AN EXAMINATION OF THE GLUTEAL MUSCLE ACTIVITY ASSOCIATED WITH DYNAMIC HIP ABDUCTION AND HIP EXTERNAL ROTATION EXERCISE: A SYSTEMATIC REVIEW
Paul Macadam, BSc1 John Cronin, PhD1, 2 Bret Contreras, MA1
The International Journal of Sports Physical Therapy | Volume 10, Number 5 | October 2015 | Page 573
I have added a short analysis of this article as it may not be accessible online to the general public. We like this article because it explains why we do different phases of exercises as practitioners. It is more important to be able to perform a non-weightbearing exercise with good technique and proper muscle activation than a dynamic weight-bearing exercise with poor technique and improper activation patterns.
This article explores the available research related to gluteus maximus and gluteus minimus activity associated with dynamic hip abduction and external rotation exercises. EMG was used in all 23 articles for quantification. The articles had to include dynamic exercises for these muscles. Isolated exercises were not allowed, although there was subjective judgment used by the authors to do determine this. 467 subjects who were injury free were chosen. 52 exercise variations were chosen. Weight-bearing and non weight-bearing exercises were analyzed. The authors hypothesized that exercises which were more dynamic would result in greater percentage of maximum voluntary isometric contraction (MVIC).
Exercises performed in weight-bearing position elicited higher percentage of MVIC than non weight-bearing. Gluteus medius was also more active than gluteus maximus in this positions. The top gluteus maximus and gluteus medius exercises (greatest percentage of MVIC) were weight-bearing, suggesting that standing and changing the base of support imposes greater demands of the musculature. With several non weight-bearing exercises producing moderate percentage MVIC, the study also shows that these exercises are beneficial for those who can’t perform the weight-bearing exercise.
Lateral step up, cross over step up and rotational single leg squat produced the highest gluteus maximus activation. Side bridge with hip abduction, standing hip abduction with elastic resistance at the ankle and side lying hip abduction produce the highest gluteus medius activation. The information from this article can be used to educate the provider on which exercises provide the greatest muscle activation. Higher percentage of MVIC was a result of more dynamic exercises as hypothesized. However, the patient needs to be able to perform the exercise with proper technique and stability, which most of the time will require an easier/less dynamic one to start with.