Physical Therapy Exercises for Gluteus Medius Strength
Manhattan Physical Therapy
What Is the Gluteus Medius and Why Does It Matter?
The gluteus medius is one of three primary glute muscles:
Gluteus maximus
Gluteus medius
Gluteus minimus
It sits on the outer surface of your pelvis, between the larger gluteus maximus and the smaller gluteus minimus. You have one on each side.
Primary Functions of the Gluteus Medius
The gluteus medius is responsible for:
Hip abduction (moving your leg out to the side)
Pelvic stabilization during walking and running
Assisting with hip internal and external rotation
Controlling hip position during single-leg activities
When you stand on one leg, your gluteus medius prevents the opposite side of your pelvis from dropping. If it cannot do this effectively, your knee may collapse inward, your hip may rotate excessively, and extra stress may be placed on the knee joint and lower back.
Even small changes in hip mechanics can increase stress at the patellofemoral joint. Research has shown that just 10 degrees of excessive hip internal rotation can significantly increase joint stress at the knee. That is one reason gluteus medius strength is often addressed in physical therapy for knee pain.
How Does Gluteus Medius Weakness Contribute to Pain?
Weak or poorly coordinated gluteus medius muscles have been linked to several common lower extremity conditions, including:
Patellofemoral pain syndrome
Iliotibial band syndrome
Anterior cruciate ligament (ACL) injuries
Achilles tendinopathy
Chronic low back pain
In individuals with patellofemoral pain, studies have shown:
Increased hip internal rotation
Increased hip adduction
Reduced hip abductor strength
This combination can lead to excessive knee valgus, meaning the knee collapses inward during running, jumping, or squatting.
Which Exercises Best Strengthen the Gluteus Medius?
Research has evaluated gluteus medius exercises using two main approaches:
EMG activation studies
Muscle force and loading studies
EMG-Based Findings
Earlier systematic reviews identified exercises such as:
Side-lying hip abduction
Single-leg bridge
Standing hip abduction
Hip hitch (pelvic drop)
Lateral step-ups
These exercises show high muscle activation on electromyography (EMG). That is useful for understanding muscle engagement, especially in early rehab. But EMG has limitations. High activation does not automatically mean greater long-term strength or hypertrophy. It simply tells us how much the muscle is active during a specific movement.
Muscle Force-Based Findings
More recent research comparing loaded hip exercises found high gluteus medius forces during:
Side planks
Single-leg squats
Single-leg Romanian deadlifts (RDLs)
Split squats
Single-leg hip thrusts
These are weight-bearing, functional movements that require pelvic control under load. They tend to produce greater overall mechanical demand.
The Common Theme
Despite different methodologies, most research agrees on one key principle:
Effective gluteus medius exercises either involve direct hip abduction or require the pelvis to remain stable during single-leg weight-bearing tasks.
In clinical practice, both open-chain (non-weight-bearing) and closed-chain (weight-bearing) exercises have value. The right choice depends on your pain level, strength, goals, and access to equipment.
What Are the Best Physical Therapy Exercises for Gluteus Medius Strength?
Below are foundational exercises commonly used in physical therapy settings for improving gluteus medius strength and control.
1. Side-Lying Hip Abduction
Best for: Early rehab and muscle awareness
Lie on your side with legs stacked.
Keep the top leg straight and slightly behind your body.
Lift the top leg upward without rotating your hips backward.
Lower slowly and repeat.
For added resistance, use ankle weights or a resistance band. Keeping the hip in neutral or slight internal rotation may increase gluteus medius involvement.
2. Single-Leg Squat
Best for: Functional strength and knee control
Stand on one leg.
Bend the knee and hip while keeping your pelvis level.
Avoid letting your knee collapse inward.
Return to standing.
Use a chair, wall, or countertop for balance if needed. This exercise challenges both strength and pelvic stability.
3. Side Plank (With or Without Leg Lift)
Best for: Lateral hip and core stability
Lie on your side and prop yourself up on your forearm.
Keep your body in a straight line.
Hold the position.
To progress, lift the top leg while holding the plank. If too difficult, perform the plank from your knees.
4. Lateral Band Walk
Best for: Activation before workouts or sports
Place a resistance band around your knees, ankles, or feet.
Slightly bend your knees.
Step sideways while keeping tension on the band.
Moving the band lower (toward the ankles or feet) increases demand on the gluteus medius.
5. Single-Leg Romanian Deadlift (RDL)
Best for: Strength under load and balance
Stand on one leg while holding a dumbbell in the opposite hand.
Hinge at the hips and extend the free leg behind you.
Keep your pelvis level.
Return to standing.
Holding the weight in the opposite hand increases the challenge to the stance leg’s gluteus medius.
In most cases, these exercises can be performed for:
3 to 4 sets
8 to 15 repetitions
Or 20 to 45 second holds for isometric variations
Loading should gradually increase over time, as tolerated. Avoid sacrificing good form for instability. Standing on a foam pad or balance device may limit your ability to progressively add resistance.
What Mistakes Should You Avoid When Training the Gluteus Medius?
Strengthening the gluteus medius is not complicated, but there are common errors that slow progress or even aggravate symptoms.
1. Chasing the “Burn” Instead of Progress
Feeling your glutes working does not guarantee results. Research comparing squats and hip thrusts found that greater muscle sensation did not automatically translate to greater strength or muscle growth.
