gluteus maximus

What is gluteus maximus

Gluteus maximus is the largest of the three gluteal muscles and most superficial of gluteal muscles 1. Gluteus maximus makes up most of the shape and form of your buttock and hip area. The gluteus maximus is a thick fleshy muscle with a quadrangular shape. Gluteus maximus is a large muscle and plays a prominent role in the maintenance of keeping the upper body erect. Gluteus maximus is also a site of intramuscular injection. Gluteus maximus overlies large sciatic nerve; covers ischial tuberosity only when standing; when sitting, moves superiorly, leaving ischial tuberosity exposed in the subcutaneous position.

Gluteus maximus principal function is the major extensor of the hip and it also externally rotates and abducts your thigh. Hip extension is an important action in daily activities (standing, stepping and walking) and sporting actions (running, sprint-running and jumping).

Gluteus maximus is innervated by the inferior gluteal nerve (L5–S2). Gluteus maximus dysfunction is most likely due to inferior gluteal nerve dysfunction; this would cause difficulty in rising from a seated position, climbing up stairs and loss of hip extension. The most common cause of inferior gluteal nerve dysfunction is a posterior hip dislocation. Another etiology is incorrect intramuscular (IM) injection placement. Intramuscular (IM) injection placement should be in the upper outer quadrant of the buttock. Otherwise, both the inferior and superior gluteal nerves are at risk of injury 2. Paralysis of the gluteus maximus does not affect walking on a plane surface 1. The gluteus maximus only contracts during a part of the stance phase. This phase occurs when the heal strikes the ground to when the foot is flat. The gluteus maximus works by resisting further flexion of the hip and initiate extension. The gluteus maximus actively functions when climbing upstairs or lifting from a seated position 3.

The gluteal muscles are a grouping of muscles that make up the buttock area. These muscles include:

  • Gluteus maximus
  • Gluteus medius
  • Gluteus minimus

Figure 1. Gluteus maximus anatomy

Gluteus maximus anatomy

Gluteus maximus origin and insertion

Gluteus maximus originates from the dorsal ilium, sacrum, and coccyx.

The gluteus maximus has two insertion points: superficial fibers to the greater trochanter and a band of the fascia lata (iliotibial tract) and the deep fibers that insert into the gluteal tuberosity of femur between the adductor magus and vastus lateralis. It originates in the gluteal surface of the ilium 4.

The gluteus maximus also has associations with three bursae 5. These include:

  • The trochanteric bursa – separates the gluteus maximus from the greater trochanter
  • Ischial bursa – separates the gluteus maximus from the ischial tuberosity
  • The gluteofemoral bursa – separates the iliotibial tract from the vastus lateralis

Gluteus maximus blood supply and lymphatics

The gluteus maximus receives vascular supply by both the inferior and superior gluteal artery. These vessels enter the gluteus maximus at the center of the muscle. The inferior gluteal artery proceeds to descend along the greater trochanter of the femur. It accompanies the descent of the sciatic nerve, which proves to be critical as rupture of the inferior gluteal artery can cause gluteal compartment syndrome and sciatic nerve palsy 6. The artery supplies the superficial skin and anastomoses with the perforating arteries of the lower limb. The inferior gluteal artery is also susceptible to pseudoaneurysm formation following intramuscular injection 7.

Gluteus maximus innervation

The innervation of the gluteus maximus muscle is from the inferior gluteal nerve. The inferior gluteal nerve originates from the ventral rami of L5, S1, and S2. Classically, the inferior gluteal nerve was thought not to provide cutaneous innervation. However, the recent literature describes findings of cutaneous branches of the nerve which might contribute toward gluteal pain during lumbar disk herniation. Surgeons must also be aware of this nerve as injury might result in compression ulcers and various pain syndromes 8.

