A word on glute “Activation”

For a while now there has been a lot of talk about gluteal “inhibition” and its contribution to bad hip mechanics in squats, lunges, jumping and a myriad of other lower extremity movements. The finger most often gets pointed at the gluteus medius specifically and its “weakness”. But before you start throwing in a bunch of open kinetic chain (OKC) hip abduction exercises (going forward, you might see me refer to these as “Jane Fondas”) in a well-intentioned attempt

to improve your clients’ squats, take some time to think about the following:

1. Language is important. It is erroneous to say that a person’s glutes are “not activating”, “not firing”, “shut down” or anything else that implies that there is absolutely no activity there. We should be using the term “gluteal amnesia” or better yet “gluteal dysfunction” to refer to inhibited (ie. not firing optimally), altered or delayed firing patterns in the glutes.

2. Don’t just assume that everyone is plagued with this dysfunction. We all know trends tend to happen in the fitness business. If you’re pointing the finger at the glutes, it should be because something in your assessment or ongoing intervention with this client has led you to suspect there is a dysfunction there.

3. Yes, “we are only as strong as our weakest link”, but don’t limit yourself to strengthening the glutes independently. If you put a brand new link in a chain, you’re strengthening that link, but not necessarily the entire chain.

Several studies have indeed shown higher percentages of maximum voluntary isometric contraction (MVIC) in side-lying hip abduction when compared to resisted side-stepping (ie. band walks) (Distefano et al., Youdas et al.). We can infer that the main reasons for this difference in activation in the side-lying hip abduction position are 1) the large moment arm created by the mass and position of the lower extremity and 2) the fact that we are essentially “isolating” the gluteus medius (with a few adjustments to the position of the hip/pelvis, side-lying hip abduction is essentially the muscle testing position for the gluteus medius).

While this is a great way to strengthen the gluteus medius specifically, Jane Fondas and their variations are typically used in the early stages of clinical rehabilitation when we have reason to avoid weight-bearing. Functionally though, the gluteal muscles are primarily pelvis and lower extremity stabilizers (not to mention spinal stabilizers as we move up the kinetic chain). During gait, the gluteal muscles act to provide sagittal plane stabilization of the trunk, control trunk rotation in the transverse plane and stabilize the pelvis in the frontal plane. So you can bet that you need to be doing more than Jane Fondas if your goal is to improve the function of the glutes (I’m not talking isolated strength or hypertrophy here).

Don’t get me wrong, I have no axe to grind with the use of isolated movements and/or OKC movements for the lower extremity. I actually think they are great for promoting that mind-muscle connection most people so desperately need with the gluteus medius, so they work really well for neuromuscular re-education. I’m a fan of good old glute bridges and side bridges because isometrics tend to facilitate mind-muscle connections, but I also like to use OKC lower extremity PNF strengthening patterns to incorporate movement in all 3 planes. Something like this works great to get a client “connected”, provided they receive the right cues and assistance:

 

(The first pattern has the hip moving into flexion, adduction and external rotation and then into extension abduction and internal rotation. The second pattern has the hip moving into flexion, abduction and internal rotation and then into extension, adduction and external rotation. You want to cue your client to initiate the rotation before the flexion/extension. If you’re not familiar with PNF patterns, I suggest you watch some videos to integrate this before you prescribe it to your client. YouTube has many quality videos on this.)

Let’s go back to our side-lying abduction vs resisted side-stepping studies. Another study by Berry et al. found that in the resisted side-stepping exercise, it was actually the stance limb, not the moving limb (the limb doing a Jane Fonda) that had higher EMG activity (higher EMG is correlated with higher %MVIC). Without going into great detail, we can tribute this to the need for the hip musculature to respond to the ground reaction force and conclude that closed kinetic chain (CKC) exercises for the lower limb are likely to correlate with higher glute activation. And well, I don’t have to explain why they will have a more potent transfer to our other big CKC lifts, do I??

Re-patterning the gluteus medius

While we can appreciate the value of weight-bearing exercises for further re-patterning of the gluteus medius, there’s a progression to be had before we start throwing out lunges of all kinds and pistol squats. It’s gotta be harder than standing on one leg or walking, but if you go right into heavy single-leg work, your body will go right back to the path of least resistance (usually the faulty one).

Here are just a few progressions you might find useful:

Lateral step-ups and cross-over step-ups

I like these because they basically incorporate the lower extremity PNF strengthening patterns into a CKC movement. Keep the step low and cue your clients to keep their center of mass forward to avoid pushing off with the back leg.

Use 6-8 reps/leg for each

The number of sets will depend on how and where you program this in the session (we’ll discuss this later)

 

A step up from these (pardon the pun) is another simple yet underutilized exercise: the single-leg Romanian deadlift. Loading only the hand opposite the stance leg gives it additional multi-planar character, but even holding a weight in both hands (or no weight at all, depending on where you are in your progression) solicits the glutes to resist hip adduction torque and internal rotation of the thigh, all while generating movement in the sagittal plane.

Use 6-8 reps/leg

 

The “How to”

All that being said, the next question is usually how and where do I program this? As you get to know me, you’ll see that (other than for research purposes) I don’t like to be confined to a set protocol. So many factors play in to why, when, where, with who and how you are going to use this. In my opinion, a good coach uses a variety of knowledge, tools and methods to analyze the best way to approach a problem. Here are a couple of ways I program this:

In the warm-up:

The expression “practice makes perfect” holds so much truth, especially for motor re-patterning. If you want adaptation, you need repetition. Sticking these in as part of every warm-up, or at the very least on leg day, can be quite efficient. If done properly, with proper attention and relevant cues, a couple of sets of each exercise for each leg works well.

As a rehab primer:

Programming a re-patterning/mind-muscle connection exercise before a main exercise is what I like to call a rehab primer.

Perform 1 set of 6-8 reps/leg, followed by your main exercise and do this for each set.

What about Glute Max?

Did I just ask exactly what you were thinking? Good! You’re right, we’ve gotta think about the gluteus maximus as well, and I’ll address that in a future article.

*Important note: I apologize for using Jane Fonda’s name in vain. Jane Fonda is great.

-MD

Article by Mai-Linh Dovan, M.Sc., Functional (P)Rehabilitation Specialist @Thibarmy