Have you been called knock-kneed? Have bad balance problems or knee pain? One muscle may be the source of these issues: your gluteus medius. It may seem odd that things like knee troubles, back pain after squats, and problems standing on one foot could all have the same cause, but in this article you’re going to discover how the gluteus medius can be the sources of these problems and more. While this news might sound bad, the flip side is this: strengthening your glute medius can have huge benefits for your body and improve your mobility. Read on to learn how these problems are connected and for gluteus medius exercises to strengthen your hips and protect your lower body. Off-Balance? We’ve all felt a little off-balance before. Maybe you stood up too quickly, or were distracted while trying to reach for something, or maybe you just had a little too much to drink the night before… But if you regularly feel unstable when working out or when both feet aren’t on the ground, there could be a muscular imbalance in your hips. Try this: Stand up and lift one leg off the floor. How do you feel? Do you feel stable, solid, and like the hip of your standing leg is working hard, but steadily? Or, do you feel like that hip is unable to keep up and carry the weight of your other side? Maybe you feel a big droop or like you need to put your foot down quickly for balance? Any of these could be a sign your gluteus medius muscle is in serious need of some strengthening and repatterning. What is the Gluteus Medius? As the name implies, your gluteus medius is the middle 1 of 3 glute muscles. Sandwiched in between the gluteus maximus and minimus, your gluteus medius stretches from the upper pelvis to the top of your femur bone. Your glute medius plays a key role in movements at your hip – especially abducting and rotating your thigh [1]. Your gluteus medius is also a major player in the game of steadying your pelvis. This comes into play when you’re balancing on one leg – like when you’re balancing to reach something or setting up to kick in sports like soccer and for the martial arts. But this pelvic stabilizing role is perhaps most important when it comes to two activities we do often – walking and running. As you walk, your glute medius keeps your pelvis steady so that the hip of your leg that is swinging off the ground doesn’t sag. This is crucial – if that hip were allowed to drop, your moving foot would also drop – slamming into the earth instead of swinging over it and allowing you to move forward [2]. Without the glute medius keeping that pelvis lifted, we wouldn’t get very far or move very fast. How a Weak Glute Medius Spell Trouble for Knees Weakness in your gluteus medius can contribute to many issues down the kinetic chain of your body, including valgus knees. You might know valgus knees as knock-knees. This is where your knees seem to bend in toward each other. This photo is a pretty extreme example, but it isn’t all that far off from how some people’s knees look when they go into a movement like a squat. If your gluteus medius is weak, it may not externally rotate your thigh like it’s supposed to. This improper rotation at the top of your femur can cause the other end of the bone to rotate inward – meaning your knees will also point in towards each other, giving you knock-knees [3]. Why Valgus Knees are a Serious Issue Valgus knees can cause patellofemoral (knee) pain but the issue can also cause pain to reverberate down to your ankle or foot [4]. Valgus knees can be serious, and not just because they are painful. They can make your body more vulnerable to major problems like meniscus, anterior and posterior cruciate ligament (ACL and PCL) injuries especially in sports like soccer and basketball that require high speed changes of direction and volleyball that require jumping [5]. If you’ve ever known anyone with an ACL tear or if you’ve had one yourself, you know that this isn’t something to play around with. ACL injuries can knock you out for weeks and could mean surgery and major pain. Effects of the Q Angle Unfortunately, women are more prone to valgus knees due to something called the Q angle, or quadriceps angle [6]. The Q angle is measured by imagining one line going straight up through the middle of your patella and another line going from your patella to a point on the superior front of your pelvis. The angle created between these lines is the Q angle. Larger Q angles can represent a bigger risk of certain injuries, including ACL troubles, and a propensity for valgus knees. Because women have wider hips – and thus a bigger Q angle – they’re more prone to both ACL problems and valgus knees [7]. Some of this is just the luck of the structural draw, but a weak glute medius can exacerbate the problem by failing to provide even pelvis balance and abduction of the leg. Testing Gluteus Medius Function A common method to test the function of the glute medius is the Trendelenburg test. This test identifies weaknesses in your glute medius and other hip muscles by examining your body position when you stand on one leg. (If you got up and stood on one leg when you started reading, you’ve already performed this test!) Usually, standing on one leg will mean strong contractions in the muscles of your glute med and other hip abductors on the standing leg, which work to keep your entire pelvis stable [8]. But when these muscles are weak, they’re unable to keep things steady and the hip of your lifted leg will drop noticeably – either backwards or down. How Else Does Glute Medius Weakness Show Up? Weak glutes won’t only cause balance troubles and valgus knees, it can affect your body even farther up and down the kinetic chain [9]. Weak glutes that fail to keep your body stable when moving can cause