Gluteus maximus function

Gluteus maximus principal function is the major extensor of the thigh and it also externally rotates and abducts your thigh. Although a powerful extensor, gluteus maximus only acts when force is necessary. Gluteus maximus is most effective when thigh is flexed and force is necessary, as in rising from sitting, climbing stairs, straightening from a bending position, walking up stairs or on a hill and running. Gluteus maximus also acts on the pelvis, supports it and the trunk which is vital when a person is standing on one leg. By attaching to the tensor fascia lata, the gluteus maximus also steadies the femur 9. Gluteus maximus is generally inactive during standing and walking.

The gluteus maximus works with the semitendinosus and semimembranosus muscles to extend the hip. The muscle also works in conjunction with the iliopsoas, piriformis, and the obturator muscles to externally rotate the hip.

Gluteus maximus action

In athletes, the gluteus maximus muscle is among the most important to train due to its action of extension of the hip joint which translates to explosive movements 1. A 2018 study looked at the correlation between gluteus maximus muscle to quadriceps femoris ratio in faster athletes compared to slower athletes. Results yielded that the larger the ratio, the faster the athlete 10.

Another 2018 study suggests that associated hip muscles may become more atrophied after hip arthroplasty, but larger cohorts would be needed to clarify the results 11. Variability in the neuromuscular activity of the gluteus maximus in patellofemoral pain syndrome compared to healthy individuals was also documented 12.

Gluteus maximus exercises

Though several different gluteus maximus exercises exist, a comprehensive understanding of which exercises best target the gluteus maximus and the magnitude of muscular excitation associated with each exercise is yet to be established 13. The findings from this review 13 provide an indication of gluteus maximus excitation generated by a variety of hip extension body weight exercises, which may assist practitioners in making exercise selection decisions for programming.

