Hip Muscle Activity During 3 Side-Lying Hip-Strengthening Exercises in Distance Runners

Abstract

Lower extremity overuse injuries are associated with gluteus medius (GMed) weakness. Understanding the activation of muscles about the hip during strengthening exercises is important for rehabilitation. To compare the electromyographic activity produced by the gluteus medius (GMed), tensor fascia latae (TFL), anterior hip flexors (AHF), and gluteus maximus (GMax) during 3 hip-strengthening exercises: hip abduction (ABD), hip abduction with external rotation (ABD-ER), and clamshell (CLAM) exercises. Controlled laboratory study. Laboratory. Twenty healthy runners (9 men, 11 women; age = 25.45 ± 5.80 years, height = 1.71 ± 0.07 m, mass = 64.43 ± 7.75 kg) participated. A weight equal to 5% body mass was affixed to the ankle for the ABD and ABD-ER exercises, and an equivalent load was affixed for the CLAM exercise. A pressure biofeedback unit was placed beneath the trunk to provide positional feedback. Surface electromyography (root mean square normalized to maximal voluntary isometric contraction) was recorded over the GMed, TFL, AHF, and GMax. Three 1-way, repeated-measures analyses of variance indicated differences for muscle activity among the ABD (F(3,57) = 25.903, P < .001), ABD-ER (F(3,57) = 10.458, P < .001), and CLAM (F(3,57) = 4.640, P = .006) exercises. For the ABD exercise, the GMed (70.1 ± 29.9%), TFL (54.3 ± 19.1%), and AHF (28.2 ± 21.5%) differed in muscle activity. The GMax (25.3 ± 24.6%) was less active than the GMed and TFL but was not different from the AHF. For the ABD-ER exercise, the TFL (70.9 ± 17.2%) was more active than the AHF (54.3 ± 24.8%), GMed (53.03 ± 28.4%), and GMax (31.7 ± 24.1%). For the CLAM exercise, the AHF (54.2 ± 25.2%) was more active than the TFL (34.4 ± 20.1%) and GMed (32.6 ± 16.9%) but was not different from the GMax (34.2 ± 24.8%). The ABD exercise is preferred if targeted activation of the GMed is a goal. Activation of the other muscles in the ABD-ER and CLAM exercises exceeded that of GMed, which might indicate the exercises are less appropriate when the primary goal is the GMed activation and strengthening.