recruitment of other muscles to do the job – like say, the muscles of your low back. As your quadratus lumborum and other low back muscles attempt to take on more and more of a job they aren’t designed for, these muscles and develop trigger points from being overworked and you can start to feel some major low back pain. And studies have shown that not only do people with low back pain tend to have weaker gluteus medius muscles than people without back pain, low back pain patients have weaker glute meds on the side with back pain than on pain-free side [10]. This just goes to show the importance of the glute medius for a healthy, pain-free body. Other leg abductors, like your tensor fascia latae, can also become overworked if your glute medius is slacking off. Studies have shown similar results when it comes to IT band troubles. In one study, runners with iliotibial band syndrome had weaker glute meds than runners without IT band problems, plus had weaker glute meds on their affected side than on their side without IT troubles [11]. What all these interactions mean is that a weak glute medius doesn’t only affect your butt! Gluteus medius issues can show up around your whole body – and in a ton of different movements. Take for example two extremely common exercises – lunges and squats. If your glute medius is weak, I’d bet you aren’t performing these moves effectively, no matter how often you do them. Those valgus knees can really show up here and weak gluteus medius muscles can translate to an inward slant of your knees during both squats and lunges. It can also result in leaning forward more than necessary to balance – potentially putting your back in jeopardy. What’s more, you might be able to notice an asymmetrical weight shift if that glute medIUS isn’t working properly to balance your pelvis as you lower into a lunge or squat [12]. You put the effort into doing these moves because you want to become stronger. But if you’re performing moves with improper form, you aren’t really getting stronger in a helpful way and you’re increasing your risk of injury What you’re doing is reinforcing problematic positions and chronic weaknesses. That sounds depressing, but there’s an easy way to fix this – gluteus medius exercises. 4 New Gluteus Medius Exercises for Strength and Balance Luckily, I’ve never had to deal with a weak glute medius because I grew up playing hockey. Every stride in skating requires hip abduction – the main glute medius action – so anyone who has spent a lot of time on the ice is probably in the same boat. However, hockey players like myself still need to train other movement patterns that involve the gluteus medius to ensure complete development. And if you’ve got valgus (knock) knees, or notice trouble with balance or form in moves like squats and lunges, then you likely need to strengthen your glute medius muscles to avoid all of the problems we’ve talked about above. Here are some hip abductor exercises that will help. Gluteus Medius Exercise #1: Multi Angle Clamshell Part 1: Neutral Stand with your right foot and right shoulder next to a wall Lift your right foot off the ground Use your left leg to drive your body into the wall Hold for 5-10 seconds and release, completing 2-5 reps Part 2: Externally Rotated Now turn your left foot to a 45-degree angle away from the wall Lift your right leg and drive it into the wall, this time externally rotating your left hip to drive the push Hold for 5-10 seconds and release, completing 2-5 reps Part 3: Internally Rotated Next turn both feet in towards the wall at a 45-degree angle Lift your right leg while making sure to keep only the right shoulder against the wall Use your left leg to drive your right leg into the wall, externally rotating your left leg Hold for 5-10 seconds and release, completing 2-5 reps Repeat on the other side – make sure to hit all 3 angles! Gluteus Medius Exercise #2: 4 Point Hip Abduction Get into the quadruped stance with knees on the ground Keep your hands under your shoulders, knees straight behind your hands and keep a neutral spine Keep the your body still as you activate your left glute to slowly lift your left leg up until it’s parallel with the ground Abduct your left leg away from the midline and hold it out to the side for 5-10 seconds Keep your body still as you return you reverse the motion to return the leg to the ground Repeat for 3-5 reps then switch sides Gluteus Medius Exercise #3: 1-leg Side Bridge Lay on one side with your feet stacked and elbow directly under the shoulder Lift your hips off the ground so your body is in a neutral position Now lift your top leg up and hold as you keep it elevated for 10 seconds Lower down completely and relax for 3 seconds and repeat Gluteus Medius Exercise #4: Prone Straddle Hold Lie in a prone position with your arms stretched out by your ears and your toes pointed Lift your legs off the ground and abduct your hips to move them apart Keep your thighs off the ground as you continue to abduct your hips Hold with legs outstretched, noticing if you’re able to push further as you hold Hold for 10-30 seconds then rest One beneficial side effect to these gluteus medius exercises: when you train your glute medius at the end range of hip abduction like you’re doing in the Prone Straddle Hold, you’re also working to lengthen your hip adductors. This means that you’re strengthening multiple movements at your hip, better increasing your mobility, and protecting yourself from injury. So go ahead and add these into your routine to build strong and mobile hips and keep your low back, knees and ankles healthy. Original article and pictures take https://www.precisionmovement.coach/gluteus-medius-exercises/ site
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