This week we’ve launched a new ‘Cutting Edge Clinicians’ Mailing list designed for therapists that treat runners and other athletes. We’ll be sharing a series of free downloads on a range of topics, all with a focus on providing something that’s useful in clinic. The first of these in an evidence-based Glutes Circuit that’s had over a thousand downloads in just a few days! Today’s blog is explain some of the reasoning and evidence behind our exercise selection.
To download the Glutes Circuit and join our new mailing list simply click the image below.
The circuit has three sections; activation, movement control and strength work…
Exercises 1 and 2 (wall press and side planks) are isometric holds, with both exercises showing high gluteal activation in EMG studies (as summarised within the download PDF). Isometric exercises have been found to have a general inhibitory effect on pain (Naugle et al. 2013) and appear to reduce cortical inhibition associated with tendinopathy (Rio et al. 2015). Recent research has found isometric activation exercise increases corticomotor excitability of Glute Max (GM) and has suggested they may aid with strength work,
“GM activation exercise may be considered a method to prime the brain for subsequent GM strengthening by enabling an individual to target GM more precisely.” Fisher et al. (2016)
Exercise 3 (single leg squat) focusses more on control than strength. The aim is to use the gluteal muscles to control femur and pelvic position during weight-bearing. It’s placed early in the programme to prevent fatigue from reducing movement control. Progression in this case is by varying the movement speed or range rather than adding load.
Exercises 4, 5 and 6 (step ups, band walks and side lying abduction) are to build strength in the gluteal muscles. Step ups have been found to recruit both Glute Max and Med in EMG studies and incorporate a control component. Band walks have also been found to activate Glute Med, especially when resistance is placed across the toes as this resists both hip abduction and external rotation and may reduce TFL involvement (Cambridge et al. 2012 plus see graph below). Side lying hip abduction has been found to have high levels of Glute Med activation with minimal TFL (McBeth et al. 2012) so may be well suited to targeted activation of Glute Med. If loaded sufficiently it can lead to significant gluteal fatigue making weight-bearing exercises more challenging to control, as a result we’ve put it at the end!
Source: Cambridge et al. (2012)
Closing thoughts: we’ve presented a Glutes Circuit you can download and use in clinic and some of the reasoning behind it. It’s important to say though that it won’t be appropriate for every patient and certainly isn’t a recipe! We have to factor the patient’s ability, pain levels, pathology and goals into exercise selection (along with a host of other factors) but hopefully this can be a useful tool to add to your exercise tool box!
Click here for more on the glutes and their role in injury