More than 23,000 people per day in the United States require medical attention for ankle injuries, and one of the most common causes, especially among active people, is running. Running is known to cause lower-extremity injuries in both the ankles and knees, and the risk for injury is recognized to increase with weak hip abductor and hip extensor muscles. The primary hip abductor muscles are the gluteus medius and gluteus minimus, both of which are located directly under the gluteus maximus and are responsible for moving the leg to the side and away from the body. The primary hip extensor is the gluteus maximus muscle, which is responsible for standing from a chair or the upward motion of a squat. Thus, strengthening these muscles can go a long way toward reducing the risk of lower-extremity injuries.

Maintaining Balance

Running is a high-intensity, dynamic activity that requires physical effort, mental attention and the ability to maintain, achieve and restore balance during activity (also known as postural control). Most runners can identify with the concept of postural control—a moment when they stepped on an uneven sidewalk and felt an ankle turn and correct automatically, or a brush with disaster when they stepped off the side of a treadmill belt, but quickly adjusted and kept stride.

Other common examples of postural control occur when a runner encounters an unexpected rough surface or needs to move from the sidewalk to the grass and does so seamlessly. Postural control helps the runner to readily adapt to surface change and continue running. The strength of the gluteus medius and minimus muscles is directly related to the ability to maintain postural control and quickly restore it when the running environment changes. Thus, strong hip abductor muscles are a key to prevent common ankle injuries from running (Gafner et al., 2018).

Proper Running Mechanics

Whereas weak hip abductor muscles can lead to diminished balance during running, weak hip extensor muscles are known to negatively alter running mechanics. Specifically, individuals with weak hip extensor muscles are more likely to stand too upright while running, which leads to relying too much on knee extension to propel the body forward, and overuse injuries of the knee can result (Teng and Powers, 2016).

Suggested Exercises to Improve Hip Abductor and Extensor Strength

Research has shown a significant positive correlation between performance on balance tests and hip abduction strength, demonstrating that strong hip abductors muscles are necessary to maintain balance during running to prevent injuries (Wilson et al., 2017). The exercises listed below work the primary hip abductors—the gluteus medius and minimus—in order from the least to most advanced exercise. And because the gluteus maximus muscles are needed to maintain proper running mechanics and spare the knees, exercises that also work these muscles are marked with an asterisk.

1. Side-lying hip abduction
2. Seated machine hip abduction
3. Standing cable hip abduction
4. Side lunge*
5. Single-leg squat*

Sample Workouts for Hip Abductors and Extensors

Workout #1

Repeat the exercise sequence three to four times.

Note: The side lunge is suggested with body-weight only; however, resistance may be added when appropriate.

Workout #2

Repeat the exercise sequence three to four times.

Note: The single-leg squat can be performed using a partial range of motion (ROM) as the exercise utilizing full range of motion is particularly challenging and suited only for the most experienced exercisers; body-weight only is recommended.

The gluteus maximus, medius and minimus muscles make quick postural adjustments possible during running and maintain proper running mechanics, both of which enhance running performance and reduce the risk of injury. Keeping those muscles strong is critical to success and enjoyment with running and strength can be built and maintained with a few common hip-strengthening exercises.

When building strength, remaining flexible is important too. Learn about stretching your clients safely and effectively with our Biomechanics of Assisted Stretching online course.

References

Gafner, S.C. et al. (2018). Hip-abductor fatigue influences sagittal plane ankle kinematics and shank muscle activity during a single-leg forward jump. Journal of Electromyography and Kinesiology, 43, 75-81.

Teng, H.L. and Powers, C.M. (2016). Hip-extensor strength, trunk posture and use of the knee-extensor muscles during running. Journal of Athletic Training, 51, 519-524.

Wilson, B.R. et al. (2017). The relationship between hip strength and the Y-balance test. Journal of Sport Rehabilitation, 27, 1-24.