Hip Abductor Strength for Performance & Injury Prevention.
Something that I have been exploring with my research on my masters course is the important role of the ‘hip abductors’ in reducing risk of injury. So I thought I would create a quick blog post to highlight the role they play and the importance a good function.
What are the hip abductors?
Primarily, we will look at the gluteus medius & gluteus minimus (to keep it simple).
What do they do?
Their role during the gait cycle is predominantly one of stabilisation. When the foot strikes the ground there is a strong horizontal force acting on the hip that pushes the hip outwards (laterally). The hip abductors resist this movement, acting to maintain the mediolateral balance of the hips.
If they are unable to resist these forces the result is that the hip will go into adduction (the angle of the leg moves towards the centre of the body). When this happens, the knee is forced in to a valgus position (knee will drop in, putting pressure on the inside (medial) aspect of the joint), the tibia (shin bone) will externally rotate which in turn will likely cause the foot to pronate.
All of this as a domino effect from the hip! – In fact, the two most common running injuries, patellofemoral pain syndrome & IT Band Syndrome (which both present with pain around the knee) have both been shown to be correlated to weakness in the hip abductors.
So that gives you an idea of the importance of a strong healthy hip! Below I have listed a few exercise examples that target the hip abductors – these are all evidenced based exercises that have been shown to result in the highest activation of the gluteus medius:
Side Lying Abduction:
Step 1: In side-lying, bend bottom leg for support
Step 2: Keeping the top leg straight & foot horizontal, raise the leg up, and slowly lower back down.
Step 3: Ensure hip does not hike when raising the leg.
Destefano et al. 2009 in an EMG study found that this was ‘the best exercise for Gluteus Medius’.
Step 1: Stand next to wall, raise leg with a flexed knee.
Step 2: With hip flush against the wall push back against the wall
Step 3: Hold for 30s, repeat 3-4 times both sides.
O’Sullivan, Smith & Sainsbury, 2010 found, when compared to the Pelvic Drop & Wall Squat, that the Wall Press had the highest MVIC of 76%
Side Plank with Adbuction:
Step 1: From a side-lying position raise your body up to a plank position using the forearm and bottom foot.
Step 2: From this position raise the top leg straight up, and slowly lower back down.
Step 3: Ensure not to hike at the hip when raising the leg.
Boren et al. 2011 top exercise for activation, beating single leg squat.
Step 1: Position a band around lower legs.
Adopt a quarter squat position, feet shoulder-width apart, head and chest up.
Step 2: Take a slow, lateral step. Keep toes pointed forward. Step 3: After completing the step, follow with the opposite leg. Keep the feet at least shoulder width apart to maintain band tension.
Distefano et al, 2009 found good activation of the gluteus medius
Single Leg Squat:
Step 1: Stand on your left leg and lift your right leg up and straight out in front of you. Lift your arms in front for balance.
Step 2: Sit your hips backwards and bend your standing knee to lower down towards the floor.
Step 3: From the bottom position, push down through your heel to extend the knee and stand back up to a tall position.
Step 4: Switch legs and repeat
Boren et al. 2011 showed good Gluteus Medius and Gluteus Maximus contraction of 81% of MVIC for Gluteus Medius and 71% for Gluteus Maximus.
So this is just a quick post to highlight the role of this muscle group. It is particularly important for distance runners to ensure that they possess adequate strength to be able to tolerate the loads for the period of time that they run.