 

Bell, D. R., Oates, D. C., Clark, M. A., & Padua, D. A. (2013). Two-and 3-dimensional knee valgus are reduced after an exercise intervention in young adults with demonstrable valgus during squatting. 

Ramskov, D., Barton, C., Nielsen, R. O., & Rasmussen, S. (2015). High Eccentric Hip Abduction Strength Reduces the Risk of Developing Patellofemoral Pain Among Novice Runners Initiating a Self-Structured Running Program: A 1-Year Observational Study. 

journal of orthopaedic & sports physical therapy

Snyder, K. R., Earl, J. E., O’Connor, K. M., & Ebersole, K. T. (2009). Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. 

Hewett, T. E., Myer, G. D., Ford, K. R., Heidt, R. S., Colosimo, A. J., McLean, S. G., & Succop, P. (2005). Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes A prospective study. 

Florence Peterson Kendall, Elizabeth Kendall McCreary, Patricia Geise Provance, Mary McIntyre Rodgers, William Anthony Romani

Gluteus Medius Exercises (Activation)

Related Courses:

Course Description: Gluteus Medius Exercises (Activation)

Study Guide: Gluteus Medius Exercises (Activation)

Introduction to Gluteus Medius Exercises
1 Sub Section

Overactive Synergists

Optimizing Motion (Best Practice)

Research on Gluteus Medius Muscle Exercises

Best Exercises for Gluteus Medius Isolated Activation
4 Sub Sections

Integrated Stabilization
3 Sub Sections

Reactive Activations
3 Sub Sections

Subsystem Integration

Gluteus Maximus & Gluteus Medius Muscle Taping

Case Study and Sample Activation Circuit: Gluteus Medius Exercises

Bibliography

Related Courses:

Comments

Guest

Gluteus Medius Exercises (Activation)

Related Courses:

Course Description: Gluteus Medius Exercises (Activation)

Study Guide: Gluteus Medius Exercises (Activation)

Introduction to Gluteus Medius Exercises1 Sub Section

Overactive Synergists

Optimizing Motion (Best Practice)

Research on Gluteus Medius Muscle Exercises

Best Exercises for Gluteus Medius Isolated Activation4 Sub Sections

Integrated Stabilization3 Sub Sections

Reactive Activations3 Sub Sections

Subsystem Integration

Gluteus Maximus & Gluteus Medius Muscle Taping

Case Study and Sample Activation Circuit: Gluteus Medius Exercises

Bibliography

Related Courses:

Comments

Guest

Introduction to Gluteus Medius Exercises
1 Sub Section

Best Exercises for Gluteus Medius Isolated Activation
4 Sub Sections

Integrated Stabilization
3 Sub Sections

Reactive Activations
3 Sub Sections