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Injury Prevention 101: Glute Max

The gluteus maximus muscle is the largest muscle in your bum. It not only propels you forward, but also plays an important role in hip and pelvic stability. Weakness in the glute max can lead to lower back injuries, hip, knee, hamstring, adductor and even calf strains!


This article is a summary of the fourth session in the Injury Prevention series which I presented live in the Sports Injury Advice and Support group. You can watch the videos of the presentations in the group if you search for #injuryprevention. The other topics include position sense, core stability, glute med, hamstrings, quadriceps and calves.

In this article:

  • What the glute max does

  • Why your hip flexors are important

  • Glute max exercises

  • Download the exercises as a PDF



What the glute max does


The glute max is you main hip extensor muscle (taking your leg back).  It is also used to accelerate the body upward and forward from a position of hip flexion e.g. when sprinting, squatting, or climbing a hill.


The glute max is not the only muscle that propels you forward. The hamstrings, hip adductors and calf muscles all play a part. If the glute max is weak or switched off, the other muscles have to work harder which can lead to muscle strains or tendinopathies (e.g. Achilles tendon pain).


Because 75% of the glute max attaches into the iliotibial band, it also plays an important role in pelvic and hip stability by preventing your pelvis to drop and your hip to turn in excessively when you walk and run. Thus playing a part in preventing back, hip, knee and ankle injuries. I've explained how you can test your own hip/pelvic stability here.


Interesting fact: The clam exercise is usually prescribed as an early stage rehab exercise for the glute med muscle. However, studies have shown that you activate the glute max to the same extent as the glute med when you do the clam at 60 degrees hip flexion.


Why your hip flexors are important


There is some research to suggest that tight and overactive hip flexor muscles can inhibit your glute max. Mills et al.  tested glute max muscle activation during a double leg squat in 2 groups of students. The one group had tight hip flexor muscles and the other group were deemed to have normal hip range of motion.


They found that the group with the tight hip flexors had 60% less glute max activation. Interestingly their hip extension strength was the same as the other group, but they demonstrated 2.6 times more hamstring activation relative to the glute max.


This is the first study to investigate this, but it does seem to suggest that tight hip flexors deactivates your glutes and can predispose you to strains in other muscles e.g. that hamstring.



Glute max exercises


You’ll be happy to know that all of the exercises that we talked about in the Glute Med article also activate the Glute Max. The most beneficial ones that I listed there are the supported single leg squat and the single leg sit to stand. That said, I do prefer to start with double leg bridges so that you can make sure that you get a feel for how to activate your glutes properly.


NB: These exercises may not be right for you and you should check with your healthcare provider before trying them. Remember, you can consult me via Skype for a diagnosis of any injuries or a bespoke treatment plan.


Hip flexor stretches

Remember, tight hip flexors can switch the glutes off. The main hip flexor muscles are the iliopsoas and rectus femoris. You should stretch both of these.


Purpose: It should be clear from the discussion above that this is extremely important. You will activate your glute max much better if your hip flexors aren’t tight.

Starting position: Half kneel with your one knee on a pillow and your other leg out in front of you. Hold on to something for balance if needed.

Movement: A. Push your hip forward, but at the same time tilt your pelvis backwards. This is important – if you allow your pelvis to tilt forward, the stretch will not be as effective. This will mainly stretch the iliopsoas muscle, but if you’re very tight you may have to spend time on this part first and then add in part B.

B. Once you can easily achieve part A, maintain that position and grab hold of your foot. You may have to loop a belt or towel around your foot if you are very stiff.

Check that: Your pelvis remains tilted backwards throughout the stretch. Remember, strong sustained stretches switches muscles off, so these should be followed by dynamic movements if you're doing them shortly before doing sport.

Aim: Hold the stretch for 30sec and repeat 3 times on each side.



Glute max strengthening level 1


Double leg bridge – feet up

I prefer to do the bridge with my feet on a chair. It allows the glutes to work through a much larger range and my patients don’t seem to strain their backs as easily as when they do it with their feet on the floor.