Figure 2. Gluteus maximus workout

gluteus maximus workout

Table 1. Summary of all different gluteus maximus exercise studies reviewed

Author and dateSubjects (Sex, age, height, mass)Methodology (MVIC position and electrode site placement)Hip extension exercisesMean ± SD EMG excitation (%MVIC)
Worrell, Crisp, LaRosa 14Group 1: 6 males, 7 females (22 ± 8.6 years; 171 ± 15 cm; 69.1 ± 14.1 kg)
Group 2: 13 males, 6 females (27.5 ± 5 years; 175 ± 9 cm; 73.3 ± 15.3 kg)
Prone hip extension against manual resistance at 0 ° of hip flexion.
Placement half-way between the second sacral prominence and the greater trochanter of the femur.
Lateral step up (20 cm height)20 ± 11 group 1
16 ± 7 group 2
Zeller, et al. 159 males (20.3 ± 1 years; 182 ± 5 cm; 78.8 ± 4.0 kg)
9 females (22 ± 8.6 years; 170 ± 6 cm; 64.3 ± 5.5 kg)
Prone hip extension against manual resistance with knee flexed at 90 °
Placement not specified.
Single leg squat62.7 ± 43 male 81.2 ± 28 female
Ayotte, et al. 1616 males, 7 females (31.2 ± 5.8 years; 173.1 ± 10.1 cm; 77.0 ± 13.9 kg)Supine hip extension against fixed resistance pad placed proximal to the popliteal fossa from 30 ° hip flexion.
Placement 1/3rd of the distance from the second sacral vertebra to the greater trochanter.
Forward step up (15.2 cm height)
Lateral step up (15.2 cm height)
Retro step up (15.2 cm height)
Single leg mini squat (15.2 cm depth)
Single leg wall squat, other leg knee extended
74 ± 43
56 ± 29
59 ± 35
57 ± 43
86 ± 43
Ekstrom, Donatelli, Carp 1719 males, 11 females (27 ± 8 years; 176 ± 8 cm; 74 ± 11 kg)Prone hip extension against manual resistance applied above the knee with knee flexed to 90 °
Placement between the lateral edge of the sacrum and the posterosuperior edge of the greater trochanter.
Bridge
Lateral step up (20.3 cm height)
Lunge
Quadruped hip extension with arm raise
Single leg bridge
25 ± 14
29 ± 13
36 ± 17
56.2 ± 22
40 ± 20
Ekstrom, Osborn, Hauer 1827 males, 32 females (age range 21-35 years)Prone hip extension against manual resistance applied just above the knee with knee flexed at 90 °
Placement between the lateral edge of the sacrum and the posterosuperior edge of the greater trochanter.
Bridge
Bridge with knees extended and feet on a swiss ball
27 ± 13
20 ± 14
Farrokhi, Pollard, Souza, et al. 195 males, 5 females (26.7 ± 3.2 years)Prone hip extension against strap resistance positioned superior to the knee joint with the knee flexed to 90 °
Placement midway between the second sacral vertebra and the greater trochanter.
Lunge
Lunge with trunk extension
Lunge with trunk flexion
18.5 ± 11.0
19.3 ± 11.8
22.3 ± 12.0
Boudreau, Dwyer, Mattacola, et al. 2022 males, 22 females (23.3 ± 5.1 years; 174.5 ± 9.1 cm; 74.6 ± 16.5 kg)Standing hip extension against strap resistance placed around the distal third of the thigh with knee flexed to 90 °
Placement half the distance between the greater trochanter of the femur and the spinous process of the second sacral vertebra along an oblique angle at the level of the greater trochanter.
Forward step-up and over (20.3 cm height)
Lunge
Single leg squat
16.5 ± 11.7
21.7 ± 14.7
35.2 ± 24.0
Distefano, Blackburn, Marshall, et al. 219 males, 12 females (22 ± 3 years; 171 ± 11 cm; 70.4 ± 15.3 kg)Prone hip extension against manual resistance with knee flexed at 90 °
Placement 1/3rd of the distance between the second sacral vertebra
and the greater trochanter.
Lunge
Lateral lunge
Transverse lunge
Single leg deadlift
Single leg squat
44 ± 23
41 ± 20
49 ± 20
59 ± 28
59 ± 27
Lewis, Sahrmann 2211 females (27.7 ± 6.2 years; 165.2 ± 3.6 cm; 62.3 ± 6.9 kg)Prone hip extension against manual resistance with knee flexed at 90 °
Placement on the muscle belly.
Prone hip extension from hip flexion of 30 °
Prone hip extension from hip flexion of 30 ° with verbal cues to activate the glutes
Prone hip extension from hip flexion of 30 ° with verbal cues to activate the hamstrings
9.7 ± 2.9
21.6 ± 9.8
11.2 ± 5.2
Sakamoto, et al. 2316 males, 15 females (24.5 3.5 years; 170.0 ± 9.0 cm; 66.9 ± 11.9 kgProne hip extension against manual resistance with knee extension
