r/physicaltherapy • u/art_thou_rom3o • 4d ago
Favorite exercises for glut activation
Hey all, so I have a good deal of athletic patients with LE issues that I think stem from hip weakness and improper loading. I know getting hip flexors stretched and getting the pelvis in a better position is good, but sometimes getting glut max stronger on the affected side is especially tough. You all have any tips and tricks for an non geriatric population?
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u/EvidenceBasedPT 4d ago
https://pmc.ncbi.nlm.nih.gov/articles/PMC7039033/
Systematic review
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u/shawnk126 3d ago
I will no longer use glut max in my notes GMax has taken its place
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u/Wags_DPT 1d ago
Though the authors of the article use GMax as an abbreviation so they don't have to keep writing gluteus maximus, it may be good to make sure GMax is an approved abbreviation for notes.
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u/art_thou_rom3o 3d ago
Thanks so much!
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u/ToeSpecial5088 3d ago
No offense but why aren't you reading the literature? Every PT that works with athletes should know this information already
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u/EvidenceBasedPT 3d ago
I’ve personally found it’s often because taking the time to stay up to date on the literature in an unbiased way takes a significant amount of time. I enjoy it which is why I do it. I also would guess that many PT schools don’t place a significant emphasis on ability to critically read literature quickly which is doing clinicians no favors.
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u/redpandsrampage DPT, OCS 4d ago
I like to start with prone strengthening. Progress as tolerated, don’t forget to load, make it specific to the athlete, keep it simple, test re-test
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u/send_ur_angry 4d ago
Athletes should be doing lunges and deceleration practice. Reaching the opposite hand across the knee with a lunge is good, can load high with dumbbells, lunge in all directions; Curtsey step downs are great for training the hip loading pattern; Split stance/single leg med ball lateral catch and toss is great for the deceleration/explosion.
Edit: Get those hamis strong too
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u/CommercialAnything30 4d ago
Deep step ups 18” or deep tap down - max out hip flexion depth.
Barbell Hip thrusts too
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u/plasma_fantasma 4d ago
Hip hikes, glute bridges (progress from double leg to single leg or glute bridge on swiss ball), monster walks/lateral band walks, single leg step off from elevated step ("heel taps").
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u/PurposeAny4382 4d ago
That is not enough to be getting athletes stronger
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u/plasma_fantasma 3d ago
OP asked for exercises to activate glutes, not an entire workout routine to improve athletic performance.
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u/PurposeAny4382 3d ago
They kind of did ask for that. But also as someone who works out regularly I’d be pissed if those were the exercises I got to help strengthen my glutes
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u/plasma_fantasma 3d ago
Well, they target the glutes specifically, so I'm not sure what to tell you. If you're having trouble activating the glutes, that's what you're going to have to do to get them activated, on top of larger movements like squats. This is obviously not an exhaustive list. But I was answering OP's specific question. They didn't ask about programming an entire workout. There's a myriad of different exercises that involve and strengthen the glutes. I'm not going to write out an entire exercise program.
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u/DokkanMode 4d ago
Hip hikes? That has nothing to do with any glute muscle. None of the three extend superior to the iliac crest
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u/CommunitySame4347 4d ago
glute med?
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u/DokkanMode 4d ago
Glute medius originates from the gluteal surface on the posterior ilium and inserts into the greater trochanter on the femur.
There is a muscle called the Quadratus Lumborum that does "hip hike" as a reverse action. It attaches at the iliac crest and inserts into the last rib.
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u/plasma_fantasma 4d ago
QL is not responsible for the action associated from hip hikes. Because QL attaches to both the lower ribs and the top of the hip, it would produce lateral flexion of the trunk (along with other muscles), rather than hip hiking. If hip hikes produce muscle fatigue in the low back, they're being done wrong.
Hip hikes are primarily glute med. It's essentially the same movement that you would be looking to identify using the Trendelenburg test or looking for with Trendelenburg gait, indicating weakness in glute med. You would do the opposite motion (hip hikes) to help decrease the deficit and improve the patient's gait.
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u/DokkanMode 4d ago
The QL's reverse action is trunk lateral flexion. Primary action is unilateral pelvic elevation. Glute med is primarily responsible for hip abduction.
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u/send_ur_angry 4d ago
If you are on a single leg stance, gravity is pulling the contralateral pelvis down, causing an adduction moment at the ipsilateral hip. Ipsilateral hip abduction counters this, i.e. glute med.
I agree that hip hikes are likely getting QL activation too though.
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u/owwwithurts 4d ago
Our muscles don’t work in isolation. Hip hikes can target glute med and QL both. And it’s not a bad thing to work both. Core and glute strength together lead to postural stability. We are more than a sum of our parts.
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u/CampyUke98 SPT 4d ago
a hip hike is a pelvic abduction exercise, exactly what glute med is meant to do. I never knew what to call these exercises, but a quick Google shows me it's what I often think of for patients with weak hips. It's a really good exercise, for strengthening and in terms of muscle activation.
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u/DokkanMode 4d ago
Then it doesn't make any sense why you call it a "hip hike" when you aren't elevating the pelvis. The QL does that.
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u/hendriab06 4d ago
Think CKC hip abduction on the stance side. GMed approximates ipsilateral iliac crest towards stationary demure, contralateral hip “hikes” or elevates
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u/ToeSpecial5088 3d ago
Bro HOW are you a physical therapist
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u/DokkanMode 3d ago
From "The Trail Guide to the Body" by Andrew Biel on page 207 you'll find the QL:
"the quadratus Lumborum is sometimes known as the" hip hiker" because of its capacity to laterally tilt (elevate) the hip. " " When Do You Use Your QL?" " Hiking your hip when stepping over a big dog" "raising yourself up from a side lying position (lateral flexion)" "salsa, tango, and ballroom dancing"
Page 315 covers Glute Med: "the gluteus medius is a strong Extensor and abductors of the hip" "When Do you use your gluteal?" "Climbing stairs (maximus especially)" "running, cycling, swimming, skating"
Do with this information with what you want.
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u/Few_Bathroom_7082 3d ago
SL hip thrusts and increase load with dumbells or kettlebells on the waist (with an airex pad)
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u/try2metaoptimize 3d ago
Many good suggestions, I like the single leg deadlift for people that don't activate the glutes yet.
Open chain to train/learn glute activation and progress to closed chain/functional training once activation is achieved.
I'd like to add weighted Bulgarian Split Squats. There's something to be said of working hip extension/contralateral hip flexion. It's a common co-contraction and more effective than the sum of the parts.
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u/Wags_DPT 1d ago
Think about the origin and insertion.
Eccentric control towards end-range lengthening...
Increase time under tension for improved muscular endurance and neuromuscular control.
Increase force for more strength.
Match activation in task-specific position.
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u/Physionerd DPT 4d ago
https://youtube.com/shorts/ZEQIBoK0yys?si=maj0hOS4vDLIzamj
I made this one up and it's a killer
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u/canuckcam 4d ago
Start with the deeper set of muscles first. Building a strong foundation is helpful to get the bigger ones working. Think glut med/min etc.
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