Gluteal muscle activation during common therapeutic exercises.

STUDY DESIGN Experimental laboratory study. OBJECTIVES To quantify and compare electromyographic signal amplitude of the gluteus maximus and gluteus medius muscles during exercises of varying difficulty to determine which exercise most effectively recruits these muscles. BACKGROUND Gluteal muscle weakness has been proposed to be associated with lower extremity injury. Exercises to strengthen the gluteal muscles are frequently used in rehabilitation and injury prevention programs without scientific evidence regarding their ability to activate the targeted muscles. METHODS Surface electromyography was used to quantify the activity level of the gluteal muscles in 21 healthy, physically active subjects while performing 12 exercises. Repeated-measures analyses of variance were used to compare normalized mean signal amplitude levels, expressed as a percent of a maximum voluntary isometric contraction (MVIC), across exercises. RESULTS Significant differences in signal amplitude among exercises were noted for the gluteus medius (F5,90 = 7.9, P<.0001) and gluteus maximus (F5,95 = 8.1, P<.0001). Gluteus medius activity was significantly greater during side-lying hip abduction (mean +/- SD, 81% +/- 42% MVIC) compared to the 2 types of hip clam (40% +/- 38% MVIC, 38% +/- 29% MVIC), lunges (48% +/- 21% MVIC), and hop (48% +/- 25% MVIC) exercises. The single-limb squat and single-limb deadlift activated the gluteus medius (single-limb squat, 64% +/- 25% MVIC; single-limb deadlift, 59% +/- 25% MVIC) and maximus (single-limb squat, 59% +/- 27% MVIC; single-limb deadlift, 59% +/- 28% MVIC) similarly. The gluteus maximus activation during the single-limb squat and single-limb deadlift was significantly greater than during the lateral band walk (27% +/- 16% MVIC), hip clam (34% +/- 27% MVIC), and hop (forward, 35% +/- 22% MVIC; transverse, 35% +/- 16% MVIC) exercises. CONCLUSION The best exercise for the gluteus medius was side-lying hip abduction, while the single-limb squat and single-limb deadlift exercises led to the greatest activation of the gluteus maximus. These results provide information to the clinician about relative activation of the gluteal muscles during specific therapeutic exercises that can influence exercise progression and prescription. J Orthop Sports Phys Ther 2009;39(7):532-540, Epub 24 February 2009. doi:10.2519/jospt.2009.2796.