The Gluteus Medius – WTF?

Unless you’ve been in a cave over the past couple of decades, you’ve surely heard at some point about the importance of the gluteus medius in functional performance. To read a summary of the current gluteus medius research, please see Chris Beardsley’s excellent report HERE. Each of the gluteal muscles have functional subdivisions, and the gluteus medius has three distinct regions: anterior, middle, posterior.

Gluteals-II

Glutes: Minimus, Medius, Maximus

It is commonly thought that although the primary role of the gluteus medius is hip abduction (raising leg out to the side or stabilizing the hip during gait), the anterior (ventral) fibers of the gluteus medius assist in hip internal rotation whereas the posterior (dorsal) fibers of the gluteus medius assist in hip external rotation. This has been confirmed in studies measuring moment arms, and it’s explained in the end of the video below.

Interestingly, studies such as THIS brand new one have shown that the posterior fibers of the gluteus medius activate more highly with the hip in internal rotation compared to external rotation. I never gave this much thought until last Saturday when my friend Erin (HERE is her Instagram) visited me at my Glute Lab and trained her glutes (she’s competing tomorrow in bikini in Vegas at the NPC USA Nationals). If you recall, I interviewed Erin HERE where she presented my readers with a bunch of novel and effective band glute exercises. A few days ago I posted a band glute circuit Erin did on Instagram HERE and it received a lot of attention.

When she showed me the exercise below, I didn’t think much of it at first. Just seemed like another nifty hip external rotation exercise to me. However, I started thinking about it, and I quickly realized that this was hip internal rotation, pivoting around the feet. And it’s hip internal rotation in a fairly neutral hip position in terms of hip flexion/extension (it’s close to anatomical position in 0 degrees of hip flexion…considering the way she’s slightly anteriorly tilting her pelvis, I’d guess that she’s at 15 degrees of hip flexion below).

This caused me to be skeptical of this exercise as a glute builder. I know that Erin pays better attention to what areas of the glutes are being worked than pretty much any client I’ve ever trained, but this wasn’t in full agreement with the research.

I palpated Erin’s glutes and verified that it indeed heavily activated the upper glutes, and it seemed to me that the entire glute medius was firing, especially the posterior fibers. Wondering if maybe Erin is just unique in the way she fires her glutes, I tested 3 other clients two days later (and also on myself) and confirmed that their upper glutes fire very well during this band hip internal rotation exercise as well. I haven’t tested the gluteal EMG activity yet, but it’s pretty safe to say based on palpation that this exercise is a good glute exercise to include in your band circuit arsenal. I like to include various hip extension, hip abduction, and hip external rotation exercises, and now there’s this hip internal rotation exercise.

See upper x's - these mark the upper posterior, middle, and anterior origins.

See upper x’s – these mark the upper posterior, middle, and anterior origins used in THIS study.

Please give this unique exercise a try and pay attention (I palpated my own glutes) to what region you’re working – let me know if you think it’s the posterior fibers of the gluteus medius in addition to the entire glute medius, or the upper gluteus maximus.

gluteus_medius

Make sure to not perform this on a super tall bench as you want the hips to just be slightly flexed. I haven’t tried it out yet in neutral (lying flat on the ground), but Erin tried the exercise in greater hip flexion from an elevated bench and didn’t feel it working nearly as well. This is interesting considering that Delp found that hip internal rotation moment arms of the glute muscles increase in hip flexion…so this doesn’t agree with his findings.

It seems like there’s more to the glutes than previously thought and that we’re still coming up with interesting and efficient ways of activating and strengthening these important muscles.

glute med

25 Comments

  • Karie says:

    Since starting SC program my glutes are more activated in all my lifts. I have had issues with my pirirformis muscle tightening in the past (or is what my Rehab Therapy said) it seems they are more active during glute activation / focus exercises or is it my medius ? (not sure If I am asking this correctly). I do proper mobility & stretching to prevent this issue from before. The Jane Fonda experiment exercises really activate my glutes in three diff areas too. Just wondering how I can tell the diff between these too (pirirformis & Medius)?

    • Sarah says:

      Karie, I found the same Piriformis issue (with RMT input) when I was about 2 mos into glute specific training. I had a few episodes where it flared up like this but haven’t for some time now (6 months?) . Although, I’ve made a point of seeing my RMT every 4-6 weeks so maybe that’s helped but I’ve also incorporated foam rolling into my warm ups. as wee as specific glute stretches post-liting.

  • Gary H says:

    To piggy back off your findings anecdotally, I did notice when performing a reverse hyper, that the top of my glutes would fire to a higher degree when I finished with slight internal rotation at the top. Would be interesting when you’re able to perform emg.

    • Anna says:

      That is interesting, me on the contrary externally rotate on the top (extension) and internally rotate when down (flexion). (on hyper extensions)… I also perform kind of twerking movement in a deep squat with my mini band on between ankles while a rest between hip thrust sets.. That does fire up “something else” 🙂

      • Anna says:

        Oh i also tried the Erin’s move today as an activation exercise and it did felt like some other fibre! I love my mini band and always put ot on while i rest between sets. to keep the correct musles activated..

