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The Cure for Weak Gluteal Muscles: Part 2

Strength Exercises

To be able to strengthen the gluteal muscles as a whole, we must target all muscle groups within this region consistently to be able to allow hypertrophy. Contreas (2016), and commonly known as the “Glute Guy” states there are different movements that are going to recruit different muscles in the gluteals: frontal abductions, transverse abductions, rotators, hip drivers, and head drivers. Frontal abduction gluteal exercises involve the standing cable hip abduction, banded side walk, lying band and ankle weight abduction and the off-bench side lying abduction. Transverse abduction exercises such as the banded side lying clamshell and the banded sumo walks are going to target the gluteals in the transverse plane. Rotators such as the cable external rotation are going to involve the abdominals as a stabilizer while activating the gluteus medius. An example of a hip driver exercise would be a barbell hip thrust - which is a huge compound exercise that activates 90% of the gluteal muscles. Head drivers exercises that involve any type of squatting motion, lunge variation or step up (see Figure below).

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Even though having strong gluteals is important, the surrounding muscles around this region can be beneficial in providing support and stability to the spine and hip complex. If the glutel muscles ever become strong enough to overpower other muscles group, this can cause other muscles to compensate and this my lead to lower back pain and/or muscle imbalances.

Stretchers, Activators, and Pumpers

In the Figure shown above, you can see that all the exercises listed are colored and differentiated by: stretchers, activators and pumpers. This is segmented by the amount of time each exercise needs to fully recover. Barbell back squats take longer to recover from, because they show moderate gluteal activity, involve a big range of motion, with an emphasis on the eccentric phase and there is peak tension when the gluteals are lengthened. Combine these, and you have a lot of muscle damage, which allows more time for recovery (approx. 3-4 days). The barbell squat would generally be categorized as a stretcher exercise.

The barbell hip thrust would take less time to recover from because the range of motion is smaller, and there is peak tension when the gluteals are maximally shortened. However, the barbell hip thrust involves tremendous gluteal activity (Contreas, 2015) with a heavy-loaded eccentric phase (controlling the movement on the way down). The recovery time for this exercise and all other activator type exercise takes 2-3 days.

Banded side walks have a very small range of motion while gluteal activity is fairly low. This exercise would be determined as a pumper type of exercise. This is because the short range of motion and varying tension on the gluteals allow for more reps to be performed, which causes a lot of metabolic stress on the muscle as opposed to a stretcher exercise that results in a great deal of muscle breakdown.

Frequency and Adherence

Before diving into any strength program, there are many factors that are going to affect the outcome. The number one factor is going to be adherence. Adherence to any training program is going to be important because it is the only way to show results based on consistency. Another significant factor is going to be frequency. A study done by Thomas and Burns (2016) determined the effect of strength training frequency and it’s improvements in lean mass and strength. Seven women and 12 men with strength training experience were and assigned to follow a high frequency (HFT) or low frequency (LFT) training program. The HFT group trained each muscle group as the agonist, 3 times per week, exercising with 3 sets per muscle group per session (3 total body workouts). The LFT group trained each muscle group as the agonist one time per week, completing all 9 sets during that one workout. LFT protocol consisted of a routine split over three days: 1) pectoralis, deltoids, and triceps; 2) upper back and biceps; 3) quadriceps, hamstrings, calves, and abdominals. Both of these groups would adhere to their training programs for a total of eight weeks. The results of this study demonstrate that both High Frequency Training (three sets on three occasions per week) and Low Frequency Training (nine sets, on one occasion per week) produced similar improvements in lean mass and strength in these 19 active, men and women, following an eight week training period. It is recommend that coaches and exercise professionals could use both training frequencies within a periodized training program to increase lean mass and in strength in athletes and/or individuals striving for this particular goal.

Discussion

Inactivity, injuries, and muscle imbalances are the three main causes to weakness in the gluteal muscles. Weakness in this area can decrease athletic performance and cause lower back and joint pain in athletes and sedentary individuals. An increase in physical activity and consistent strength training will increase the strength in the gluteals and fix these issues. The best exercises to strengthen the gluteals involve isometric contractions, compounds movements, and bilateral and unilateral movements. Perhaps coaches, exercise specialists, and physical therapists can incorporate gluteal strength training for their athletes and clients who strive to be stronger and healthier individuals.

