– outer surface of illium, between the posterior and anterior gluteal lines.
-lateral and superior surfaces of the greater trochanter of femur.
Action : on the tigh ( femur )
– medial rotation
Gluteus medius strengthening
Gluteus medius eccentric loading exercise
The aim of this exercise is to work the tendon of the gluteus medius muscle on the outside of the hip in a very specific way. The tendon and muscle are worked whilst they are being lengthened, not while they are contracting.This is what eccentric loading means.
Stand squarely on the floor next to a wall good leg facing the wall. ( see pic. 1)
Using your arms and your good leg, but not your bad leg, lift your pelvis up so that you are tipped over towards your bad side. On tip toes on your good side. ( see pic. 2)
Now lift you good leg off the floorbending at the knee. Slowly and gradually lower your pelvis so that you are tipped over to your good side stretching your bad side. Use only the muscles (gluteus medius) only your bad hip to control the decent. You can use your hands to steady yourself, but the idea is that your bad hip is taking all of your body weight as you tip over and gradually lowering you down as far as you can go. ( pic 3 )
Return to the start position using your good leg and arms, but not using your bad leg. The bad side works only on the way down, not the way up.
Repeat 10 times and have a rest.
Aim for 3 sets of 10 exercises morning and evening, but be guided by your discomfort. It is normal to ‘feel’ the exercise, but it should not be really painful. If it is not to bad you can do more repetitions. If it is very uncomfortable you should do fewer repetitions.
Other exercises :
One leg squat : ( you can help yourself with a chair )
Side plank abduction
This is reproduced from Boren et al. 2011 who did an excellent study and also compared their results with earlier work. Their top 3 exercises for Glute Medius were side plank abduction with dominant leg down, side plank abduction with dominant leg up and single leg squat (in that order). Notice again that these positions, despite being “non-functional” do create a lot of activity in Glute Medius and again more so than weight bearing positions such as single leg squat. Of note too is that they found less activity with side-lying abduction than the previous studies. This raises a good point with research and rehab. Nothing is concrete. You simply cannot say “this exercise has no role” as you will find evidence to support your claim and evidence to refute it. Also they used a slightly different technique which might account for the difference.
Single Limb Squat
Single leg balance- focus should be on maintaining a level pelvis without adducting the hip. Use support initially if needed. Aim for 10-15 seconds, repeat 5-10 times (stop if painful).
Running may need to be avoided or at least reduced during a reactive tendinopathy. This is the last thing you want as a runner but may be a necessity in early management of GT. The issue with tendinopathy is that if you continue to overload the tendon it can progress from a reactive tendon, to dysrepair and degeneration during which stages the tendon structure starts to change. Reactive changes are reversible but degeneration of the tendon generally isn’t. That doesn’t mean it can’t be managed it’s just better to prevent it happening in the first place!
In mild cases you may continue to run but try to ensure running remains pain free and there is no reaction for at least 24 hours after. Your Physio should guide you on continuing to run and/ or returning to running after rehab
- Try to find the exercises that best suit you and the ones that bast work for you. If you find sidelying exercises are getting you results without causing symptoms then great. If not try some of the others above and see which ones seem to work your glutes and get results.
- Try to do 3 sets of 10-15 reps with a 1-2 minute break between the sets.
- Then progress up towards 20-25 repetitions, you’re aiming to fatigue the muscle so there will be lots of individual variation in the reps needed to do that. That said if you can do more than 30 reps without fatigue than try to find a harder exercise.
The best advice is to see a Physio who can assess you and provide appropriate exercises and help you perfect the technique.
Information and Pictures courtsey of :