Placement 1/3rd of the distance between the
second sacral vertebra and the greater trochanter.
Prone hip extension with knee extension
Prone hip extension with 90 ° knee flexion
Prone hip extension with lateral hip rotation and knee extension Prone hip extension with lateral hip rotation and knee flexion
12.7 ± 8.6
23.1 ± 21.2
22.5 ± 10.4
21.2 ± 12.0
Lubahn, Kernozek, Tyson, et al. 2418 females (22.3 ± 2.3 years; 166.82 ± 9.2 cm; 61.1 ± 7.1 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement on the muscle belly.
Forward step up (Height unknown)
Single leg squat
Squat
36.4 ± 18.6
47.4 ± 21.2
21.7 ± 15.8
Boren, et al. 2524 (Anthropometrical details not provided)Prone hip extension against a strap with the knee flexed at 90 °
Placement not specified.
Forward step up (20 cm height)
Lateral step up (15 cm height)
Plank with bent leg hip extension
Skater squat
Single leg bridge
Single leg deadlift
Single leg squat
Quadruped bent leg hip extension DOM
Quadruped bent leg hip extension non-DOM
54.7
63.8
106.2
66.2
54.2
58.8
70.7
59.7
21.0
Bouillon, Wilhelm, Eisel, et al. 2620 males, 20 females (22 ± 1 years; 170 ± 10 cm; 65 ± 13 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement inferior and medial to a line
drawn between the PSIS and the posterior greater trochanter.
Lateral lunge
Lunge
12 ± 3
11 ± 2.5
Nakagawa, et al. 2720 males (23.5 ± 3.8 years; 176 ± 6.1 cm; 74.6 ± 9.1  kg)
20 females (21.8 ± 2.6 years; 163 ± 7.3 cm; 59.4 ± 7.3 kg)
Prone hip extension against strap with the knee flexed at 90 °
Placement parallel to the mid–muscle belly.
Single leg squat24.6 ± 2.7 females
18.9 ± 8.9 males
Tateuchi, Taniguchi, Mori, et al. 2810 males, 6 females (24.3 ± 5.2 years; 165.7 ± 7.9 cm; 59.0 ± 8.0 kg)Prone hip extension against manual resistance.
Placement halfway on the line extending between the sacrum and greater trochanter.
Prone hip extension from 30 ° hip flexion to 10 ° hip extension10.9 ± 3.3
De Ridder et al. 298 males, 6 females (24.7 ± 3.2 years; 172.9 ± 6.4 cm; 64.5 ± 12.5 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement midway between the posterosuperior iliac spine and the
ischial tuberosity.
Prone back/torso extension
Reverse hyperextension
44.9 concentric
33.1 eccentric
30.3 concentric
20.3 eccentric
Kang, et al. 3018 males, 12 females
(22.8 ± 2.9 years; 170.3 ± 4.1 cm; 66.9 ± 10.8 kg)
Prone hip extension against manual resistance with the knee flexed at 90 °
Placement halfway between the greater trochanter and second sacral vertebra in the middle of the muscle and at an oblique angle.
Prone hip extension with knee flexion with hip abducted 0 °
Prone hip extension with knee flexion with hip abducted 15 °
Prone hip extension with knee flexion with hip abducted 30 °
20.2 ± 8.6
23.4 ± 9.9
29.6 ± 11.5
Lee, Ko, Lim 3120 males (22.9 ± 2.1 years; 174.4 ± 3.9 cm; 70.0 ± 6.2 kg)Side-lying hip abduction against strap resistance with the hip in 90 ° abduction.
Placement 1/3rd of the distance between the second sacral vertebra and the greater trochanter.
Lunge
Lunge with compression pelvic belt
Single leg deadlift
Single leg deadlift with compression pelvic belt
Single leg squat
Single leg squat with compression pelvic belt
11.5 ± 6.9
13.9 ± 7.7
27.9 ± 18.4
36.3 ± 21.9
30.5 ± 19.4
35.5 ± 21.7
Webster, Gribble 321 male, 8 females (22.9 ± 4.5 years; 164 ± 6.5 cm; 65.4 ± 10 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement half-way between the second sacral prominence and the greater trochanter of the femur.
Single leg squat with rotation
Transverse lunge
78 ± 45
58 ± 3
Bolgla, et al. 3318 males (24.3 ± 3.4 years; 180 ± 10 cm; 81.2 ± 9.7 kg)
16 females (24.0 ± 1.5
years; 165 ± 10 cm; 59.9 ± 8.8 kg)
Prone hip extension against strap with the knee flexed at 90 °
Placement parallel alignment over
the belly.
Single leg wall slide, other leg knee flexed
Single leg mini-squat
Lateral step down (20 cm height)
Forward step down (20 cm height)
21.6 male 32.0 female
20.3 male
26.6 female
8.4 male
24.6 female
19.0 male
27.2 female
Hollman, Galardi, Lin, et al. 3441 females (18-36 years)Prone hip extension against strap with the knee flexed at 90 °
