Activation training facilitates gluteus maximus recruitment during weight-bearing strengthening exercises

Hip-focused strengthening and task-specific movement training for an individual with chronic, recurrent femoroacetabular impingement syndrome

OBJECTIVES

Examine the effects of hip-focused strengthening and task-specific movement training for a female who has undergone multiple surgical procedures yet continues to experience chronic, recurrent FAIS-related symptoms.

STUDY DESIGN

Case Report.

METHODS

A 23-year-old active female with an eleven-year history of FAIS and two previous surgical procedures recently experienced a third recurrence of symptoms brought on by increased physical activity levels. The patient performed progressive exercises focused on improving hip extension, abduction, and external rotation strength. The patient also received task-specific movement training aimed at minimizing hip adduction and internal rotation during movement that provoked her symptoms.

RESULTS

Following treatment, the patient's self-reported hip pain during movement improved 2.2 points and was abolished during four of the five activities examined. The patient exhibited strength gains for the hip extensors (22 %), abductors (36 %), and external rotators (20 %). The patient exhibited decreased hip adduction during all activities (mean difference = 10.6°) and decreased hip internal rotation during three of the five activities (mean difference = 3.7°).

CONCLUSION

This case report highlights the effects of hip-focused strengthening and task-specific movement training for a patient with longstanding FAIS and multiple surgical procedures.

Does a Hip Muscle Activation Home Exercise Program Change Movement Patterns on the Forward Step-Down Test?

CONTEXT

Poor knee biomechanics contribute to knee joint injuries. Neuromuscular control over knee position is partially derived from the hip. It is unknown whether isolated activation training of the gluteal muscles improves lower-extremity frontal plane mechanics. This study examined if a home-based hip muscle activation program improves performance on the Forward Step-Down Test as well as increases surface electromyography (sEMG) activation of the gluteal muscles.

DESIGN

The study utilized a single-group repeated-measures design.

METHODS

Thirty-five participants (24 females, mean age = 23.17 [SD 1.36] years) completed an 8-week hip muscle activation program. The Forward Step-Down Test score and sEMG of gluteus maximus and medius were assessed preintervention and postintervention.

RESULTS

Forward Step-Down Test scores improved significantly from preintervention (Mdn = 3.5) to postintervention (Mdn = 3.0, T = 109, P = .010, r = .31.), but this result did not meet clinical significance. sEMG analysis revealed a significant increase in mean gluteus maximus activation (P = .028, d = 1.19). No significant dose-response relationship existed between compliance and the Forward Step-Down Test scores or sEMG results.

CONCLUSIONS

A home-based hip activation program increases gluteus maximus activation without clinically significant changes in frontal plane movement quality. Future studies may find clinical relevance by adding motor learning to the activation training program to improve functional muscle use.

How to activate the glutes best? Peak muscle activity of acceleration-specific pre-activation and traditional strength training exercises

PURPOSE

Isometric training and pre-activation are proven to enhance acceleration performance. However, traditional strength training exercises do not mirror the acceleration-specific activation patterns of the gluteal muscles, characterized by ipsilateral hip extension during contralateral hip flexion. Therefore, the aim of the study was to determine gluteal muscle activity of acceleration-specific exercises compared to traditional strength training exercises.

METHODS

In a cross-sectional study design, the peak electromyographic activity of two acceleration-specific exercises was investigated and compared to two traditional strength training exercises each for the gluteus maximus and medius. Twenty-four participants from various athletic backgrounds (13 males, 11 females, 26 years, 178 cm, 77 kg) performed four gluteus maximus [half-kneeling glute squeeze (HKGS), resisted knee split (RKS), hip thrust (HT), split squat (SS)] and four gluteus medius [resisted prone hip abduction (RPHA), isometric clam (IC), side-plank with leg abduction (SP), resisted side-stepping (RSS)] exercises in a randomized order.

RESULTS

The RKS (p = 0.011, d = 0.96) and the HKGS (p = 0.064, d = 0.68) elicited higher peak gluteus maximus activity than the SS with large and moderate effects, respectively. No significant differences (p > 0.05) were found between the HT, RKS and HKGS. The RPHA elicited significantly higher gluteus medius activity with a large effect compared to RSS (p < 0.001, d = 1.41) and a moderate effect relative to the SP (p = 0.002, d = 0.78).

