By Dylan Tannyan
The gluteus medius (glute med) is the often neglected but important part of the glute muscle complex. Similar to the glute max, the glute med is present on both sides of the pelvis and attaches to the femur. However, the glute med more specifically attaches on the great trochanter (the bony bump you can feel on the side of your hip/leg).
The main functions of this muscle are to abduct (lift away from your body) and externally rotate the hip joint. This important postural muscle helps prevent “hip drop” any time we are standing or moving on one leg. Try standing on one leg and see: Does your hip push out towards the same side that you are standing on? Does the opposite side of your hip drop down compared to the side that you are standing on? These motions comprise what we define as hip drop.
During harder tasks like walking, running, stairs, or side to side movements you will require more strength to control hip drop. Comparable to pronation in the foot, hip drop is NOT a bad thing. It is a natural movement that has to occur in our body to move efficiently. Like most things in life, moderation is key. While hip drop is not a bad thing in isolation, we still need to have control of this motion using our glute med to help keep injuries and pain at bay. The glute med helps control our whole lower chain from the lower back, to the hip, knee, and ankle.
We are going to review a very simple and common exercise, the clamshell. The following will focus on set up to make sure you are contracting that glute med and loading up the proper muscle. While this is a good starting point for the glute med, strengthening the muscle while lying on your side will not perfectly translate to standing, running, or side-cutting movements. It is important to progress the loading and strengthening of this muscle to match your physical activity needs.
Begin lying on one side and bend your knees to around 90 degrees. Your ankles should be in line with your hip, not in front of or behind it. The key to this exercise is keeping your pelvis facing forward and not letting the pelvis roll back during the movement. You can use an extra towel or soft surface if it is sore to lie on your side.
Take your top hand and place it on the side of your hip so you can monitor if your hip rolls back during the movement.
While keeping your toes close to each other, lift one knee away from the other, opening like a clamshell. Slowly lower back to the starting position, relax, and repeat. The movement should occur at the hip joint and you should definitely feel the glute med engage on the side of your hip.
For a progression, you can simply add a looped resistance band around your thighs and go through the same steps for the exercise. There will be more required strength and control with the resistance band and you absolutely must make sure your pelvis is not rolling back or else it takes away the value of the exercise.
With both exercises you should not be excessively bracing your core or holding your breath. The repetitions and sets for these exercises can vary greatly depending on your goals/strength. Aim for at least 3 sets of 10 up to fatigue (quality over quantity!) or until hitting 10-12 repetitions.
Dylan is a Toronto based registered physiotherapist who enjoys working with a wide range of patients whose goals range from chronic pain improvement to sport and high performance. He also specializes in vestibular and concussion rehabilitation. Dylan utilizes a mix of specific exercise prescription, manual therapy, dry needling, and education with two main objectives: outcome and efficiency. Dylan wants all of his patients to reach their functional goals as well as have the confidence, education, and physical tools to manage their injury over the long term. Dylan currently works out of Synergy Sports Medicine and Rehabilitation in East York and has limited homecare appointment availability. If you are looking for a physiotherapist you can book with him here or contact him directly at email@example.com