Attention: All those with knee, hip joint, and lower back pain. Your solution could be: Glute strengthening!
In this month’s blog we’ve listed our 6 favourite glute exercises – all of which you can do at home!
Evidence shows that significant weakness in hip abduction, external rotation and extension is associated with increased hip internal rotation and hip adduction during functional tasks in those with patella-femoral pain (Selkowitz et al 2013). In simpler terms, gluteal weakness leads to poor leg alignment (think knock-knees) during functional activities, causing knee pain. Our gluteals are large muscles, if we are not using them we are probably loading up our lower back, hip, knee and ankle joints a lot more than we should. That is why your Physio, Podiatrist, Chiro (list could go on) has told you to do some glute work!
A lot of people don’t actually know how to activate their glutes. They may instead use muscles like their tensor fascia latae (TFL) or quadriceps (See pictures below). If this sounds like you, or if your physio has suggested some glute strengthening, try the following exercises.
The first 4 exercises are mat based exercises, primarily for gluteal activation – to learn how to switch on the right muscles. The last 2 exercises are more functional to your everyday life. The key is to start simple with activation then work towards function.
1. Hip Abduction
This exercise is great to practise how to switch on the glutes, and not overwork the TFL or hip flexors. A simple exercise, I often prescribe this initially for clients with gluteal tendinopathy or tears.
Start position: Side-lying, with 2x pillows under top leg (so that leg starts at hip height). Ensure hip bones pointing straight ahead, and that the bottom waist is lifted so the hips are stacked. Top leg is parallel (knee and foot pointing directly ahead) or with a slight turnout from the hip joint. Top heel in line with sit bones. Hands on hips – feel that hip flexors don’t work too hard.
Instructions: Slowly lift the leg about 15cm off the pillow. Hold for a count of 5 seconds. Slowly lower.
How many: 10 reps, with a 5 second hold. Aim for 2 sets each side.
- Top leg drifts forward – this will load the hip flexors. Aim to keep that heel in line with the sit-bones, or think to lift the leg at an angle of '11.30’ on a clock-face (up and slightly behind you).
- Top leg bends at the knee – think to create length and reach out of the leg.
- Top knee rotates downward – you will overwork TFL – point the knee straight ahead or slightly upwards.
- Rolling top hip backwards as you lift.
- Overarching/flattening lower back – start in neutral (a small arch in your lower back).
- Lifting the leg too high and flattening your bottom waist.
2. Wall Clam
One of our favourites, to learn how to use your external rotators (glutes and deep lateral rotators near the sit bone).
Start position: Side-lying, with your feet against wall (at hip distance, with a 90 deg bend at the hip and knee). Neutral lower back, and top knee at hip height. Slight pressure into the wall.
Instructions: Rotate the top thigh upwards, as high as you can before you start to roll top hip back. Slowly rotate leg downwards until the knee return the hip height.
How many: 10 reps x 2 sets each side.
- Rolling top hip back – you won't feel your glutes, keep both hip bones pointing to the side.
- Leading with the foot or swiveling the foot – try and lead with the knee, and keep the foot fairly still (if anything the arch will lift slightly, and a small turnout will happen after).
- Dropping the knee too low on the return.
- Starting with a rounded or overarched lower back.
3. Hip Bridge
To activate gluteus maximus. There are lots of progressions to make this exercise harder.
Start position: Lying on your back, knees bent and feet hip distance apart.
Instructions: Lift the hips up using your glutes. Keep the alignment of your legs as you do so, and pelvic neutral. Slowly lower the hips reaching with the tailbone. When you lift up, keep some pressure through the inside of the heel as you think to press the knees slightly outwards (without letting them fall out) – this will connect the glutes more.
How many: 10 reps x 2-3 sets.
- Overarching the back – don’t lift too high; ensure you keep your pelvis/lower back neutral. If you tend to overarch, think about tucking the tailbone under slightly.
- Knocking knees in or out – keep the centre of the hip, knee and 2nd toe in the same line.
- Overworking hamstrings or lower back – drive through your heels to lift; ensure the feet don’t start too close or too far away; activate the glutes before you lift.
Progressions: Ask our Physios how to make this exercise more challenging!
4. 4pt Kneeling hip extension/ ‘Donkey Kick’
A more challenging position to focus on alignment and core control whilst you work the glutes.
Start position: All fours - hands shoulder distance apart and knees under hips. Find a neutral lower back (gentle arch) and keep this during the exercise!
Instructions: Shift weight slightly onto one knee, as you lift the opposite leg up. Imagine reaching heel to ceiling, trying to get the leg above horizontal. Slowly lower.
How many: 10-12 reps x 2 sets.
- Overarching the lower back – this can cause lower back pain and you wont feel glutes! Think about a gentle tuck of the tailbone if this is you.
- Rotating pelvis or torso, or shifting weight too far over. Try and keep the shoulders/torso/hips square to the floor and the support hip over the knee. This requires some core control.
- Letting the head drop and sinking at the shoulder blades – think length at the back of the neck whilst you are looking down, and press out of your hands and lift your chest so you don’t collapse.
Progressions: Add a dumbbell behind the knee or an ankle weight to make it loaded! But only if you have good form.
Perhaps our most functional movement – we use it for sitting, going to the toilet, and when we bend. Learn to squat properly using your glutes, and it will carry on into your everyday life.
Start position: Standing with your feet shoulder distance, small turnout from the hip (and rest of leg).
Instructions: Begin to lower down, by first pushing your bottom back and bending the hips, quickly followed by bending the knee. Bring the arms forward to counterbalance, and push your bottom back further. The torso will lean forward. Keep neutral and your leg alignment. Lift up, driving through your heels to straighten the hips and knees.
How many: 10-15 reps x 3 sets.
Key faults: This list is endless!
- Knocking the knees or rolling in through the ankle – keep the leg alignment, this means hip, knee and 2nd/3rd toe in the same line. Think of weight in the inside of the heel, as you press the knees outwards.
- Bending too much from the knees – this is when you will feel the quads. Try and keep the knees behind the line of the toes- this means you will have to push your bottom back more.
- If your heels are lifting – release your calfs! And push your bottom back more.
- Overarching or bending the lower back – keep neutral. Don’t flare the ribs and overarch the back. Opposite to this, try not to tuck the tailbone under – think of spreading the sit bones.
Progressions: Add theraband around knees.
6. ? ? ? Our most challenging exercise - want to know what it is? Come and ask one of our Physios!
Written By: Courtney Kranz - Physiotherapist, Pilates Practitioner
Photos by our lovely photographer: Dani :)
Selkowitz, D. M., Beneck, G. J., & Powers, C. M. (2013). Which Exercises Target the Gluteal Muscles While Minimizing Activation of the Tensor Fascia Lata? Electromyographic Assessment Using Fine-Wire Electrodes. J Orthop Sports Phys Ther, 43(2), 54-64.