Focus on measurable progress:
Add resistance gradually
Improve control and range of motion
Track reps, load, or hold times
Progression drives adaptation, not just sensation.
2. Obsessing Over “Activation”
Your glutes are not asleep. They are working during most standing and walking tasks. While cueing and technique adjustments can improve efficiency, excessive focus on activation drills without progressing to meaningful loading often limits results.
Activation drills like band walks are useful as a warm-up, not as a complete strengthening program.
3. Prioritizing Instability Over Strength
Balance tools like BOSU balls or foam pads may look advanced, but they often reduce how much load you can use.
There is always a trade-off between instability and force production. If your goal is strength, you need progressive resistance. Stable surfaces allow you to safely increase load over time.
4. Training in Isolation Only
The gluteus medius never works alone. During single-leg squats, RDLs, lunges, and step-ups, it works alongside:
Gluteus maximus
Quadriceps
Hamstrings
Core stabilizers
Instead of isolating it forever, integrate it into compound movements that reflect real-life tasks.
How Should You Structure Gluteus Medius Training in a Weekly Program?
A common question in physical therapy clinics is: How often should I train my glute med?
The answer depends on your goal.
If Your Goal Is Injury Prevention or General Strength
Train 2 to 3 times per week as part of lower body workouts.
A sample structure:
Day 1
Single-leg RDL
Split squat
Lateral band walks
Day 2
Single-leg squat
Step-ups or lateral step-downs
Side plank with leg lift
Perform:
3 to 4 sets
8 to 15 reps for strength
15 to 45 second holds for planks
Allow at least 48 hours between heavy sessions.
If Your Goal Is Rehab for Knee, Hip, or Low Back Pain
Start with lower-load exercises such as:
Side-lying hip abduction
Clamshell variations
Standing hip abduction
Short side plank
Once pain improves and control increases, gradually transition into:
Single-leg squats
Split squats
Single-leg RDLs
Lateral step-downs
The key is graded exposure. Avoid sudden increases in volume or intensity.
How Does Gluteus Medius Strength Help Knee and Hip Pain?
The gluteus medius plays a major role in controlling hip adduction and internal rotation during movement. When it lacks strength or endurance:
The femur may rotate inward excessively
The knee may collapse inward
Patellofemoral joint stress may increase
Research has linked hip weakness to patellofemoral pain and abnormal movement patterns during running and jumping.
Gluteal strengthening programs have been shown to:
Reduce pain intensity
Improve stair-climbing tolerance
Decrease discomfort during squatting
Improve dynamic balance after ACL reconstruction
However, improvement rarely comes from glute strengthening alone. Effective rehab also considers:
Training load management
Running mechanics
Footwear
Mobility limitations
Overall strength balance
What About Gluteus Medius in Early Rehabilitation?
In early rehab, especially when pain is present, exercises with moderate EMG activation may be appropriate. Moderate activation (roughly 20 to 40 percent of maximum effort) is often used for:
Neuromuscular re-education
Endurance training
Motor control restoration
Higher activation exercises (40 to 60+ percent) are generally more appropriate for:
Strength development
Progressive overload
Return-to-sport preparation
Early-stage examples:
Side-lying plank with hip abduction
Reverse clamshell variations
Single-leg bridge
Later-stage examples:
Walking lunges with contralateral load
Skater squats
Unilateral deadlifts
Exercise selection should match the stage of recovery.
What Are the Best Stretches for the Gluteus Medius?
Strength is important, but flexibility and mobility matter too. Here are five useful stretches:
1. Figure Four Stretch
Lie on your back, cross one ankle over the opposite knee, and gently pull the bottom leg toward your chest.
2. Seated Glute Stretch
Sit in a chair, cross one ankle over the opposite thigh, and hinge forward with a neutral spine.
3. Standing Side Bend
Reach one arm overhead and lean to the opposite side to stretch the lateral hip.
4. Pigeon Pose
A deeper hip stretch combining flexion and rotation. Modify as needed if it feels too intense.
5. Z-Sit
A seated rotational hip stretch that challenges both internal and external rotation.
Stretching should feel like tension, not sharp pain. Hold each stretch for 20 to 40 seconds and breathe steadily.
Final Thoughts on Gluteus Medius Strength
The gluteus medius is essential for pelvic stability, knee alignment, and efficient movement. Weakness in this muscle has been associated with several lower extremity conditions, but the solution is not endless clamshells.
If you are dealing with persistent hip, knee, or low back pain in NYC, a structured evaluation can help determine whether gluteus medius strengthening should be part of your plan and how to implement it safely.
What Do They Say About Us?
Alexander Liu
"Everyone on the team at Manhattan Physical Therapy is super nice and caring. They were able to pretty quickly diagnose my knee and hip problems and immediately put me to work to reduce the pain.."
Henry Myerberg
"You're not just a patient when you come to the Manhattan Physical Therapy. You feel like family there. In particular, Erica with her colleagues John, Lidia and Joe not only fix and improve you physically, they make you feel welcomed and cared for.."
Hakyung Kim
"Everyone is so kind and helpful! my knee and hip pain have improved massively since starting Manhattan PT, highly recommend to anyone. special thanks to Bianca, Lidia, Joe, and John!"
Manhattan Physical Therapy
✆ Phone (appointments):
(212) 213-3480
Address: 385 5th Ave, Suite 503, New York, NY 10016