Placement at one-half the distance between the sacrum and greater trochanter.
Single leg squat20.9-23.8
Emami, Arab, Ghamkhar 3510 males (22.5 ± 3.8 years; 177 ± 7 cm; 74.1 ± 8.0 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement at the midpoint of a line running from S2 to the greater trochanter.
Prone hip extension with knee extension18.3 ± 12.1
MacAskill, Durant, Wallace 3614 males, 20 females
(21.5 ± 1.7 years; 170.5 ± 11 cm; 67.6 ± 7.5 kg)
Prone hip extension against manual resistance with the knee flexed at 90 °
Placement 1/3rd of the distance between
the second sacral vertebra and the greater trochanter.
Forward step up (15 cm height)
Lateral step up (15 cm height)
28.7 ± 18.7
31 ± 19.9
Park, Yoo 3718 males
(21.9 ± 2.2 years; 175.1 ± 5.3 cm; 66.6 ± 8.4 kg)
Prone hip extension against manual resistance with the knee flexed at 90 °
Placement at half the distance between the trochanter and the sacral vertebrae in the middle of the muscle on an oblique angle.
Back/torso extension with extended knees and hands across chest
Back/torso extension with extended knees and hands behind head Back/torso extension with flexed knees 90 ° and hands across chest
Back/torso extension with flexed knees 90 ° and hands behind head
28.3 ± 14.5
26.5 ± 13.6
34.8 ± 20.6
36.6 ± 22.6
Suehiro, et al. 3821 males (20.2 ± 0.4 years; 171.1 ± 5.0 cm; 64.3 ± 10.5 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement halfway between the greater trochanter and the second sacral vertebra.
Prone hip extension with 90 ° knee flexion and neutral hip position
Prone hip extension with 90 ° knee flexion and 15 ° hip abduction
Prone hip extension with 90 ° knee flexion and 15 ° hip abduction and 20 ° hip external rotation
14.1 ± 9.4
22.5 ± 13.6
41.0 ± 23.6
Kim, Kim 3914 males, 16 females (24.7 ± 3.2 years; 167.5 ± 8.2 cm; 61.5 ± 6.9 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement 1/3rd the distance between the second sacral vertebrae and the greater trochanter.
Prone hip extension to 10 °
Prone hip extension to 10 ° with abdominal drawing-in
Prone hip extension to 10 ° with pelvic tilt > 15 °
Prone hip extension to 10 ° with abdominal drawing-in with pelvic tilt > 15 °
23.9 ± 18.5
24.4 ± 14.3
32.5 ± 21.3
45.9 ± 33.7
Kim, Yoo 4018 males (23.3 ± 1.8 years; 177.4 ± 5.3 cm; 74.2 ± 7.2 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement not specified.
Prone hip extension with upper body on table
Prone hip extension with body on floor
62.3 ± 27.1 56.5 ± 20.2
Mills, Frank, Goto, et al. 4120 females (Anthropometrical details not provided)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement 1/3rd the distance between the second sacral vertebrae and the greater trochanter
Squat12.4 ± 6.3
Yoon, Lee, An 4215 subjects (26.7 ± 3.7 years; 167.1 ± 9.2 cm; 58.1 ± 11.7 kg)MVIC position not specified
Placement not specified
Prone hip extension from 0 ° hip flexion
Prone hip extension from 15 ° hip flexion
Prone hip extension from 30 ° hip flexion
19.7 ± 7.9
22.5 ± 9.4
18.9 ± 7.8
Youdas, Hartman, Murphy, et al. 4313 males (23.4 ± 1.3 years; 180 ± 10 cm; 79.7 ± 10.6 kg)
13 females (23.5 ± 1.2 years; 170 ± 10 cm; 63.7 ± 7.4 kg)
Prone hip extension against manual resistance with the knee flexed at 90 °
Placement on the muscle belly, parallel to the line of action.
Bridge
Bridge with feet on swiss ball
Single leg bridge
Single leg bridge with foot on bosu
Bridge with hamstring curl
Bridge with feet on swiss ball and hamstring curl
16.4
13.0
32.6
28.4
18.5
10.9
Choi, Bak, Cho, et al. 4414 males, 13 females (27.8 ± 5.8 years; 166.4 ± 10.1 cm; 66.2 ± 13.4 kg)MVIC position not specified
Placement between the sacrum and greater trochanter
Bridge
Single leg bridge
Single leg bridge (raised leg abducted to 30 °)
41.5 ± 16.4
47.3 ± 16.0
46.7 ± 12.0
Jeon, et al. 4516 males (25.4 ± 4.2 years; 174.7 ± 2.8 cm; 73.1 ± 2.1 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement at the midpoint of the line extending between the greater trochanter and sacrum
Prone hip extension with upper body on table
Prone hip extension with upper body on table and abdominals drawing-in
