Iliotibial Band (ITB) Syndrome is an overuse injury which causes pain on outer part of the knee. Common to runners, hikers and cyclists, there are several factors which may contribute to it development. David Burnett shares some modifiable tips and exercises to reduce pain or avoid injury from the start. Let’s find out more!
All Things Glutes! 5 Progression Exercises to Strengthen Your Gluteus Medius
Written by: Blake Scott, MPhty, BA (Kin, Hons), Registered Physiotherapist
The Glute muscle group is a very popular group of muscles in the rehab world, especially the Glute Medius muscle!
Often the “Little Brother” of the Gluteus Maximus (Glute Max), the Gluteus Medius (Glute Med) plays an important role in maintaining a level pelvic alignment (preventing abnormal or excessive unilateral hip drop during single leg activity) and proper hip/knee/ankle alignment in single leg activity (walking, running, hopping). The Glute Max is more of a powerful global muscle responsible mainly for hip extension (think sprinting, running, stairs etc.).
There are many pathologies associated with the inability to maintain a proper alignment with the pelvis and femur including Patella Femoral Pain Syndrome (PFPS), Medial Tibial Stress Syndrome (shin splints), low back pain, and increased risk of ACL injury to name a few.
A study using EMG analysis (monitoring muscle activation with electrodes) was performed in 2011 by Borgen et al.1 to determine which exercises commonly performed in the clinical setting best activate the Glute Med and Glute Max.
The results of this study can help rehab professionals to develop a tailored, gradual graded strengthening program to specifically target poor muscle strength/activation, especially in the early phases of rehab.
The results of this study compared each exercise’s Glute Med/Max muscle contraction as a percentage of the individuals maximal voluntary muscle contraction (MVIC).
The study results are shown in the chart below:
As you can see the side plank abduction with the dominant leg (DL) down has the highest percentage of MVIC of the Glute Med making this an excellent rehab exercise if an individual struggles with maintaining a level pelvis and/or femoral knee alignment with single leg activity.
Although this is a great study for identifying exercises that target Glute Med activation, it does have some limitations in that it does not include exercises that require external equipment (therabands, weights) and is mainly relevant for early phase rehab only.
Below are video examples of the top Glute Med exercises identified by this study:
1. Side Plank with Static Hip Abduction
Aim for 30-60 second holds, 3-5 repetitions each side
2. Single Leg Squat
Keep a close eye on hip/knee/ankle alignment. Ideally you are trying to maintain a level pelvis with the middle of your knee tracking over your 2nd toe. 5-8 reps, 3-4 sets
3. The Banded Clam Shell
Looks easy but if you add a mini band and prolonged holds, it is a great way to feel a burn in the Glute Med! Hold 10-15 seconds for 10 reps
4. Front Plank with Hip Extension
This is a great challenge for the core as well! Try to avoid any excessive side to side movement through your hips as you lift your leg up towards the ceiling. 5 second holds, 5-8 reps, 3-4 sets
5. Lateral Step-Up/Down
Similar to single leg squats, keep a keen eye on hip/knee/ankle alignment of your stance leg. 5-8 reps, 3-4 sets
Blake Scott, MPhty, BA (Kin, Hons)
Blake joined GRSM in July 2018. Blake graduated with his B.A. Hons – Major: Kinesiology from the University of Western Ontario and a Master of Physiotherapy from the University of Sydney. Blake’s graduating class at University of Sydney ranked 1st in the 2017 QS World University rankings for sports-related subjects including Physical Therapy, Sports Therapy and Rehabilitation.
Blake has worked in hospital & multi-disciplinary clinics and has also been the team Physiotherapist for the University of Sydney Women’s Australian Rules Football Team. Blake has always been an avid sportsman growing up playing hockey, soccer, baseball, and volleyball. His dedication for sport has developed into a passion for treating sport-related injuries and promoting a healthy active lifestyle.
Blake’s treatment style focuses on the implementation of exercise and manual techniques to relieve pain and improve function.He also believes that a comprehensive injury education is important in enabling his clients to take control of their injury and optimize their outcomes. In his free time Blake enjoys staying active playing recreational baseball and hockey as well as taking his dog Louie for hikes.
Boren, Kristen et al. “Electromyographic analysis of gluteus medius and gluteus maximus during rehabilitation exercises.” /International journal of sports physical therapy/ vol. 6,3 (2011): 206-23.
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