Forebygg kneplager- og kneskader ved bruk av common sense og vitenskap

Som jeg lenge har snakket om har styrke i setemuskulaturen (gluteus maximus, medius og minimus) er meget sentral rolle når det kommer til plager og skader, både oppover (korsrygg) og nedover (knær og ankler). Redusert styrke og stabiliseringsevne har en direkte korrelasjon med typiske overbelastnignsskader (for eksempel jumpers knee), men også akutte skader (korsbånd, sidebånd og menisk). 

 

Forebygging av slike problemer har populært blitt løst via ettbeinsøvelser, men også mer isolerte øvelser for viktig hoftemuskulatur (primært gluteus medius), men hvilke øvelser er egentlig best til de ulike formål?

 

Ettbeins knebøy og ettbeins markløft viser seg å aktivere gluteus maximus i omtrent like stor grad og viste seg også å aktivere gluteus medius i større grad enn flere andre isolerte øvelser for denne viktige muskelen. Er det kanskje en grunn til at disse øvelsene overgår leg extension og leg curls i rehab-sammenheng? Jeg dør litt hver gang jeg hører folk får anbefalt slike isolerte øvelser for sine plager (spesielt kneplager)

 

Videre ble det konkludert med at sideliggende hofteabduksjon var overlegen for aktivering av gluteus medius. Tilfeldig at denne øvelsen snek seg fint inn i e-boken Optimal Oppvarming?

  

Go hit some glutes`…..

  

Ref:

Gluteal muscle activation during common therapeutic exercises.

Distefano LJ, Blackburn JT, Marshall SW, Padua DA.

STUDY DESIGN: Experimental laboratory study. OBJECTIVES: To quantify and compare electromyographic signal amplitude of the gluteus maximus and gluteus medius muscles during exercises of varying difficulty to determine which exercise most effectively recruits these muscles. BACKGROUND: Gluteal muscle weakness has been proposed to be associated with lower extremity injury. Exercises to strengthen the gluteal muscles are frequently used in rehabilitation and injury prevention programs without scientific evidence regarding their ability to activate the targeted muscles. METHODS: Surface electromyography was used to quantify the activity level of the gluteal muscles in 21 healthy, physically active subjects while performing 12 exercises. Repeated-measures analyses of variance were used to compare normalized mean signal amplitude levels, expressed as a percent of a maximum voluntary isometric contraction (MVIC), across exercises. RESULTS: Significant differences in signal amplitude among exercises were noted for the gluteus medius (F5,90 = 7.9, P<.0001) and gluteus maximus (F5,95 = 8.1, P<.0001). Gluteus medius activity was significantly greater during side-lying hip abduction (mean +/- SD, 81% +/- 42% MVIC) compared to the 2 types of hip clam (40% +/- 38% MVIC, 38% +/- 29% MVIC), lunges (48% +/- 21% MVIC), and hop (48% +/- 25% MVIC) exercises. The single-limb squat and single-limb deadlift activated the gluteus medius (single-limb squat, 64% +/- 25% MVIC; single-limb deadlift, 59% +/- 25% MVIC) and maximus (single-limb squat, 59% +/- 27% MVIC; single-limb deadlift, 59% +/- 28% MVIC) similarly. The gluteus maximus activation during the single-limb squat and single-limb deadlift was significantly greater than during the lateral band walk (27% +/- 16% MVIC), hip clam (34% +/- 27% MVIC), and hop (forward, 35% +/- 22% MVIC; transverse, 35% +/- 16% MVIC) exercises. CONCLUSION: The best exercise for the gluteus medius was side-lying hip abduction, while the single-limb squat and single-limb deadlift exercises led to the greatest activation of the gluteus maximus. These results provide information to the clinician about relative activation of the gluteal muscles during specific therapeutic exercises that can influence exercise progression and prescription. J Orthop Sports Phys Ther 2009;39(7):532-540, Epub 24 February 2009. doi:10.2519/jospt.2009.2796.

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