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Lateral Hip/Side Butt Strength: Why the emphasis?

The hip abductors & rotators/side butt/clamshell muscles are an underappreciated and often misunderstood group of muscles.

While the gluteus maximus is the most famous of the glutes, the gluteus medius (glute med) and gluteus minimus (glute min) are equally important.

The primary role of these two is to influence the relationship between the pelvis (socket) and top of the femur/thigh bone (ball).

In a single leg stance position (walking), gravity (red) attempts to pull the swinging leg (right side) down towards the floor.

The left hip (blue) has to work in order to keep the pelvis level which allows the top of the femur (ball) to remain properly oriented to the socket.

This leveling of the pelvis also allows the spine to remain in a normal/neutral position.

Despite this inherent importance, the lateral hip musculature (like the glute max) often suffers as a result of a sedentary lifestyle. Simply walking will not reverse the problems.

Sitting on your butt results in the squishing of your glute max between your sit bones and whatever surface you're sitting on, add some heat to that pressure and extend it over several hours and you have created a butt laminate.

The gluteus medius (glute med) and gluteus minimus (glute min) don't get squished per se but they do get put in a prolonged slackened position for extended periods of time. When you sit, the knees typically fall away from each other (abduction) and the thigh bones rotate outwards (external rotation).

This puts the glute med, glute min and all the other smaller hip rotators in a position they're designed to perform but problems arise when you accumulate TIME in that prolonged position - the tissue will begin to adapt to and ultimately prefer the slack that sitting affords.

This can affect both strength and endurance. If you recognize compensations early on in a workout or even with seemingly benign activities (walking, up/down stairs, etc.) then I would argue both strength AND endurance are lacking. If compensations are noticed during or after a workout then I would assume that that individual is strong but lacks the endurance to perform the workout completely. This even applies to folks with super strong back squats and deadlifts - you may have the strength to perform a 1RM with little/no difficulty but if your hips are compensating after a run or double unders then endurance is your missing piece.

If you're trying to spot hip weakness without performing all sorts of tests and measures, it can sometimes stand out with simply watching someone walk.

The trunk lean over the stance leg demonstrates lateral hip weakness. The body compensates for the lack of strength/endurance by leaning over the hip and ultimately creating stability by using the inherent shape of the ball and socket rather than relying on muscular support.

Relying on this method of support can be problematic in the long run as you're on the joint and tissue WITHIN the joint which can ultimately lead to irritation of said tissues and can also drive dysfunction from the low back all the way down to the foot.

Typically, when I see this pattern in clinic, the client is coming in for low back pain, medial/lateral hip pain, medial knee pain, posterior shin pain and/or ankle/foot pain.

It's not limited to issues in the indicated areas but trends in that direction

The Trendelenberg Gait (hip drop) or as I like to call it "Sassy hips". Equate it to an involuntary 'sashay' of the hip(s) while walking.

The "Trendelenberg" nametag sounds very nefarious but what it essentially translates to is that the stance leg hip lacks the strength/endurance as discussed above and rather than leaning towards the stance leg, the swinging side drops towards the ground.

This resulting drop drags the same side of the pelvis down which in turn artificially lengthens the swing leg and drives excessive amounts of side bending in the low back to compensate for the pelvic drop.

This compensatory pattern can drive low back pain, medial/lateral hip pain and/or lateral knee pain. This pattern often accompanies diagnoses like "IT Band syndrome" and "Trochanteric Bursitis".

If you recognize these patterns in yourself, friends & loved ones or your athletes (if you coach); take some time to ask if any type of symptoms are ongoing.

If so, take some steps to target the weakness and begin doing some isolated strengthening of the aforementioned hip muscles.

Some basic drills I like to go to initially are:

And once better isolated strength is present, you have to make it more functional. I like to increase the level function through some of the following drills:

Offset Farmer's Carry -Banded

Lateral Farmer's Walk - KB

Try these out and let me know how you feel. If you were prescribed these at some point and have (maybe) fallen off with performing them regularly, get back to it!

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