Prone hip extension with upper body on table and flexed contralateral knee joint on a chair
43.9 ± 16.1
47.5 ± 19.8
66.4 ± 25.8
Lee, Song, Kwon 4610 males, 10 females (21.1 ± 1.8 years; 168.7 ± 8.3 cm; 66.1 ± 12.3 kg)MVIC method not specified.
Placement at 50% on the line between the sacral vertebrae and the greater trochanter
Squat with 0 ° trunk flexion
Squat with 15 ° trunk flexion
Squat with 30 ° trunk flexion
6.1 ± 4.0
6.3 ± 4.0
8.0 ± 4.9
Selkowitz, Beneck, Powers 4710 males, 10 females (27.9 ± 6.2 years; 170.5 ± 11.1 cm; 67.7 ± 14.1 kg)Four conditions normalised to whichever contraction elicited greater EMG excitation:
1) Prone hip extension of 45 ° with the knee flexed at 90 ° against strap resistance.
2) Prone hip extension of 0 ° with the knee flexed at 90 ° against strap resistance.
3) Sidelying position with hip in 30 ° abduction and knee extended against strap.
4) As position 3 with hip in 45 ° flexion.
Placement Gmax (S) inserted superior and lateral to the midpoint of a line drawn between the posterior superior iliac spine and the posterior greater trochanter, Gmax (I) inserted inferior and medial to the midpoint of the same line, such that it was 2.5 to 5.0 cm above the gluteal fold.
Bridge
Forward step up Lunge
Single leg bridge
Squat
Quadruped hip extension with knee extended
Quadruped hip extension with knee flexed
17.4 ± 12.0 (S)
22.3 ± 10.1 (I)
22.8 ± 15.6 (S)
15.7 ± 6.0 (I)
20.1 ± 11.1 (S)
18.5 ± 6.2 (I)
34.6 ± 16.8 (S)
36.7 ± 10.0 (I)
12.9 ± 7.9 (S)
10.5 ± 7.1 (I)
28.5 ± 16.6 (S)
31.2 ± 16.5(I)
30.1 ± 12.5 (S)
34.3 ± 16.3 (I)
Chan, et al. 4810 males, 10 females (21.1 ± 1.7 years; 166.8 ± 7.9 cm; 58.1 ± 9.2 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement 1/3rd of the distance from iliac crest to greater trochanter, starting from greater trochanter.
Prone hip extension up to 20 ° with 90 ° knee flexion
Prone hip extension up to 20 ° with 90 ° knee flexion with abdominal bracing
14.8 concentric (S)
12.3 eccentric (S)
20.1 concentric (I)
11.7 eccentric (I)
19.7 concentric (S)
16.6 eccentric (S)
25.6 concentric (I)
36.0 eccentric (I)
Hollman, et al. 4915 females (23.3 ± 1.7 years; 169.4 ± 8.3 cm; 62.6 ± 6.7 kg)Prone hip extension against strap resistance with the knee flexed at 90 °
Placement halfway between the sacral vertebrae and the greater trochanter
Bridge
Bridge with verbal and tactile cueing
16.8
33.0
Lehecka, et al. 5012 males, 16 females (23.4 ± 2.3 years; 173 ± 11 cm; 72.6 ± 13.9 kg)Prone hip extension against strap resistance with the knee flexed at 90 °
Placement anterosuperior to Gmax, inferior to the lateral aspect of the iliac crest on a line towards the greater trochanter on the muscle belly.
Single leg bridge. DOM leg 90 ° knee flexion with foot flat. Non-DOM leg knee extended
Single leg bridge. DOM leg 135 ° knee flexion with foot flat. Non-DOM leg knee extended
Single leg bridge. DOM leg 90 ° knee flexion with foot flat. Non-DOM leg knee relaxed in flexion and femur vertical
Single leg bridge. DOM leg 90 ° knee flexion with dorsiflexed ankle. Non-DOM leg knee relaxed in flexion and femur vertical
Single leg bridge. DOM leg 135 ° knee flexion with dorsiflexed ankle. Non-DOM leg knee relaxed in flexion and femur vertical
51.0 ± 28.1
47.4 ± 24.8
47.2 ± 28.1
49.1 ± 26.4
40.4 ± 24.6
Van Oosterwijck, et al. 514 males, 9 females (22.6 ± 2.1 years; 172 ± 7.3 cm; 61.3 ± 9.5 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement midway between the posterosuperior iliac spine and the ischial tuberosity).
Prone back/torso extension without lumbopelvic control strategy
Prone back/torso extension with lumbopelvic control strategy Reverse hyperextension without lumbopelvic control strategy
Reverse hyperextension with lumbopelvic control strategy
23.8 ± 10.1
32.4 ± 21.6
22.0 ± 7.7
38.8 ± 24.1
Youdas, et al. 5213 males, 13 females (23.5 ± 1.2 years; 175.0 ± 10.0 cm; 71.7 ± 9.0 kg)Prone hip extension against manual resistance with the knee flexed at 90 °
Placement parallel to the muscle’s line of action.
Single leg bridge
Supine manual resisted hip extension
33.8
34.7

