LB-GLUTE-MEDIUS/MINIMUS-X-AB·DUCTION-SLLR-[P]REHAB


HIP AB·DUCTION – SIDE LYING LEG RAISE


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The effects of therapeutic hip exercise with abdominal core activation on recruitment of the hip muscles – 2017 – Chan
· 2 conditions: Natural Core Activation, Enhanced Core Activation – see graph for results
(1) Clam (CLAM): hip flexed 45°; knees flexed to 90°; 30° abduction + 30° external rotation of the hip
(2) Hip abduction in side-lying (HABD): hip abduction to 30° with knee fully extended
(3) Prone hip extension (PHE): knee flexed to 90°; hip extension up to 20°
· Muscle Activation:
(1) Clam: upper glute max >> Glute Medius 
(2) side-lying hip abduction: upper glute max = Glute Medius
(3) prone hip extension: lower glute max > upper glute max = Glute Medius > biceps femoris
1


Hip Muscle Activity during Supine Isometric Contraction of Hip Abduction – 2014 – Fujisawa
(1) hip flexion angle (0, 20, 40, 60, and 80 degrees)
(2) abduction of the hip joint at 20, 40, 60
– isometric contraction at 80% maximum strength.
Glute Medius: did not change with increases in hip flexion angle
upper portion of glute max: significantly increased with increased hip flexion angle
lower portion of glute max: increased with increased hip flexion angle
tensor fasciae latae: decreased with increased hip flexion angle


Which Exercises Target the Gluteal Muscles While Minimizing Activation of the Tensor Fascia Lata? – 2013
– Selkowitz et al
– To compare hip abductor muscle activity and to determine which exercises are best for activating the gluteus medius and the superior portion of the gluteus maximus, while minimizing activity of the tensor fascia lata (TFL).
– 20 healthy persons participated. Electromyographic signals were obtained from the Gluteus Medius, superior gluteus maximus, and TFL muscles using fine-wire electrodes as subjects performed 11 different exercises

Hip abduction in side lying Starting position was lying on a treatment table, on the side opposite the tested limb. The table was placed along a wall. The lower extremity on the table was flexed to 45° at the hip and 90° at the knee. The subject’s back and plantar foot were against the wall for control of position and movement. The subject then abducted the tested hip to approximately 30° and then returned the limb to the table. To control for the correct movement, the subject kept the heel in light contact with the wall (via a towel) while sliding it along the wall, with the toes pointed horizontally away from the wall.
Clam in side lying, with elastic resistance around thighs Starting position was lying on a treatment table on the side opposite the tested limb. The table was placed along a wall. Both limbs were flexed to 45° at the hip and 90° at the knee, with the tested limb on top of the other limb. The subject’s back and plantar surface of the foot were placed against the wall for control of position and movement. The subject raised the tested limb’s knee up off the other limb, such that the hip was in 30° of abduction, before returning to the starting position while keeping both heels in contact with each other and the wall. Subjects performed this activity with blue-colored Thera-Band (The Hygenic Corporation, Akron, OH) tubing around the distal thighs, with no stretch or slack on the tubing prior to raising the limb. The elastic resistance was used because the motion involved is a multiplanar arc that is only minimally resisted by gravity.

TABLE 1 Normalized Electromyographic Amplitude of Each Muscle for Each Exercise*
Exercise Tensor Fascia Lata Gluteus Medius Superior Gluteus Maximus
Side lying hip abduction 32.3 ± 13.1 43.5 ± 14.7 (P = .012) 23.7 ± 15.3 (P = .033)
Bilateral bridge 8.2 ± 7.4 15.0 ± 10.5 (P = .011) 17.4 ± 11.9 (P = .008)
Clam 11.4 ± 11.4 26.7 ± 18.0 (P = .006) 43.6 ± 26.1 (P<.001)
Hip hike 31.4 ± 14.4 37.7 ± 15.1 (P = .196) 17.7 ± 15.2 (P = .001)
Lunge 21.6 ± 14.5 19.3 ± 12.9 (P = .623) 20.1 ± 11.1 (P = .728)
Quadruped hip extension, knee extending 15.6 ± 9.3 27.3 ± 14.9 (P<.002) 28.5 ± 16.6 (P<.007)
Quadruped hip extension, knee flexed 18.7 ± 10.6 30.9 ± 15.2 (P = .001) 30.1 ± 12.5 (P = .012)
Sidestep 13.1 ± 7.1 30.2 ± 15.7 (P = .002) 27.4 ± 16.7 (P = .002)
Squat 4.6 ± 3.8 9.7 ± 7.3 (P = .017) 12.9 ± 7.9 (P<.001)
Step-up 21.4 ± 11.4 29.5 ± 14.9 (P = .065) 22.8 ± 15.6 (P = .754)
Unilateral bridge 18.1 ± 12.9 30.9 ± 20.7 (P = .007) 34.6 ± 16.8 (P = .001)

*Values are mean ± SD percent maximum voluntary isometric contraction.

Significantly greater than tensor fascia lata (P<.05).

Significantly less than tensor fascia lata (P<.05).


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