Context: Weakness or decreased activation of the hip abductors and external rotators has been associated with lower extremity injury, especially in females. Resisted side stepping is commonly used to address hip weakness. Whereas multiple variations of this exercise are used clinically, few data exist regarding which variations to select.
Objective: To investigate differences in muscle-activation and movement patterns and determine kinematic and limb-specific differences between men and women during resisted side stepping with 3 resistive-band positions.
Design: Controlled laboratory study.
Patients or other participants: A total of 22 healthy adults (11 men, 11 women; age = 22.8 ± 3.0 years, height = 171.6 ± 10.7 cm, mass = 68.5 ± 11.8 kg).
Intervention(s): Participants side stepped with the resistive band at 3 locations (knees, ankles, feet).
Main outcome measure(s): We collected surface electromyography of the gluteus maximus, gluteus medius, and tensor fascia lata (TFL) for the moving and stance limbs during the concentric and eccentric phases. We also measured trunk inclination, hip and knee flexion, and hip-abduction excursion.
Results: Hip-abductor activity was higher in women than in men ( P ≤ .04). The pattern of TFL activity in the stance limb differed by sex. Women performed the exercise in greater forward trunk inclination ( P = .009) and had greater hip excursion ( P = .003). Gluteus maximus and medius activity increased when the band was moved from the knees to the ankles and from the ankles to the feet, whereas TFL activity increased only when the band was moved from the knees to the ankles. Findings were similar for both the stance and moving limbs, but the magnitudes of the changes differed.
Conclusions: Compared with placing the band around the ankles, placing the band around the feet for resisted side stepping elicited more activity in the gluteal muscles without increasing TFL activity. This band placement is most appropriate when the therapeutic goal is to activate the muscles that resist hip adduction and internal rotation.
Keywords: electromyography; gluteus maximus; gluteus medius; hip weakness.