Gluteus Medius-Hip Adductor Interaction

Have you ever been on a teeter totter? When one person is larger than the other, it just doesn't work very well. One side is always sinking to the ground, while the other person is left hanging. It isn't nearly as fun as being able to balance each other out and sooner or later, one person is going to give in and go home.

Glute Med - Adductor Pic

That's kind of what the relationship is like between the Gluteus Medius and the Hip Adductors. The Glute Med is responsible for keeping your thigh knee out away from your midline. Conversely, your adductors' job is to pull your thigh and knee inwards towards the midline of your body. If one group is stronger or tighter than the other, the knee constantly be pulled one way or the other and something will give, causing an injury. A lack of balance in this teeter totter will eventually cause a problem (usually at the knee).

Most athletes suffer from tight and strong adductors as well as a weak Glute Med. This is a common, but dangerous combination. When this happens, the knee has a tendency to move into a Valgus position (moves inward towards the midline), causing patellafemoral pain and worse yet, and ACL injury.

What's the best way to solve this issue?

Stretch and Strengthen

Stretch the Adductors - This can be done in a variety of ways. At this point, we won't get caught up in what adductor stretch may be better or worse than another. As long as dynamic mobility and flexibility are being addressed, that's what is important. Because flexibility training desensitizes the nervous system, stretching will do 2 things to help fix this situation.

The muscles will be less sensitive to a stretching sensation, thus they will be more likely to go into an elongated position when the Glute Medius in contracting.
The decreased sensitivity will mean that it won't be as likely to activate when we don't want it to turn on. Hypersensitivity in the case of the adductors is usually negative because we need them to know how and when to shut off.

Strengthen the Gluteus Medius - There are a lot of great techniques out there. A great tool for strengthening the glute med is a loop or miniband. The videos below give a great demonstration as to how to use the Stroops Loops to maximize Glute Med activation.

What happens when this balance is out of sync?

When the Glute Med is weak and inactive, and the adductors are tight and overactive, knee pain and injury is sure to follow. The knee will move into a valgus position, causing patellafemoral knee pain and even worse, an ACL tear. This occurs the when the lower leg internally rotates and the knee moves too far into valgus for the ACL to prevent the tibia from shifting forward. This is the most common mechanism for non-contact ACL tears.

It is unfortunate, but many times a little bit of adductor flexibility and glute med strength is all it takes to get protect your athletes from very serious and debilitating injuries.

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