References

Added, M., de Freitas, D. G., Kasawara, K. T., Martin, R. L., & Fukuda, T. Y. (2018). Strength- ening the gluteus maxiumus in subjects with sacroiliac dysfunction. International journal of sports physical therapy, 13(1), 114-120. doi: 10.26603/ijspt20180114

Berg, H., Eiken, E., Miklavcic, O., & Mekjavic, L. (2007). Hip, thigh and calf muscle atrophy and bone loss after 5-week bedrest inactivity. European Journal of Applied Physiology, 99(3), 283-289. doi: 10.1007/s00421-006-0346-y

Contreas, B. (2013, January 12). How to fix glute imbalances. Retrieved from https://bretcontreras.com

Contreas, B. (2016, November 27). Your optimal training frequency for the glutes part I: exercise type. Retrieved from https://bretcontreras.com

Cooper, N.A., Scavo, K.M., Strickland, K.J., Tipayamongkol, N., Nicholson, J.D., Bewyer, D.C., & Sluka, K.A. (2015). Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. European Spine Journal, 25, 1258-1265.

Crow, F. J. , Buttifant, D. , Kearny, G. S. & Hrysomallis, C. (2012). Low load exercises targeting the gluteal muscle group acutely enhance explosive power output in elite athletes. Strength and Conditioning Research, 26(2), 438-442. doi: 10.1519/JSC.0b013e318220dfab

Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. (2004). Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exercise, 36, 926–934. 2004. doi: 10.1249/01.MSS.0000128145.75199.C3

McCurdy, K., Walker, J., & Yuen, D. (2018). Gluteus maximus and hamstring activation during selected weight-bearing resistance exercises. Journal of Strength and Conditioning Research, 32(3), 594-601. doi: 10.1519/JSC.0000000000001893

OEDwyer, Catriona, Sainsbury, David, & OESullivan, Kieran. (2011). Gluteus medius muscle activation during isometric muscle contractions. Journal of Sport

Rehabilitation, 20(2), 174-186. Retrieved from https://doi.org/10.1123/jsr.20.2.174Plummer, A., & Oliver, D. (2014). The relationship between gluteal muscle activation and throwing kinematics in baseball and softball catchers. Journal of Strength & Conditioning Research (Lippincott Williams & Wilkins), 28(1), 87–96. doi: 10.1519/JSC.0b013e318295d80f

Presswood, L., Cronin, J., Keogh, J., & Whatman, C. (2008). Gluteus medius: Applied anatomy, dysfunction, assessment, and progressive strengthening. Strength and Conditioning Journal, 30(5), 41-53. doi:10.1519/SSC.0b013e318187f19a

Reiman, M., Bolgla, L., & Loudon, J. (2012). A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabilitation exercises. Physiotherapy Theory and Practice, 28(4), 257-268. doi: 10.3109/09593985.2011.604981

Ricci, Santiago, Zampar, Pinola, & Fonseca. (2015). Upper extremity coordination strategies de pending on task demand during a basic daily activity. Gait & Posture, 42(4), 472-478. doi: 10.1016/j.gaitpost.2015.07.061

Stastny, P., Tufano, J. J., Golas, A., & Petr, M. (2016). Strengthening the gluteus medius using various bodyweight and resistance exercises. Strength and Conditioning Journal, 38(3), 91–101. http://doi.org/10.1519/SSC.000000000000022

Sullivan, S. (2003). Effects of simulated body weight increases on joint moments and muscular activity while rising from a chair.

Thomas, M. H., & Burns, S. P. (2016). Increasing lean mass and strength: a comparison of high frequency strength training to lower frequency strength training. International Journal of Exercise Science, 9(2), 159-167. Retrieved from International Journal of Exercise Science.

