Wilder et al 34 noted that most variations between hip abductor strength exist due to the chosen testing position.Д®lectromyography (EMG) may be used to assess the activation of a muscle as measured by electrical activity levels, with the general consensus assumed that exercises producing higher levels of activation are generally accepted to be more appropriate to use for strengthening. 34 The supine position neutralizes the effects of gravity and provides an option for individuals to avoid lying on an injured affected side 36 while the standing position is proposed by Cahalan, Johnson and Chao 37 to be the most functional position when assessing hip abductor strength as the majority of daily living activities involve hip abduction performed in this position. 34 The sideвЂђlying position is frequently utilized to test hip abductor muscle strength in clinical settings 35 and is generally the suggested position by manufacturers of isokinetic testing devices. 32, 33Д®xamining hip abductor strength can be accomplished through various clinical tools and procedures and in both nonвЂђweightвЂђbearing (NWB) body positions: sideвЂђlying or supine and in a weightвЂђbearing (WB) body position: standing. Moreover, a weakness in hip abductor musculature and thus subsequent strengthening exercises are prescribed for iliotibial band syndrome, 28, 29 chronic ankle instability 30, 31 and patellofemoral pain syndrome. 3, 25 Janda and Jull 26 and, Page, Frank and Lardner 27 have suggested that an association between gluteal musculature inhibition and low back pain exists. 23 Gluteal weakness and ensuing hip dysfunction has a strong relationship ( r = в€’.74) with knee pathology 24 while a specific weakness in hip abduction and external rotation has been associated with patellofemoral pain syndrome. 5, 10, 22 Consequently, individuals performing these movements are often observed doing both hip abduction and excessive lateral pelvic movement caused by increased activity of the quadratus lumborum. Hip abductor weakness may lead individuals to adopt movement strategies to mask their weakness, 21 resulting in compensatory motions at the lower back, hip, and knee. 3, 17вЂ“ 19 This is highlighted when the hip abductors and external rotators fail to produce sufficient torque during weight bearing movements resulting in excessive hip adduction and internal rotation, an increase in knee valgus angle and pelvic drop. 16 Performance deficiency in these selected hip muscles results in altered pelvofemoral biomechanics which is linked to lower extremity pathology. 10вЂ“ 14 The Gmax and Gmed musculature extensively contribute to weight bearing movements by assisting in load transference through the hip joint, 15 supplying local structural stability to the hip joint and maintaining lower extremity alignment of the hip and knee joints. 2, 7 The gluteal musculature may significantly participate in dual roles of enhancing athletic performance 3, 8вЂ“ 10 while preventing and contributing to the rehabilitation of lower extremity injuries.

4, 5 The Gmed functions as a hip abductor 2 and hip rotator 6 with the anterior area of the Gmed performing hip internal rotation while the posterior area performs hip external rotation. The primary actions of the Gmax are hip extension and hip external rotation, 1вЂ“ 3 with the superior area of the Gmax also functioning as a hip abductor. Though several different exercise protocols exist, scientific evaluation of their specific effects on the gluteus maximus (Gmax) and gluteus medius (Gmed) has yet to establish which exercises activate the musculature and what level of activation is elicited.

A wide variety of hip abduction and hip external rotation exercises are used for training, both in athletic performance and in rehabilitation programming.

Lying hip abduction