Therapist TM

What is the best gluteal exercise to give to your clients???

If the #1 condition people complain about is the neck and shoulders, then the # 2 is the lower back. I keep saying that sitting is a primary cause of lower back pain as it tightens up the hip flexors including the psoas major and iliacus. These muscles of the anterior hip region often become strong in their shortened position and have what is called stretch weakness. If a muscle cannot maintain its control or strength through full range then we can expect dysfunction in the movement patterns of that region and secondary compensations.

The (gluteal) gluteus maximus is one of five strongest muscles in the body which also exclude the heart, masseter, soleus and uterus. The gluteal muscle is responsible for stabilization of the core and hips and is especially involved with squatting, running, lunging and bending activities.

It is also common that the buttocks is super weak because of the lack of use and the limited application of full range. Once you have controlled any pain then it is time to strengthen with various low load recruitment exercises, isometric holds and concentric loading. Lastly we apply dynamic strength exercises which require groups of muscles to work together as agonists, synergists and antagonists.


Many of us have under active gluteal or gluteus maximus muscles because of our constant sitting lifestyle. As a consequence, other muscles will compensate for this under activity. One of the many muscles compensating is the erector spinae muscle, found just either side of your spine, resulting in possible lower back stiffness. Another muscle that frequently compensates for an under active gluteus muscle is the hamstring. We often see patients in our clinic struggling to perform the “bridge” because they are experiencing a cramping sensation in the hamstrings. This should not happen when the gluts are working properly.


There are many exercises one can do to re-activate the glut muscles problems may include the problem with isolating the muscle. When performing a bridge exercise some of your clients with under active gluteals may have felt tension and/or cramping in the hamstrings. This means that the hamstrings are dominant and are taking over from your gluteals.

Applying the Cook Hip lift exercise however is designed to reduce the overactive lower back muscles as well as the overactive hamstring muscle out of the equation.  The Cook hip lift manoeuver is done lying supine with a tennis ball cradled between the knee and lower ribs. Hold the leg in this tight hip flexion whilst pushing up into a hip lift using the other leg. Only lift up a small range as this is hard to do and only needs to recruit the glut muscles.

If you have clients with arthritic issues this is an easier move and also within this video attached is a variation to a gluteal stretch. It is necessary to have both strength and length within the muscles to function and perform as we would like them to. Please go to the video to get – the low load muscle activation; – the Cook Hip lift exercise; – the simplified version to stretching for those with hip conditions.

Let me know how you go eh ;-)???

Paula Nutting Director Your Musculoskeletal Specialist
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