Why are Strong Glutes Important?

By Grant Uyemura, DPT Student

What do the glutes do?

The glute is made up of 3 muscles glute maximus, medius, and minimus. The main action of the glute maximus is hip extension and external rotation. The glute medius acts as a hip abductor with anterior fibers assisting internal rotation while the posterior fibers aid in external rotation. The glute minimus is responsible for hip abduction and internal rotation.Why are strong glutes important?

Weak glutes can cause low back/hip pain, iliotibial band syndrome, patellofemoral pain
syndrome, and chronic ankle sprains.

Best exercises for glutes?

According to Distefano et al. they found the best glute medius exercises were side-lying hip abduction and the best glute maximus exercises was the single leg deadlifts and single leg squat. Boren et al. found that a front plank with hip extension was the best glute maximus exercise while a side plank with hip abduction was best for the glute medius. Both studies found that the best overall exercise for glute strengthening was a single leg squat.

Blog post written by Grant Uyemura, DPT Student from University of St. Augustine. At the time of publishing Grant was in a clinical rotation with me at Catz PTI.

1. Boren K, Conrey C, Le Coguic J, Paprocki L, Voight M, Robinson TK. Electromyographic
analysis of gluteus medius and gluteus maximus during rehabilitation exercises. Int J
Sports Phys Ther. 2011;6(3):206-223.

2. Distefano LJ, Blackburn JT, Marshall SW, Padua DA. Gluteal Muscle Activation During
Common Therapeutic Exercises. J Orthop Sport Phys Ther. 2009;39(7):532-540.
doi:10.2519/jospt.2009.2796.

3. Macadam P, Cronin J, Contreras B. an Examination of the Gluteal Muscle Activity
Associated With Dynamic Hip Abduction and Hip External Rotation Exercise: a Systematic Review. Int J Sports Phys Ther. 2015;10(5):573-591.

What is Femoroacetabular Impingment?

By Grant Uyemura, DPT Student

Femoroacetabular Impingement (FAI) is abnormal contact between the femoral head and acetabulum, which can cause hip pain, labrum, and/or cartilage damage. There are three different types of FAI’s: Cam, Pincer, and mixed. Cam impingement lesions are more prevalent in younger males than in females. Pincer lesions are more common in middle aged, active women.1 A study by Tannast et al. found that 86% of patients have a combination of both cam and pincer impingement.2

Types of FAI

Cam: Aspherical femoral head tries to fit into a spherical socket. Can cause chondrolabral junction separation due to shearing force.

Pincer: Over coverage of acetabulum socket, can cause labrum crushing and degeneration/ ossification.

Mixed: Combination of cam and pincer deformities.
Clinical Presentation

• Anterior or anterolateral hip/groin pain

• Stiffness

• Painful hip flexion past 90º and internal rotation

• Pain with prolonged sitting

What Physical Therapy can do?

The goal of physical therapy is to increase range of motion, increase strength, and decrease pain in order to maximize function and return to your prior level of function. Surgery should only be considered when conservative treatments do not control symptoms or functional limitations are unacceptable.4

 Blog post written by Grant Uyemura, DPT Student from University of St. Augustine. At the time of publishing Grant was in a clinical rotation with me at Catz PTI.

References:

1. ​Kuhns BD, Weber AE, Levy DM, Wuerz TH. The Natural History of Femoroacetabular Impingement. Front Surg. 2015;2(November):1-7. doi:10.3389/fsurg.2015.00058.

2. ​Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: Radiographic diagnosis – What the radiologist should know. Am J Roentgenol. 2007;188(6):1540-1552. doi:10.2214/AJR.06.0921.

3. ​Stephanie Pun, MD, Deepak Kumar, PT, PhD, and Nancy E. Lane M. Femoroacetabular Impingement. Nih. 2016;67(1):17-27. doi:10.1002/art.38887.Femoroacetabular.

4. ​Enseki K, Harris-Hayes M, White DM, et al. Nonarthritic Hip Joint Pain. J Orthop Sport Phys Ther. 2014;44(6):A1-A32. doi:10.2519/jospt.2014.0302.