Strengthening and neuromuscular training exercises are important in the prevention and rehabilitation of injuries. Hip abduction strengthening exercises are often utilized in lower extremity rehabilitation programs since they have functional implications in activities of daily living and may facilitate positive outcomes for hip injuries and knee dysfunction (Lubahn 2011). Studies have used a six week strength, flexibility, and neuromuscular training program targeting the hip muscles resulting in decreased incidence of knee injuries in female athletes over a single playing season.

What is Hip Abduction Strengthening?

Hip abduction is moving the leg from the center line of the body. These exercises include both weight bearing and non-weight bearing. These exercises can include side lying or standing hip abduction with or without resistance and single-leg standing (SLS) exercises, such as squats, lateral step downs, proprioceptive training, and plyometrics. SLS activities require hip abductor muscle activation of the leg on the ground, keeping the body erect (Lubahn 2011). If you want to add weighted exercises leg press, forward and lateral lunges can be very effective. By using proper biomechanics this can improve hip muscle recruitment and power during functional and sports specific movements.Lubahn (2011) looked at muscle activation in the gluteus maximus and gluteus medius for three exercises: double-leg squat, single-leg squat, and step-up for two conditions (with and without an applied load to the knee). There was a difference in muscle activation between the three exercises (double-leg squat, single-leg squat, and step-up) for gluteus maximus. Adding resistance did not change the amount of integrated activation across all exercises for the gluteus maximus. When an applied load was added to the double-leg squat, gluteus maximus activation increased by 6%. When an applied load was added to the step-up and single-leg squat gluteus maximus activation decreased by 2% and 7.4%, respectively. However, this change in muscle activation was not large enough to be considered significant for either the step-up or the single-leg squat. The results showed that the use of exercises with resistance may not increase the integrated or peak muscle activation of the gluteus maximus and gluteus medius during single-leg squat and step-up. The double-leg squat exercise with an applied load provided by a resistance band may be more beneficial than the same exercise performed without the band. The single leg squat achieved the highest integrated and peak activation of the gluteus maximus and gluteus medius of the three exercises.

What is Hip Extension Strengthening?

These involve lifting and holding your leg either behind or to the side of your hips. These exercises force your glutes and hamstrings to contract, working against both your body weight and the resistance provided by gravity (Lubahn 2011). Exercises for beginners learning to activate their glutes can include a bridge or a bridge hold, prone glute squeeze, prone unilateral glute squeeze, donkey kick and prone hip extension. Once we have mastered the art of butt squeezing, we can move to a single leg bridge, weighted hip thrust and weighted donkey kicks. When we perform all of these exercises, our main focus should be on firing our glutes, if you aren’t focusing on the task at hand, you may not see results. Strong glutes can improve performance during athletic movements, can help prevent injuries and help with lifting. It is important not to neglect your glutes, they will help you in the long run.

3-Phase Glute Amnesia Program

Phase 1

The purpose of this phase is to re-teach yourself to activate your glutes.  In this phase you want your main focus to be squeezing your glutes as hard as you can.  After this phase you should have the muscle memory with glute activation.

Hip Flexor Stretch

Perform 3 sets of 15-30 second holds.

Prone Glute Squeeze

Perform 3 sets of 10 reps (squeeze for 5 seconds and relax).

Clams

Perform 3 sets of 8-10 reps.

Prone Leg Raise

Phase 2

The purpose of this phase is to work on strengthening the glutes.  Introducing unilateral exercises make activating your glutes harder because you’re only working one side of your glutes. In this phase more repetitions and a light band can be used.

Bridge

Perform 3 sets of 15 reps

Side Lying Leg Raise

Perform 3 sets of 10-15 reps with a one second hold at the top.

Standing Hip Abduction

perform 3 sets of 8-12 reps with a one second hold.

Standing Hip External Rotation

Perform 3 sets of 8-10 reps.

Phase 3

This progression is difficult. Stay with it, maintaining glute activation during each exercise!

Hip Thrust

Perform 3 sets of 5-10 reps.

Lunges

Perform 3 sets of 8-12 reps on each side.

Single Leg Squats

Perform 3 sets of 5-10 reps on each side.

Reference:

Lubahn AJ, Kernozek TW, Tyson TL, Merkitch KW, Reutemann P, Chestnut JM. Hip muscle activation and knee frontal plane motion during weight bearing therapeutic exercises. Int J Sports Phys Ther. 2011 Jun;6(2):92-103.

Written by Chris Barber, CPT