Best Exercises for the Gluteus Maximus

The gluteal musculature has been implicated in a varietyof pathologies due to its potential impact on lower extremity biomechanics. Read my previous article for an evidence-baseddiscussion of general gluteal strengthening, rehabilitation, EMG activity during exercise, and associated pathologies. Talking specifically about the gluteus maximus, its impaired function has been demonstrated in individuals diagnosed with femoroacetabular impingement.⁹

Gluteus MaximusBiomechanics

Origin:Ilium posterior to posterior gluteal line; dorsal surface of sacrum and coccyx; sacrotuberous ligament

Insertion:Iliotibial tract and gluteal tuberosity

Primary Function: Extends thigh and assists in hip abduction and external rotation; steadies thigh and assists in rising from seatedposition

Introductory Exercises

Introductory exercises where the gluteus maximus reaches the highest EMG levels include:^{12, 14-18}

• Front plank with hip extension

• Gluteal squeeze

• Side plank with hip abduction

• Quadrupedwith contralateral arm/leg lift

• Unilateral bridge

[Table] Percentage of Maximal Voluntary Isometric Contraction of the Gluteus Maximus during Therapeutic Exercise

Interaction With Other Muscles

As I mentioned in the previous article, when we are choosing an exercise to prescribe, we should consider how other muscles interact with or against the gluteus maximus. Individuals demonstrating excess femoral internal rotation during functional tasks may be relying too heavily on the tensor fasciae latae to control their pelvis because their gluteus medium is weak or inhibited.

[Table] Gluteal-to-TFL Activation Index during Therapeutic Exercise

More Functional Exercises

Finally, when youre ready to progress your patient towards more functional closed kinetic chain, sport- or activity-specific exercises, consider the following exercises with the highest gluteus maximus activation:^{12, 14-19}

• Cross-over step-up

• Hip thrust variations (barbell, band, American)

• Rotational single-leg squat

• Skater squat

• Single-leg squat

[Table] Percentage of Maximal Voluntary Isometric Contraction of the Gluteus Maximus during Closed Kinetic Chain Exercise

Caveats

Exercise prescription is a multi-faceted decision, which is driven by the individual patients goals, functional limitations, and the evidence supporting the treatment of these factors. Using EMG studies to drive the selection of exercise is highly valuable, especially during early rehabilitation or when attempting to isolate individual muscles or groups of muscles.

However, there are limitations when comparing different studies due to methodological differences (type of EMG, patient population, data analysis, etc.). Moreover, thousands of exercises have not been evaluated in the literature because of the costs and time needed to conduct these studies.

So, these studies should be used to guide your decision-making, but they should not override your clinical expertise when accompanied by biological plausibility.