Lateral Hip Stability for Injury Prevention and Back Pain Relief
Updated: Oct 2
There is a small but strong muscle called the Gluteus Medius that is located on the lateral aspect of the hip and pelvis. This muscle is responsible for hip abduction and for helping to create hip stability when the leg is fixated on the ground in any weight-bearing position.
Despite its size and small surface area, this muscle plays a vital role in hip, pelvis and lower body stability. It therefore also plays an important role in lumbopelvic alignment and stability. It is a muscle that I always assess for unilateral and bilateral strength. It is often a muscle that is underactive and weak in many clients suffering with lower body, hip, pelvic and lumbar dysfunction or pain.
I cannot possibly count how many clients I have prescribed Gluteus Medius exercises for. It is often a key variable in orthopedic rehab and injury prevention.
Here’s why.
The Importance of Lateral Stability
When the body lacks proper lateral hip stability, our overall mechanics are off. This places stress on any number of other joints and the muscles that connect to them.
Calves / Ankles - What happens at the feet travels up the kinetic chain and it also works in the other direction.
Knees - Excess lateral movement can put pressure on knee ligaments, the ITB attachment, patella tendon and other structures, causing pain and wear and tear.
Hips / Pelvis - Whether it’s a labrum issue, arthritic changes in the hip joint, a bursitis, a hamstring strain, a chronic SI joint effusion or something else, if the hip and pelvis keeps shifting to the right or left excessively on a regular basis, it’s going to chronically create friction and wear and tear on something. So if you have an existing injury or are trying to prevent one, any issues with lateral stability, either unilateral or bilateral, need to be addressed.
Low Back - Glutes Medius weakness is one of the most underrated factors in low back pain, in my opinion. It is one of the main things I look for in all of my clients who come in with low back issues. It won’t necessarily cause the problem on its own, but it will only compound the problem.
How Do You Know If Your Gluteus Medius is Weak?
The best 3 ways to figure out if this muscle is weak are as follows. Keep in mind thatit does help to have someone else doing the assessment but you can definitely try it on your own first.
Side Leg Lift Test
This is like doing the side leg lift exercise
Lay on your side
Bring the top leg behind your body, but keep it in line with the rest of your body.
Perform 15 repetitions at a slow pace, going as high as you can and bringing your toes all the way to the floor with each repetition.
If you can’t get to 10 repetitions easily, that’s a problem!
Squat Assessment/ Overhead Squat Assessment
Stand in front of a mirror or take a video of yourself from the fromt and from behind doing a squat.
Feet shoulder width apart
Feet parallel if possible
Knees and legs stay neutral entire time
Perform 3 squats while facing the video camera and then 3 what with your back to the video camera. Keep your arms in front of your body as you squat down.
Then repeat with your arms straight overhead.
You are not trying to get your butt all the way to the ground. This is a half to three-quarter squat.
Afterwards, look at the video to see if your body shifted to the left or to the right during the squats. If there was a notable shift, there is a good chance that you have an issue with one of your Glutius Medius
Single Leg Squat Assessment
Stand on one leg
Put your hands on your hips or keep them to the sides
Perform a quarter to half squat 3 times
If you’re pelvis drops to one side excessively, you may have weakness in your Gluteus Medius.
Please note that if you are experiencing a serious injury or severe pain, it’s always best to consult an injury recovery specialist before trying these self-assessments.
Exercises for Hip Abduction / Gluteus Medius
Here are a variety of exercises that specifically isolate the Gluteus Medius muscle.
Side Leg Lifts
Hip Hikes
Side Walks
How many of each?
These are activation exercises. They are meant to be done 3 to 4 times per week or as needed. One option if are really needed at the beginning is about 10 to 15 reps for 1 to 3 sets. You can do them at the beginning, in the middle or at the end of a workout. They can also be done on their own or as part of a separate rehab session.
Please note that if you are experiencing a serious injury or severe pain, it’s always best to consult an injury recovery specialist before trying these exercises.
The Gluteus Medius Doesn’t Function In a Vacuum
The Gluteus Medius is an important muscle, but it’s just one muscle that functions among many to move and stabilize the kinetic chain. It needs to be trained and viewed in the context of the entire lower body and lumbopelvic complex. I am not suggesting that doing the 3 exercises above will fix all of your problems. Orthopedic rehab can be complicated. But sometimes it’s the little or not-so-obvvious or simple things that can make a big difference.
Final Thoughts
Lateral hip stability is very important and sometimes overlooked. The main hip abductor and lateral hip stabilizer is the Gluteus Medius. Addressing this muscle can be a key to fixing any number of stubborn injuries. There are simple exercises that can help strengthen the Gluteus Medius and that can be integrated into any rehab program or strength training routine.
Frequently Asked Questions
What is the gluteus medius?
The gluteus medius is a muscle located on the outer side of the hip and pelvis. It helps move the leg away from the body and provides hip and pelvic stability when the leg is weight-bearing.
Why is gluteus medius strength important?
Gluteus medius strength is important for maintaining lateral hip, pelvic, and lower-body stability. Weakness or underactivity may contribute to movement problems involving the hips, pelvis, knees, and lower back.
Can a weak gluteus medius contribute to lower back pain?
A weak gluteus medius may contribute to movement and stability problems associated with lower back pain. The article emphasizes that it does not necessarily cause back pain by itself but may compound existing problems.
How does lateral hip stability affect the knees?
Poor lateral hip stability can allow excessive movement through the lower body, potentially increasing stress on the knee and surrounding structures. Improving hip stability may therefore be an important part of addressing certain movement-related issues.
How can you tell if your gluteus medius is weak?
The article describes three assessments: the side leg lift test, squat or overhead squat assessment, and single-leg squat assessment. Difficulty completing the side leg lift or excessive pelvic shifting during squats may indicate a potential stability or strength issue.
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