Hip Abduction Assessment
Hip abduction in side lying with the hips and knees straight is a movement test designed to assess a subject’s ability to activate their gluteus medius muscle in conjunction with the tensor fascia latae and quadratus lumborum. It is believed that the primary role of the gluteus medius is to stabilize the head of the femur in the acetabulum during gait and during active hip abduction, acting biomechanically in a similar fashion as the rotator cuff of the shoulder when elevating the arm. Inhibition/weakness of the gluteus medius is commonly observed and has been reported in patients with a Trendelenburg gait and DJD of the hip. It is therefore essential to assess for the recruitment and activation of the gluteus medius in patients presenting with hip and low back pain symptoms. Dr. Vladimir Janda originally described facilitation of the TFL and/or quadratus lumborum in substitution for gluteus medius inhibition/weakness, resulting in a faulty hip abduction muscle firing pattern. Faulty muscle firing patterns during the HIP ABDUCTION TEST can result in hip hiking by the quadratus lumborum and/or flexion and IR of the leg by an overactive/facilitated TFL.
Mark noted that patients with gluteus medius weakness often presented with a superior and anteriorly displaced humeral head with restricted inferior and posterior glide. He also found a number of other biomechanical dysfunctions contributing to the inhibition of the gluteus medius, including hypertonicity of the hip adductors, lower lumbar segmental dysfunctions involving L4-5 or L5-S1, and/or sacroiliac joint dysfunction on that side.
In Rehab Links Module #5 you will learn how to specifically examine your subject using the side lying HIP ABDUCTION MOVEMENT TEST. In Rehab Links Module #6 the causes and manual treatment to address the dysfunctional biomechanical factors that result in gluteus medius inhibition are covered in detail. This is followed by the appropriate retraining exercisesin Rehab Links Module #7 that can be given to patients so that they can eventually perform Hip Abduction with the appropriate activation of the gluteus medius and avoid excessive recruitment of the TFL and quadratus lumborum.
Lisa Chase and Mark Bookhout launched the Rehab Links Systems online platform – a unique exercise software for medical, health and fitness professionals – to help users link manual therapy treatments with a client-specific individualized home exercise program that results in improved clinical outcomes.
Click here to view the online module series and learn more. If you have already taken an exercise course with Bookhout Seminars or Back 2 Normal Institute, Rehab Links also enables you to deepen your knowledge through membership and mentoring opportunities.