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Glute Medius Progression

9/11/2010

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So I have received inquiries about exercises I do/have done with Dan, the marathon runner who had hip issues, that I train.  I've been working on getting more videos taken.  If you haven't already done so, be sure to read the hip impingement blog from months back.   Here is a vid explaining some basic progressions I like to use to get the glute medius functioning better. Check it out.
One thing I want to point out.  As you saw in the video, he flexed his hip when he first did the side leg raise.  I then cued him into extension.  He could be extended better than what we finished with; he was fatigued since we did this after his entire workout.  When the hip flexes, that means that the tfl (abducts the hip just like the glute med, tends to become more dominant) is trying to do the work.  So always be sure that the hip is extended fully when raising the leg up.  The side leg raise is done against the wall first while actively pushing back into the wall with the heel to ensure that the glute is doing the work.  The side leg raise shown here is done after.

As I said, it is very important to do multi joint exercises to get the muscle working in a "real time" environment.  Single leg exercises Dan has done and progressed with include split squats, stepups, reverse lunges, forward lunges, and progression from dumbbells to barbells with each.  Bulgarian split squats and one leg squats would be the next that I would use.  Hip dominant exercises include one leg glute bridges, one leg rdl's, hip thrusts, band stomps and single leg reverse hypers.  These all get the glute max nice and strong as well, which he lacked. 

When we first started, his left glute med was much weaker than his right so extra sets were done for the left with the clam shells.  I also used a band to teach him to keep his knee straight during single leg movements. 

After a couple of phases with all unilateral movements, we added in some bilateral movements including plate squats, back squats, front squats, yoke bar squats, pull-throughs,  rdl's, sumo rdl's, good mornings and reverse hypers (in different phases obviously). 

On top of all of the glute work (his glute was not extending the hip like it was supposed to so the femur rubbed against the socket, hence the reason for so much glute work), his tfl, rectus femoris and psoas needed length (psoas actually needed some strength too).  So plenty of stretching and mobility work has been done for these muscles.  The hip flexor stretch I have previously shown has been a mainstay.  It should also be noted that specific abdominal muscles play a role in what goes on at the hip and pelvis as well.(  We will save that for another post. 

He now has hardly any hip pain or clicking and has actually begun to get into some light running drills without issues.  Doing what needs to be done in the weight room to help running performance and prevent injury is HUGE and hopefully more runners will begin to realize this.  In a future post (hopefully soon future), I will discuss some of the energy systems training Dan has done to maintain and build his endurance while simultaneously strengthening his hips and fixing his problems.  Stay tuned!!
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