Therefore, assessing HAB strength with a handheld dynamometer may be the most practical method for determining Gmed strength in athletes. However, this method of evaluation is possible only in a laboratory setting with trained personnel and specialized equipment. It is also possible to measure HAB strength through isokinetic dynamometry with specific speed conditions. Fortunately, HAB tests can be performed with a handheld dynamometer in a supine ( 2) or side-lying ( 48) body position, allowing force output to be quantified and expressed in standard units of Newton (N) or Newton meters (N However, a subjective scale ranging from 0 to 5 for such “functional” tests does not allow for detailed assessments of healthy resistance-trained athletes, because it is likely that the athlete can achieve the highest possible score during the test but may have relative muscle weakness during competition. For these tests, the tester can apply resistance to the lateral aspect of the knee ( 20), and if the tester determines that the patient's strength reaches a subjective level 4 of 5 ( 34), it is reported that the patient can sufficiently resist against low external forces. Other HAB strength tests can be performed in a supine or side-lying position using an ordinal scale of 0–5 ( 20). Thus, the TT has limited use as a measure of hip abductor function and strength in athletic, nonsymptomatic populations ( 23, 50). Although the Trendelenburg test (TT) is commonly used to determine whether Gmed weakness exists in clinical settings, it has been shown to be a poor predictor for Gmed weakness in people without a diagnosed pathology or lower-back pain. ![]() Specific Gmed strengthening is usually based on the knowledge of Gmed weakness, assessed by measuring HAB strength. Additionally, this article summarizes the exercises that result in the greatest muscle activity of the Gmed and explains the importance of including these exercises in a heavy resistance training program. Therefore, this article focuses on testing methods for determining Gmed weakness in apparently healthy athletes that mitigate the ceiling effect of traditional testing. It may be advised to include evidence-based high-intensity Gmed strengthening during heavy resistance training in athletes, as a means of preventing injury and avoiding the need for formal rehabilitation. However, the implication of specific Gmed exercises during heavy resistance training programs has not been clearly summarized. Recommendations for Gmed strengthening have been made previously, seeming to originate from a rehabilitative standpoint based primarily on anatomical function ( 34). Therefore, the importance of unilateral Gmed strengthening has been largely discussed, and a large number of exercises that target the Gmed have received attention from researchers and practitioners ( 5, 34, 35). Furthermore, Gmed injury in competitive sport has been associated with unilateral weakness, rather than a bilateral deficit ( 47, 48). In support of this, it has been shown that athletes with stronger hip abduction (HAB) strength are less likely to be injured compared with athletes with weaker HAB ( 25). One example of a weak muscle group's ability to disrupt movement is weakness of the gluteus medius (Gmed), which may result in adverse changes in kinematics ( 15), an increased risk of injury in athletes ( 25), and decreased sport performance ( 28). Therefore, it may be useful to utilize exercises that target weakened, or potentially the weakest, muscle groups within the kinetic chain so that these muscle groups do not limit force production and velocity in multijoint movements during competition. Subsequently, an efficient movement pattern can maintain optimal kinematics up until the point where the weakest muscle cannot maintain, or contribute to, the summation of forces. Specifically, exercise selection addresses which muscles in the kinetic chain should be developed to achieve the appropriate kinematics of an exercise or movement. Selected exercises must then be harmonized with other parameters such as exercise intensity, number of repetitions, speed of contraction, rest intervals, and training history to formulate an organized resistance training program. ![]() The process of individualizing workouts is important when designing a strength training program, with exercise selection being of paramount importance.
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