Are you interested in decreasing your back and knee pain, adding weight to your squat/deadlift/lunge, running faster or having a bulletproof core?? The solution is simple, STRENGTHEN YOUR DAMN GLUTES! As a physical therapist I see a TON of low back pain as well as lower body injuries from exercise enthusiasts, hikers, CrossFitter’s, the list goes on and on and on…..

One common denominator to ~ 90% of injuries I see, from the back down to the knee, is the inability to fire the glutes! So, if you are in pain (or trying to stay out of pain), interested in setting new PR’s, or simply looking to get in better shape this blog article is for you! Strap in, and get ready to build up your back side, your entire body will thank you!

 Credit: https://www.boxrox.com/glute-workouts/

Anatomy: Why are the glutes so important???

Alright, let’s get into the weeds as to why this aesthetically pleasing muscle group is so important. There are three muscles which make up our Gluteals:

1. Gluteus Maximus                                2.  Gluteus Medius                                              3. Gluteus Minimus

Gluteus Maximus

Gluteus maximus is the muscle which gets all the notoriety because it is largest, strongest and easiest on the eyes (that’s he last butt joke, I promise). Glute Max attaches almost everywhere on your backside

Glute Max originates from:

1. Medial iliac crest
2. Medial ala (wing) of ilium (posterior surface),
3. Posterior surface of sacrum and coccyx
4. Sacrotuberous/sacrospinous ligaments
5. Thoracolumbar fasica

Glute Max inserts on:

1. Gluteal tuberosity of femur feeding into the IT band

Like I mentioned earlier, this puppy attaches EVREYWHERE! Due to the vast attachments of glute max this muscle has a ton of function, specifically:

1. Hip extension 
2. Posterior tilt of pelvis
3. External rotation of the hip,
4. Abduction (upper fibers)
5. Stabilizes knee in extension via the IT band

Glute max is the MOST powerful hip extender in the body! Powerful hip extension is essential to athletic performance. Sprinting, jumping, squatting, snatches, stair climbing, sled pushes, hinging (aka Deadlifts), cleans and lunges all require POWERFUL HIP EXTENSION! Not to worry, I have some great ways to develop this important muscle group at the end of this blog post.

Gluteus Medius

Think about it this way, glute max is like a quarterback in football. All the fans and media want to do is talk about how great the QB is. Rightfully so, the QB is probably the most important position in football, but isn’t football a team sport? Doesn’t the QB’s safety and success depend on the protection of their offensive line??

Sure does, this is where “Gluteus Medius” comes in. Think of gluteus medius like an All-Pro Left Tackle. The left tackle is responsible for protecting the QB’s blindside, the side of the field the QB is typically looking away from. Without a solid left tackle the QB would have no time to throw and would get pummeled (and likely injured) on almost every down.

Good thing glutus medius (GMed) is one hell of a left tackle. GMed is responsible for stabilizing the pelvis so gluteus maximus can forcefully contract the way it is meant to! Without a strong and stable GMed keeping our pelvis in place, the glute max would not be able to fire optimally!

The gluteus medius originates from:

1. The external surface of ilium between anterior (middle of ilium) and posterior (superior ilium) gluteal lines 

Glute Med inserts on:

1.  Superior/lateral part of greater trochanter 

The actions of the gluteus medius are:

1. Hip abduction
2. Hip external rotation
3. Internal rotation of thigh
4. Prevents hip drop on the opposite side

Another important role of the GMed is to provide side-to-side stability of the pelvis (aka frontal plane stability). Glute med is CRUCIAL for keeping our hips stabile while we squat, lunge, and run.

The gluteal complex as a whole is responsible for externally rotating our femur as we squat down, opening up space with in the hip joint, allowing us to descend into the whole of our squat. GMed is a “big time” external rotator of the hip and essential for creating pace in the joint and maintaining optimal knee position.

In terms of knee pain, the hip is one of the main drivers of knee position. Having weak glutes and the inability to stabilize the hip/femur in the frontal/transverse plane can result in painful compensations such as “knee cave” which can lead to long-term injuries if not addressed.

Gluteus Minimus

If GMed is the left tackle of the offensive line responsible for stabilizing the pelvis for the QB (aka Glute Max) consider Gluteus Minimus (GMin) the Right tackle. The tackle position in football is so important because these players protect the edge of the offensive line allowing he quarterback time to throw. The left tackle (GMed) protects the blindside of the QB but the right tackle (GMin) also has to protect the edge of the offensive line.

The reason why I say GMin is “not quite as skilled" as GMed is purely based off surface area. Glute min is smaller and cannot produce as much force as GMed, but is still an essential part of the gluteal complex.

Gluteus minimus originates on:

1. The external surface of the ilium between the anterior and inferior gluteal lines

 Gluteus minimus inserts on:

1. Anterior part of the greater trochanter

 The actions of GMin are:

1. Abduction of the hip
2. External rotation of the thigh
3. Internal rotation of the thigh
4. Prevents hip lateral hip drop

GMin has just about the same functions as GMed. GMin stands alone from the other glutes because it internally rotates the hip due to the change in fiber direction on the front of the muscle. In short, both GMed and GMIn are essential stabilizers of the hip and lower body within the frontal and transverse (rotational) planes, especially movements requiring use to be on one leg.

To put a bow on it…..

The glutes are a vital muscle group which must be trained on a weekly basis in addition to your normal dose of squatting, lunging, and deadlifting. Yes, the gluteal group is a powerful hip extender BUT we also need them to stabile our body in the frontal and rotational planes. The best way to do this is to perform single leg progressions or use bands to strengthen our ability to externally rotate the hip (preventing knee cave)

I have attached my “go-to” glute strengthening movements below! As with all methods of training, make sure you are varying load, intensity and time under tension with all these movements. 3 sets of 10 for every movement just won’t cut it.  Vary from low weight to high rep, to low reps high weight and everything in between.

I always teach my patients to add a 3-10 second pause when training external rotation. The reason why isometric external rotation strength is so important is to help keep the hip joint space “open” and the rest of the lower body in proper alignment as we squat, lunge, hinge, etc.

Have fun with these exercises and implement them in your training NOW and the rest of your body will thank you!

Banded Hip Thrusts

I recommend going a bit heavier on these! Start anywhere from 3-5 sets of 5-12 reps with 3-5 second pause at the top of the movement. Focusing on emphasizing a hard cheek squeeze at the top. Make sure your core is engaged, the low back should not move AT ALL!

Weighted Step Ups

Step ups are also meant to be on the heavier side. Make sure to drive though the top foot (the foot on the box) to elicit powerful hip extension. 3-4 sets of 6-12 reps each side is a good place to start here. Make sure the hips stay level as you are stepping onto the box!

Side Plank Clamshell

Low load, high repetition here! Since we are working hip external rotation, make sure you add in a 3-10 second isometric hold! 1-3 sets of 6-10 reps with a 5-10 second hold is a great place to start. Make sure to keep the bottom hip up, you may begin to sag as the glutes and obliques start to fatigue. Both the top and bottom hip should be firing with this challenging movement!

Banded Squats

Slow, controlled, and methodical on this one! I want you to really focus on feeling as much tension in your glutes as you descend down into your squat. Drive your knees against the band as much as possible, while also keeping your feet screwed into the ground! I like 1-2 sets of 5-8 reps with a 5-10 second descent. If you have pain at a certain depth, go just above that area and drive your knees into the band HARD! As you progress through more reps, challenge yourself to go deep if the pain is subsiding!

Still dealing with knee, hip or back pain? Click HERE to sign up for a FREE 20 MINUTE consultation to get you back to 100% and performing better than ever!

-Dr. Riley