Tikkanen, O., Haakana, P,. Pesola, A., Häkkinen ,K., Rantalainen, T., (2013) Muscle activity and inactivity periods during normal daily life. Plos One, 8(1), 1-9. doi:10.1371/journal.pone.0052228

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The Cure for Weak Gluteal Muscles: Part 1

The gluteal muscles are an important part of the human body that provides support to the spine, stabilization to the pelvis and allows movement in the hip joint. The gluteal muscles also help to support the lower back during lifting motions, and prevent knee injuries during lifting and conditioning exercises. These muscles are made up of three different layers: gluteus medius, glu- teus maximus and gluteus minimus.

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All these muscles play a different role in our bodies and assists us in daily activities. The gluteus maximus is the largest muscle in the human body and it attaches to the side of the sacrum and femur (Delp, Hess, Hungerford, and Jones, 1999). A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabili- tation exercises. Physiotherapy Theory and Practice, 28(4), 257-268. It is the main extensor of the thigh and assists with lateral rotation. It is mainly used when force is required, such as running or climbing. The gluteus medius is located partway under the gluteus maximus and con- nects the ilium to the side of the upper femur. The purpose of this muscle is to abduct and medially rotate the lower limbs. The gluteus minimus lies under the gluteus medius and is responsible for abducting, flexing and internally rotating the hip.

The gluteal muscles play a big role in our daily lives and weakness in this muscle can cause major issues. One of the major causes of weak gluteal muscles is inactivity. (Berg, Eiken, Miklavcic, & Mekjavic, 2007). The largest muscle of the 3 is the gluteus maximus and it is only activated during movements that require force (e.g. squatting, jumping, lunging, etc.) (Bartlett, Sumner, Ellis, Kram, 2014).

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According to the studies of electromyography (EMG) on the gluteal muscles, the gluteal maximus fails to achieve high levels of activation during common everyday movements (McCurdy, Walker, & Yuen, 2018). In comparison to the other muscles in the body, the quadriceps are activated every time we stand or pick up something off the floor (Sullivan, 2003). Other examples of this would be the activation of the calves and hamstring when walking up stairs (Tikkanen, Haakana, Pesola, Häkkinen, Rantalainen, Havu, 2013), the abdominals when sitting up from a lying position, the triceps from pushing open a door and the biceps when pulling a door open (Ricci, Santiago, Zampar, Pinola, & Fonseca, 2015). However, as stated before, the gluteus maximus needs force to be activated, which means only heavy or explosive movements are going to strengthen this muscle. The problem is that many people fail to perform such movements on a daily basis which can lead to gluteal weakness and imbalances.

Gluteal Strength on Athletic Performance 

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Since the gluteal muscles are responsible for accelerating, decelerating, changing direc- tions, creating explosive power in jumps and effective hip extension, athletes need strong and active glutes to be able to perform at their highest peak (Bartlett, Sumner, Ellis, & Kram, R, 2014). According to the article Gluteus Medius: Applied Anatomy, Dysfunction, Assessment, and Progressive Strengthening (2008), rehabilitation specialists and strength and conditioning practi- tioners have identified one of the more common deficiencies in athletes: weakness of the glutei muscles, particularly the gluteus medius.

The gluteus provides frontal plane stability for the pelvis during walking and other functional activities involved in sports conditioning. It states that a weakened gluteus medius may contribute to the development of several lower-extremity injuries which will in turn reduce athletic performance in these athletes. In a study produced by Crow, Buttifant, Kearny, & Hrysomallis (2012), a group of 22 elite Australian Rules Football players performed 3 different warm-up protocols over 3 testing sessions in a randomized order to determine if low load exercises to target the gluteal muscle group acutely would enhance power output. The 7 exercises in the study included a double leg bridge, side lying hip abduction exer- cise, and quadruped lower extremity lift. The results of this study showed that this particular warm-up protocol involving low load exercises targeting the gluteal muscles is effective at acute- ly enhancing explosive power output in the lower limbs. This protocol would be most applicable for athletes competing in sports with high demands for explosive power output from the lower limbs because of the low loads involved in the protocol, it minimizes any risks of fatigue or injury before performance.

