Rehabilitation Exercise Progression for the Gluteus Medius Muscle with Consideration for Iliopsoas Tendinitis

Abstract

This study identified the most appropriate hip rehabilitation exercises for each phase to strengthen the gluteus medius muscle after hip arthroscopy and those to avoid when iliopsoas pain or tendinitis is a concern.

Changes of gluteus medius muscle in the adult patients with unilateral developmental dysplasia of the hip

“…The gluteus medius muscle has the reduced strength preoperative and length changes postoperative in patients with DDH during THA, Some specific rehabilitation exercise should be designed to strengthen the muscle and keep the stability of hip post-operative as for hip arthroscopy post-operative [37]. Weight-bearing exercises may provide more functional benefit because this type of exercise often activates a greater number of muscle group [38].…”

Guidelines and pitfalls for the rehabilitation following hip arthroscopy

“…Emphasis has been placed on the hip abductors specifically the gluteus medius because of its role in controlling pelvic stability in the frontal plane [20]. Intramuscular electromyography measuring activation of the gluteus medius compared with the iliopsoas during exercises commonly prescribed following hip arthroscopy has been studied [28]. The results showed that single leg bridging, prone heel squeeze (external rotation isometrics), and side-lying hip abduction with hip internal rotation demonstrate the greatest activity of the gluteus medius and the least of the iliopsoas [28].…”

“…Intramuscular electromyography measuring activation of the gluteus medius compared with the iliopsoas during exercises commonly prescribed following hip arthroscopy has been studied [28]. The results showed that single leg bridging, prone heel squeeze (external rotation isometrics), and side-lying hip abduction with hip internal rotation demonstrate the greatest activity of the gluteus medius and the least of the iliopsoas [28]. However, long lever hip abduction in side-lying is not recommended during this phase due to the greater joint reactive and compressive force across hip structures occurring with open chain motion [29].…”

“…Concentric action of the hip abductors should elevate the contralateral pelvis during mid-stance to raise the body's center of mass to its highest point during gait [34]. The required control of the hip abductors has been a primary focus following hip arthroscopy [16,17,28]. Hip abductor strengthening should be performed in a closed chain manner during this phase, as this is how the muscle works during gait [20].…”

Diagnosis and Management of Snapping Hip Syndrome: A Comprehensive Review of Literature

“…Many different protocols have been proposed, but evidence is still poor and there is not a gold standard treatment. As an high iliopsoas muscle activation and a weakness the gluteus medius have been found in many patients, Philippon et al [26] proposed a rehabilitative protocol based on gluteus medius strengthening, which consists into 4 consecutive phases. Garala and Prasad [27] in a retrospective case-control study found better results, according NAHS, after corticosteroids injection compared to iliopsoas tenotomy, and they indicate tenotomy in patients refractory to corticosteroids.…”