      • Anna says:

        I ment mini band under my knees (not on my ankles) sorry

  • Here’s a question/thought: Is the exerciser actually in internal rotation when they’re in the end range of the movement, or are they actually achieving a neutral position at the hip joint? Many women (including myself) have knees placed medially compared to the hip joint (ie valgus) – when the distal segment isn’t fixed (as in open chain exercises), I find that internal rotation at the hip joint actually puts that joint in neutral, although the feet appear to be internally rotated. If you’re achieving a neutral position at the hip joint the I think more gluteus medius activation would make sense. What do you think? Have you noticed a difference in your findings with males (less valgus) compared to females?

  • Derrick Blanton says:

    Because the legs are hanging off the bench:

    Possibly the superior glutes fire hard here as a pelvic stabilizer to give the glute medius an anchor to work against?

    I wonder if you palpated her lower abs if they would also be firing very hard to form a “sling” around the lower spine, and let the glute medius move the heavy legs in open chain.

    Btw, on the glute medius IR: this is why I like directing force through a section of the foot as a potential corrective for SQ, HT’s, etc.

    The movement arms of the hip change, but steady force through the foot auto-corrects what muscles need to fire to keep alignment.

  • willy says:

    Bret,

    I know she is performing internal and external rotation at the hip joint. But if you look at the distance of the inner thigh from external rotation to internal rotation it does look like the hip is “ab-ducting”. Now since her foot is allowed to pivot it seems that she is getting internal rotation in combination with hip ab-dution.
    Maybe this is why the glutes are firing up because of the abduction.

  • Ryan says:

    I started doing RDLs with a trap bar this cycle and decided I want to hit the lateral hams more so I have been doing them with my feet slightly turned in. I was quite surprised at how sore my upper glutes were for a few days after the movement.

  • Sudi says:

    Thanks Brett interesting, looks like it could be performed well in a plank position as a progression.

  • Rachel Eisenman says:

    An interesting exercise indeed. My first thought is that co-contraction of opposing pelvic/hip muscles are activating because the hips are not supported. Perhaps the external rotation muscles would be less active if the hips and legs were supported while the feet are still allowed to move during rotation of the legs.

    Given that this exercise worked better with a lower bench, it’s possible that a taller bench allows the legs to be slightly more vertical and that could be supporting/stabilizing the hips. The taller bench may all you to “have your legs under you” a little more.

    I look forward to reading your additional analysis!

  • Jerry says:

    I see exactly how this works the glute medius.

  • I’m a physiotherapist and an exercise physiologist, very interested in gluteus medius. When I instruct my patients in squat I always put heavy emphasis on the movement of “pulling the knees apart from each other” when coming out of the bottom; in my opinion, this is more of a hip external rotation movement than a hip abduction movement, thus it fits your (or Erin’s) findings. Also, when coaching old women who are at risk of falling and fracturing their femoral neck due to osteoporosis, you’ll see almost exclusively, when the women are asked to abduct at the hip joint, that they do this with their hips externally rotated. These are women normally hunched over (flexed at the hip) when walking.

  • Peter says:

    I’ve been telling to people to walk more straight to pigeon-toed and less foot-flared for activating the upper/outer glutes lately. I’m not sure why, but I’ve noticed a difference in how it hits the glutes when used along with the traditional foot-flare lifting. Cool to see this easy band exercise that goes along with this thinking

  • Harald says:

    hi bret,
    what does “WTF” in the title of the article?

    Many thanks for the answer.

  • tlc says:

    I would suggest you acquire a better understanding of muscle torque/moment arm/ muscle activation as well as muscle physiology before posting something implying that the research findings by a professor at Stanford were incorrect.

    • Bret says:

      tlc, do you have any insight to share, or are you content ponying up zero feedback while coming off as a rude dickhead? I’m pretty sure my understanding of these concepts is top notch.

  • Charles Nankin says:

    Fatty degeneration of gluteus minimus muscle as a predictor of falls: http://www.ncbi.nlm.nih.gov/pubmed/25440137
    – Gluteus minimus muscle initiated its fatty degeneration earlier than gluteus medius muscle.
    – gluteus medius muscle has a crucial role in providing stability of the pelvis including hip joint.
    – Evaluating fatty streaks in the gluteus minimus muscle could help give early indication to those who have a higher risk of falling.

  • Charles Nankin says:

    sorry brettus but i absolutely love this stuff!:

    Gluteal muscle composition differentiates fallers from non-fallers in community dwelling older adults: http://www.ncbi.nlm.nih.gov/pubmed/24666603
    – While fallers were generally differentiated from non-fallers by muscle composition, the most affected muscles were the proximal gluteal muscles of the hip joint accompanied by lower hip abduction strength.

    Helping my wife with her study project and coming across this stuff.

  • Sarah says:

    Hey Bret – looks like the video showing the actual exercise isn’t working… Can you fix that?

  • Alex says:

    Good article. I have had problems with my glute med for 4 months. Rested for 2 months and twinged it again. Even after strengthening exercises.

    So going by the video this is supposed to do sharp explosive on the way out how Erin does it in the video then I take it? Any advise on my problem is also more than welcome hah 🙂 Thanks.

  • Matt says:

    Only came across this article when lookin for glute med exercises that don’t get dominated by the tfl or internal hip rotators; as I have very weak left glutes (due to injury and arthritis) and over developed tfl and tight piriformis. This is another good exercise and it feels more suited to me than the various side lying abduction and pelvis hiking stuff I already do. Always open to suggestion and advice. Keep up the good work coz I haven’t fallen over yet!

Leave a Reply

SIGN UP FOR THE FREE NEWSLETTER

and receive my FREE Lower Body Progressions eBook!

You have Successfully Subscribed!