CONCLUSION

The acceleration-specific exercises effectively activate the gluteal muscles for pre-activation and strength training purposes and might help improve horizontal acceleration due to their direct coordinative transfer.

Acute Effect of Dynamic and Gluteal Resistance Exercise Warm-up Protocols on Jump Landing Mechanics in College-Aged Females

ABSTRACT

Rauseo, ML, Feairheller, DL, LaRoche, DP, and Cook, SB. Acute effect of dynamic and gluteal resistance exercise warm-up protocols on lower-extremity jump landing mechanics in college-aged females. J Strength Cond Res 38(2): 259-265, 2024-Inadequate neuromuscular control of the femur by the gluteal musculature is associated with noncontact and overuse injuries to the knee. Acute bouts of resistance exercises targeting the gluteal musculature can be prescribed as part of a warm-up protocol with the goal of improving subsequent neuromuscular control and performance. The purpose of this study was to determine the effect that a warm-up protocol including moderate-intensity gluteal resistance exercises (GRE) has on single leg jump landing biomechanics. Seventeen healthy, college-aged, recreationally active females (mean ± SD ; age = 21.4 ± 1.9 years; height = 166.9 ± 5.7 cm; body mass = 62.5 ± 7.4 kg) performed 3 single leg hop trials per leg after completing no warm-up (CON), a dynamic warm-up (DWU), and a dynamic warm-up with gluteal resistance exercises (DWU + GRE) across 3 laboratory visits. Lower extremity kinetic and kinematic variables were assessed during single leg hops from the point of initial foot contact to deepest knee flexion. Biomechanical differences between dominant and nondominant limb landings were also assessed. Dominant limb hip internal rotation angle after DWU + GRE (2.03 ± 9.92°) was significantly greater ( p ≤ 0.05) compared with CON (-3.36 ± 7.74°). Peak knee adduction moment (56.8%), peak knee flexion angle (5.7%), and peak knee external rotation angle (17.0%) were significantly greater ( p ≤ 0.017) in the dominant limb, compared with the nondominant limb, across warm-up protocols. The combined DWU + GRE warm-up protocol did not have a substantial impact on landing biomechanics. Clinicians prescribing GRE before activity should not expect significant changes in movement patterns after a single bout.

Persons with patellofemoral pain exhibit altered hip abductor muscle recruitment while performing hip abductor exercises

INTRODUCTION

Strengthening of the hip abductors has been advocated for persons with patellofemoral pain (PFP). It is not clear if these individuals activate the hip abductor muscles appropriately to achieve the desired therapeutic effects.

OBJECTIVE

To compare activation of the hip abductor muscles between persons with and without PFP during the performance of hip abductor exercises.

METHODS

Thirty-two individuals participated (12 with PFP and 20 without PFP). The average age (± standard deviation) was 29.7 ± 5.9 years for the PFP group and 28.1 ± 6.9 for the control group. Electromyographic (EMG) signals from the gluteus medius (GMED), superior gluteus maximus (SUP-GMAX), and tensor fascia lata (TFL) were obtained using fine-wire electrodes while participants performed 11 different exercises. Normalized EMG activity of each muscle was compared between groups across all exercises.

RESULTS

When averaged across all exercises, persons with PFP exhibited significantly greater EMG activity of TFL (mean = 25.3% MVIC; 95% CI = 19.2, 31.3) compared to those without PFP (mean = 17.6% MVIC; 95% CI = 12.8, 22.4) and significantly lower EMG activity of SUP-GMAX (mean = 16.4% MVIC; 95% CI = 11.0, 22.0) compared to those without PFP (mean = 25.4% MVIC; 95% CI = 21.0, 29.8). Persons with PFP exhibited lower EMG activity of GMED, but only for 3 out of the 11 exercises evaluated (hip abduction, hip hike, step-up).

CONCLUSION

Compared to persons without PFP, those with PFP exhibited activation differences during the performance of exercises used to target the hip abductors. Our results highlight the need for activation training prior to the initiation of strengthening exercises to achieve desired therapeutic effects.