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In 2014, a study done by Plummer, Hillary, and Gretchen determined the relationship between gluteal muscle activation and pelvis and trunk kinematics when catchers throw to second base. Forty-two baseball and softball catchers participated in this study. Muscle activity of the bilateral gluteus maximus and medius as well as pelvis and trunk kinematics throughout the throwing motion were analyzed. It was discovered that at foot contact, there were 2 significant inverse relationships between stride leg gluteus maximus activity and pelvis axial rotation, and between trunk axial rotation and pelvis lateral flexion. In addition, at foot contact, a significant positive relationship between the drive leg (throwing arm side) and trunk flexion was present. The results of this study provide evidence of gluteal activation both concentrically and eccentri- cally, in attempt to control the pelvis and trunk during the throwing motion of catchers. Stride leg (non-throwing arm side) and drive leg (throwing arm side) gluteus maximus activity was greatest during the acceleration phase of throwing. In addition, stride leg gluteus medius activity was greatest during deceleration. Plummer, Hillary, and Gretchen conclude that the gluteal muscles play a direct role in maintaining the stability of the pelvis, and catchers should incorporate strengthening of the entire lumbopelvic-hip complex into their training regimen. Incorporating concentric and eccentric gluteal exercises will help to improve musculoskeletal core stability, thereby assisting in upper extremity injury prevention. Athletes with strong gluteal muscles are able to produce more speed, maintain the stability of their pelvis during movement, and are more efficient and explosive than athletes with inactive gluteal muscles (Leetun, Ireland, Willson, Bal- lantyne, Davis, 2004).


Lower Back Pain

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According to Aboufazeli (2018), low back pain is a significantly common disorder that approximately 70-85% of all adults experience at some point in their life. One of the biggest problem in clinical examinations of patients with lower back pain is the lack of a comprehensive diagnosis protocol comprising all muscular alterations responsible for this disability. Due to the pain, patients suffering from low back pain refrain from using their back muscles properly in their daily life. At the Department of Physical Therapy at the University of Social Welfare and Rehabilitation Sciences in Tehran, Iran, researchers state that this generally leads to atrophy of the back muscles and the entire posterior chain including the gluteal muscles.


Gluteal Imbalances

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By nature, we are built as asymmetrical beings. Our anatomical nature is to be right to left pelvic and hip asymmetries and leg length discrepancies are common (Contreas, 2013). However, our daily movement affects the strength differences in each gluteus. For example, we tend to shift to one side when standing for long periods at a time and then eventually become comfortable in that position. Inactivity and living a sedentary lifestyle can also cause gluteal im- balances (Berg, Eiken, Miklavcic, & Mekjavic, 2007). If you fail to consistently activate a mus- cle at high levels of capacity, it will inevitably quit working properly. As Contreas states, strengthening the gluteals - just like any other muscle, takes time, consistency and high and low training loads. Whether both sides of your gluteals are weak or one side is stronger than the oth- er, unilateral and bilateral movements, isometric contractions, self myofascial release (SMR) and stretching can help create a stronger posterior chain and a more balanced structure.

Fixing a gluteal imbalances slightly differs from overall gluteal strength training because in order to fix an imbalance, Stastny, Tufano, Golas, & Petr, (2016), suggests to focus on the weaker side first before performing higher load bilateral movements. An example of this would be isometric contractions for the weaker side.

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A study done by O’Dwyer, Sainsbury, & O’Sullivan (2011), shows that the gluteus medius is most activated during isometric abductions and internal rotation of the hip compared to adductions and external rotation of the hip. Unilateral movements such as single leg squats, step ups, side lying leg lifts, standing hip abduc- tions, cable kickbacks and step downs are all reccommend to increase strength of the weaker gluteal muscle (Presswood, Cronin, Keogh, Justin, Whatman, Chris, 2008). Although consensus may not exist, a Position Stand from the American Council of Sports Medicine suggests that per- forming at least 2 training sessions a week that involve 2 to 3 sets of between 6 to 15 repetitions per set will lead to considerable increases in muscular strength and endurance.