Though several limitations exist within this review, some general observations can be made as follows:

  1. Body weight hip extension exercises provided a wide range of gluteus maximus electromyography excitation ranging from 6.1% to 106.2% maximum voluntary isometric contraction (MVIC);
  2. When pooled as an average, similar levels of excitation were found between force vectors though the range of excitation levels differed between vectors;
  3. Unilateral exercises produced higher electromyography values compared to the bilateral version of the same exercise;
  4. Females exhibited greater electromyography excitation than males in all hip extension exercises,
  5. Verbal and tactile cues increase gluteus maximus electromyography excitation, while bracing and drawing-in the abdominals also increase excitation levels; and,
  6. Hip extension exercises performed in greater degrees/angles of hip flexion, hip abduction or hip external rotation result in higher measured electromyography excitation levels.

The pooled averaged values for the same exercises should be interpreted as a guideline and caution should be used for interpreting their findings with further research into each exercise with the same methodology required to verify these results. Moreover, this review focused on body weight exercises, therefore, whether the loaded version of the same exercises in this review results in similar findings requires investigation. When strengthening a weaker muscle or muscle group, practitioners may wish to prescribe a gradual and progressive exercise program to ensure the targeted area is developed. Practitioners should initially consider exercises performed in the horizontal vector as they provide a large base of support and are less challenging compared to vertical vector exercises. Moreover, bi-lateral exercises should be mastered before prescribing unilateral versions. This may be of importance if individuals seek and implement a compensatory movement pattern when faced with weakness or dysfunction. Individuals may benefit from being prescribed exercises that they can perform with good technique without substitution. Subsequently, once this can be achieved, exercise difficulty can be progressed with more demanding exercises.

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