Gluteus maximus and gluteus medius in pelvic and hip stability: isolation or synergistic activation?

Gluteal muscle dysfunction has been implicated in a variety of pelvic and lower limb disorders, particularly where there is a deficit in pelvic and hip stability. Rehabilitation of gluteus medius has been much advocated in the physiotherapy management of these disorders. The literature however suggests that synergistic activation of multiple muscles, and not just gluteus medius, is critical in the control of frontal plane stability. The evidence suggests the presence of functional subdivisions within these muscles, with function being dependent on appropriate synergistic activation of multiple muscles, including gluteus maximus and gluteus medius. In addition, musculoskeletal disorders appear to adversely affect many different muscles, in terms of muscle strength, size or activation pattern. The synergistic activation of these muscles, rather than isolated activation of one particular muscle, may be an important consideration in the assessment and rehabilitation of gluteal dysfunction. Further research, both laboratorybased and in the clinical environment, is required to help our understanding of how to best recruit these muscle groups and facilitate return to full function.