Glute strength following hip injuries in gymnasts is essential. Along with the rest of the lower extremity musculature, the glutes help buffer extremely high impact forces going through the hip joint. Not to mention, they are essential to maintain dynamic hip stability under extreme ranges of motions seen in gymnastics skills.
Without proper strength of the glute medius, glute minimus, glute max, and deep hip rotators, gymnasts may struggle. This can come in the form of ongoing pain, a lack of power when getting back to training, or rapid fatigue.
One of the biggest mistakes I used to make in rehab, and see others make, is that they don’t have a systematic, science-based strength program for the glutes based on EMG data.
If we want to maximize glute strength, regain performance, and reduce injury risk, we have to make sure we are approaching strength and conditioning in rehabilitation using a periodized and progressive overload approach.
To help people out, I wanted to share my go to exercises I’ve used with 100s of gymnasts trying to get over hip injuries. They start with basic, and more to more advanced.
1. Manual Sidelying Clams, Abduction, and Prone ER
Reinman 2012, More 2018, and Bishop 2018, have great reviews looking at EMG data for the gluteus med/min/max. These studies show a moderate amount of glute activity using sidelying clamshells, reverse clamshells, and abduction. Prone external rotation places the hip in a neutral position, which is also important.
I like doing these with hands-on approaches, which mimic isokinetic motions. One reason I like this is we can create constant tension in the entire range of motion. With band or resistance machines, often times certain parts of the range are more or less demanding. Second, it allows us to change our force pressure emphasizing eccentric overload or adding rhythmic stabilziations. Check out this short video to learn more.
2. Single Leg Step Ups, Hip Lifts, Squats, and RDLs
While these open chain exercises are fantastic for hypertrophy of specific muscle groups, we have to remember we have to get people into compound closed chain movement patterns. Contreras 2015, Neto 2020, and Reinman 2012 have also revealed step-ups, hip lifts/thursts, and single-leg squats all have high amounts of glute EMG activity. I also like to add single-leg Romanian deadlifts, to help build overall posterior chain capacity.
The key here is that gymnasts with hip injuries may not be able to tolerate full range of motion and bodyweight forces early in rehab. So, we must have specific progressions to use over time. In this short video, I share some of these concepts.
3. Jumping Lunges and Landing Drills
We always have to keep in mind the end goal. All of the best rehab strength progressions fall short if we don’t train gymnasts specifically for the demands of their sport. To continue carrying the glute strength into gymnastics specific settings, I like using split pelvis, landing, and active flexibility drills.
Keep in mind, these are typically only used in the very advanced and return to sports phase of rehab. If we add these in too early without mastering the basic steps first, we could hit headaches. Jumping lunges, double and single-leg landing drills, and curled up hip lifts are some of my favorite.
Want To Learn The Exact Rehab Exercises I Use Treating Gymansts for Lower Extremity Injuries?
These exercises are a tiny fraction of the exercises, progressions, and principles you need to successfully treat a gymnast. Knowing how to progress them based on load, programming, or speed is crucial.
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Recent Advances in The Evidence-Based Evaluation and Treatment of Lower Extremity Injuries in Gymnasts
- Reiman MP, Bolgla LA, Loudon JK. A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabilitation exercises. Physiother Theory Pract. 2012 May;28(4):257-68. doi: 10.3109/09593985.2011.604981. Epub 2011 Oct 18. PMID: 22007858.
- Moore D, Pizzari T, McClelland J, Semciw AI. Rehabilitation Exercises for the Gluteus Medius Muscle Segments: An Electromyography Study. J Sport Rehabil. 2019 Jun 6:1-4. doi: 10.1123/jsr.2018-0340. Epub ahead of print. PMID: 30747561.
- Bishop BN, Greenstein J, Etnoyer-Slaski JL, Sterling H, Topp R. Electromyographic Analysis of Gluteus Maximus, Gluteus Medius, and Tensor Fascia Latae During Therapeutic Exercises With and Without Elastic Resistance. Int J Sports Phys Ther. 2018;13(4):668-675.
Contreras B, Vigotsky AD, Schoenfeld BJ, Beardsley C, Cronin J. A Comparison of Gluteus Maximus, Biceps Femoris, and Vastus Lateralis Electromyographic Activity in the Back Squat and Barbell Hip Thrust Exercises. J Appl Biomech. 2015 Dec;31(6):452-8. doi: 10.1123/jab.2014-0301. Epub 2015 Jul 24. PMID: 26214739.
Neto WK, Soares EG, Vieira TL, et al. Gluteus Maximus Activation during Common Strength and Hypertrophy Exercises: A Systematic Review. J Sports Sci Med. 2020;19(1):195-203. Published 2020 Feb 24.