INTRODUCTION
The gluteal muscles are arguably the most important muscles for runners in terms of strength and activation. The gluteal muscles consist of the gluteus maximus, gluteus medius, and gluteus minimus. These muscles work as a group to prevent femoral adduction and internal rotation, which have been linked to an increased risk of injury in the early stance phase of running. Weakness or dysfunction of the gluteal muscles in runners has been shown to contribute to many musculoskeletal disorders including low back pain, patellofemoral pain syndrome, and iliotibial band syndrome, to name a few.
The authors in a recent study, Comparative Analysis of Hip Muscle Activation During Closed-Chain Rehabilitation Exercises in Runners, looked at the effectiveness of three rehabilitation exercises (bilateral hip external rotation, forward lunge, and single leg squat) designed to stimulate the demands of the gluteals during running. The authors hypothesized there would be greater gluteal activation during the forward lunge compared to bilateral external rotation and single leg stand seeing as that exercise was the most similar to running.
METHODS
Twenty-two healthy runners performed three gluteal strengthening exercises while electrodes recorded peak amplitude of muscle activity. The researchers measured the peak amplitude of muscle activation during the concentric (muscle shortening) and eccentric (muscle lengthening) phases of the exercises and compared it to the runners’ peak muscle activation during the stance phase of running.
CONCLUSION
All three of the exercises showed the same peak amplitude during the eccentric phase. The bilateral external rotation elicited significantly reduced amplitude than the squat and lunge activity during the concentric phase of the exercise. The exercises investigated in this study were less than 70% of the peak activation levels obtained with running.
CLINICAL GUIDELINES
Because of the high prevalence of running-related injuries, and the potential of gluteal strengthening and activation in reducing these injuries, it is important to identify exercises which activate these muscles similarly to how they are used in runners. This was one of the first studies observing muscle activity during functional exercises. Although none of the exercises investigated in this study approached the peak activation levels obtained with running, the results indicate that the forward lunge with resistance band and single leg stand were superior to the bilateral external rotation exercise for concentric activation of the gluteus maximus and medius.
In theory, a progression of these exercises from clamshell to single leg rotational squat, to forward lunge could be beneficial in activating and strengthening gluteal muscles in a runner. More research is needed to identify different functional activities specific to runners.
PHYSICAL THERAPY FIRST IMPLICATIONS
Similar exercises as those measured in the study are common for physical therapists to give as part of an individualized home exercise program. Our team continues to stay up to date on the latest research in order to provide our clients with an evidence-based approach to therapy. The exercises measured in the study successfully activated the gluteals in an eccentric manner and thus performing these regularly could help to decrease a runner’s risk for developing a running-related injury.
FUNCTIONAL EXERCISE PROGRESSION FOR GLUTEAL STRENGTHENING IN RUNNERS
1. Bilateral Clamshell
2. Single-leg rotational squat
3. Lunge with Resistance Band
REFERENCE
Connelly, Chrostopher., Moran, Matthew., Grimes, Jason (2020). Comparative Analysis of Hip Muscle Activation During Closed-Chain Rehabilitation Exercises in Runners. International Journal of Sports Physical Therapy. Vol 15, Number 2: 229-237