Starting position: Lie on your back with your heels on a chair. Make sure that your bottom is close to the chair – you are looking for a 90 degree angle in your knees. The straighter your knees, the more it becomes a hamstring exercise and that’s not our goal for now.

Movement: Activate your pelvic floor and deep abdominals by squeezing as if you don’t want to wee or fart. Keep them activated and lift your bottom into the air so that your body forms a straight line. Once at the top, you should squeeze your buttocks and make sure that you don’t feel any strain in your lower back. If you do feel strain in your lower back, make sure that you are squeezing your stomach and glutes and not trying to just arch your back.

Check that: You don’t feel any strain in your lower back. If your hamstrings cramp, move your bottom closer to the chair.

Aim: Hold the position for 10sec. Rest 10 sec. Repeat 10 times. Build up to 4 reps of 30sec holds.



Glute max strengthening level 2


Single leg bridge – feet up

Starting position: Lie on your back with your one heel on a chair and your other leg bent up into your stomach. Make sure that your bottom is close to the chair – you are looking for a 90 degree angle in your knee.

Movement: Activate your pelvic floor and deep abdominals by squeezing as if you don’t want to wee or fart. Keep them activated and lift your bottom into the air so that your body forms a straight line. Make sure that your pelvis is level! Once at the top, you should squeeze your buttock and make sure that you don’t feel any strain in your lower back. If you do feel strain in your lower back, make sure that you are squeezing your stomach and glutes and not trying to just arch your back.

Check that: Your pelvis should remain level throughout the exercise. You should not feel any strain in your lower back. If your hamstrings cramp, move your bottom closer to the chair.

Aim: Build up to 3 sets of 10 slowly reps on each leg.



Glute max strengthening level 3

The research shows that the Glute Max is most active during activities like single leg squats, single leg step-ups and single leg deadlifts. So the single leg sit-stand-sit exercise that I described in the Glute Med article will work very well for strengthening your Glute Max. Two birds with one stone!


Single leg sit-stand-sit

Purpose: It’s a great exercise to strengthen your glute med, glute max, quads and position sense.

Starting position: Choose a chair that you can manage to get up from using only one leg. Your aim should be to use a chair that places your knee in 90 degrees flexion, but if this is too hard use a higher surface. I usually place some pillows on the chair to make it easier. Sit on the edge of a chair with your one leg on the floor and the other one in the air. Your hands can either be in your sides or out in front of you.

Movement: Slowly stand up from sitting, using only one leg. Make sure that your pelvis stays level and your knee moves in line with the middle of your foot. Then slowly sit down again.

Check that: Your pelvis and knee stays aligned. If you find that you “plonk” down instead of slowly lowering yourself down, you may have to use a higher chair to start with.

Aim: Test how many your can do with good form from 90 degrees knee flexion. Your aim should be to get to 22 with no wobbling and keeping your pelvis and knee aligned. I can only manage 8 with rather poor form so I should work on the exercise single leg squat with support before doing these. Retest this every 4 weeks to check on your progress.

Start strengthening it by doing sets of 8 reps until fatigue. Rest at least 1 to 2 minutes between sets.



Download the exercises as a PDF



Let me know if you have any questions. You can consult me via Skype for an online diagnosis of your injury and a treatment programme tailored to your needs. I’ve also created a free Facebook group where you can ask questions about your injuries and get injury prevention advice.


Best wishes

Maryke



About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn or ReasearchGate



References:

  1. Mills M, Frank B, Goto S, et al. Effect of restricted hip flexor muscle length on hip extensor muscle activity and lower extremity biomechanics in college‐aged female soccer players. International journal of sports physical therapy 2015;10(7):946.

  2. Reiman MP, Bolgla LA, Loudon JK. A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabilitation exercises. Physiotherapy theory and practice 2012;28(4):257-68.

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