*PART 2: Strength exercises, programming, frequency and adherence.

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Can You Lose Fat While Being in a Caloric Surplus?

After I dieted down for my trip to San Diego, my body was so over being lean, conditioned and in a caloric deficit. Dieting sucks - in my opinion. I mean the end result of it is amazing and for sure I don't regret any of it but dieting over a long period of time can be exhausting. Your body wants to be at homeostasis at all times and when you start to cut calories so quickly, it will definitely catch up to you.

Last week, I asked on my Instagram story (ugh, the love and hate relationship with social media) on what other coaches/trainers view on the question: Can you lose fat while consistently being in a caloric surplus?

I was curious mainly because I wanted to stay lean after my trip but at the same time be able to eat more... because my body craved it. I was burning about 500+ calories per day off exercise and eating too little to be able to perform efficiently throughout the day. So when I got back, I ate more and lifted more but started to gain a little bit of weight. This made me wonder if eating more would help fuel my workouts OR if being in a calorie surplus would always assure weight gain. Here are what two of my fellow trainers had to say about it:

Justin Cooper, Kula Wellness co-owner, Yoga Instructor and Personal Trainer:

Yes and no. It depends how your determining caloric surplus. I've worked with clients in metabolic distress where they were only eating 600 calories per day, feeling full and overweight not losing weight. I got them back to eating 1200 calories per day and once their body adapted and rebalanced they started losing weight. Hopefully this provides a different perspective - each case is so different.

Anthony D'Onofrio, owner of Ant D Fitness and Men's Bodybuilding Physique Pro:

I was going to say no but thinking about my last prep, I started eating way more calories than I was used to eating during prep and I started to lean out pretty quick. The reason why it worked for me is because I stepped up the intensity of my workouts. As I was leaning out, I was getting stronger (it was f*cking awesome!) I think it was about 2 months of doing that I felt like I was operating at peak performance. Definitely the strongest and leanest I’ve ever been.

 

A lot of other trainers/coaches replied to this post and had their own opinion on it, though of plenty, most I do not agree with. Some saying exclude dairy or certain foods will help them lose fat while being on a caloric deficit... things like that. Not that they're right or wrong, just something I respectfully disagree with. If you're looking for a real answer... the answer is it depends. Here are my views on it.

If you are eating at a caloric surplus and weight training consistently, you are training towards gaining muscle. Gaining muscle can mean gaining fat/weight as well, though this also depends on the intensity of your workouts. Being able to maintain lean mass in your body will help you lose fat by increasing your resting metabolic rate (RMR) and total daily energy expenditure (TDEE). 

It also depends how high of a calorie surplus you are intaking daily. If your resting metabolic rate is 1,300 calories (average for a girl of my height and weight), and I'm burning 300 calories through exercise and an estimate of 400 extra calories through TDEE, my maintenance calories would be roughly 2,000 calories. Say I eat an extra 500 calories on top of my maintenance calories on a consistent basis - I would technically gain a 1 lb per week since 3,500 calories = 1 lb.

So, really it depends but here's what I recommend doing based on your goal:

GOAL: To be stronger and gain more muscle mass.

SUGGESTION: Eat 500 calories more than your calorie maintenance daily. This will ensure you're getting enough food to fuel you to lift heavier, increase the intensity of your workouts to maintain muscle.

GOAL: To gain muscle and lose fat.

SUGGESTION: Eat at calorie maintenance or a little less. You want to make sure you're eating enough (and of the right things) to be able to gain muscle with a consistent weight lifting program. Try eating at maintenance and if you're gaining too much weight too quickly, subtract 100-200 calories from that.

GOAL: To be the strongest and leanest badass of all time.

SUGGESTION: Eat at maintenance or a little above that. (100-300 calories) and lift like a motherf*cker. Lift with high intensity, switch off with lower and higher rep ranges. Increase your volume, change up your exercises. Do full body exercises and sprints. Keep your heart rate higher on some days and work on strength (with more rest time) other days.