Exercises To Fix Your Trendelenburg Gait

Why is the recruitment of the gluteal muscles so difficult? One reason is the poor representational area in the primary motor cortex for these muscles! Here is a great way to improve muscle recruitment of the hip abductors, particularly the gluteus medius! Evidence suggests that static isometric glute med toque is a poor predictor of frontal plane pelvic drop. You only need average glute med strength to prevent a Trendelenburg gait pattern yet so many people present with this movement pattern. Hence, it is not so much strengthening, but motor control training is important to prevent this compensatory movement pattern. This dynamic exercise helps with not only strength but also MOTOR CONTROL of the hip abductors.

To perform this exercise:

✅ Elevate the leg opposite to the one you want to work on. Allow a majority of your weight to be accepted through the leg that is in contact with the floor.

✅ Focus on using your hip abductors to bring the pelvis back to a neutral alignment. Use a mirror to allow yourself to perform this with optimal form and progress to the point where you no longer require visual cues.

✅ If strength and endurance are the goal then repeat until fatigue!

✅ If Motor Control is the goal: REPEAT REPEAT REPEAT for numerous repetitions to make those neuroplastic changes in the brain! This is the only way to increase representation in your primary motor cortex!

This exercise has actually shown in studies to have the highest EMG activity for the gluteus medius, which is an important muscle to train in order to fix your Trendelenburg gait. Check out the infographic below!

Best Exercises For The Glute Med

While maintaining this, let your hip/pelvis sink on the side further away from the wall followed by lifting your hip back up to push harder into the wall, and repeat.

It is recommended to first activate the weakened area (to increase corticomotor excitability) -> strengthen -> then you can movement train. Because all the glute med strength in the world doesn’t matter if doesn’t activate at the appropriate time (AKA Motor Control). Here are 2 great exercises to challenge the muscle function of the hip abductors- primarily the gluteus medius. Remember- Keep your pelvis level, after all this is the Trendelenburg article!

Note: Feel free to hold these positions statically- this will facilitate “encoding” for cognitive processes which are thought to play an important role in helping the learner create a motor memory. Static holds require prolonged focus and concentration, thus strengthening the corticomotor pathway to create motor learning.

Note 2: research has shown the importance of strengthening not only the gluteus medius but also the quadriceps and the hamstrings. Increases in the strength of the muscles will result in a reduction of the degree of Trendelenburg gait.

While the weakness of the hip abductors is a potential cause for medial knee collapse, a lack of motor control can also be the culprit of this poor movement pattern. This is especially prevalent among higher-end athletes who demonstrate medial knee collapse with functional activities. In this case, the athlete more times than not has more than adequate strength, yet they fail to utilize and demonstrate the neuromuscular control necessary to engage the hip abductors during tasks. To see if this is the case, give the athlete visual, verbal, or manual cues to facilitate hip abductor activation.

Single leg squat has shown to fire 52-82% MVIC of the Gluteus Medius‼️ -82%, BW Boren et al. -64% +/-24, BW Distefano et al. -52% +/- 22, BW Ayotte et al.

Note: This can also be used as a strengthening exercise once the athlete demonstrates good neuromuscular control...

Gluteus medius strength may be even more important in sports when the center of mass changes direction unexpectedly, requiring strength and stabilization during unilateral stance. Because of the nature of contact sports and the role of pelvic stability to maintain the summation of forces of movements that begin in the lower extremity, Gmed strengthening should be included in sports that require unilateral support, especially during body-to-body contact.

In these sports, unilateral gluteus medius strengthening while standing can be considered as sport-specific. For example, single-leg squats with external resistance can be included during the preseason or in-season for ice-hockey players but should not be a staple of an ice-hockey player’s general strength development. Some may take this idea further and prescribe such exercises on an unstable surface in an attempt to mimic the instability experienced during competition.