July 2014

Athletes with hip flexor tightness have reduced gluteus maximus activation

In the moment: Sports medicine

By Jordana Bieze Foster

Hip flexor tightness is associated with reduced gluteus maximus activation during an overhead squat, according to findings from the University of North Carolina at Chapel Hill (UNC) that are consistent with the “lengthen and strengthen” approach to injury prevention.

Investigators compared gluteus maximus activation during an overhead squat in 20 female college soccer players with hip flexor tightness (above horizontal on a modified Thomas Test) and 20 matched controls (15° or more below horizontal).

Gluteus maximus activation was significantly lower in the group with tight hips than in the controls. The gluteus maximus-to-biceps femoris coactivation ratio was also significantly lower in the players with hip flexor tightness.

Matt Mills, MA, ATC, a former graduate student at UNC who is now an athletic training fellow at Stanford University, presented the findings in June at the annual meeting of the National Athletic Trainers Association.

“If these findings bear out, it brings a lot of credibility to the ‘lengthen and strengthen’ approach, where we lengthen the hip flexors before we strengthen the gluteus maximus,” Mills said.


Mills M, Frank B, Blackburn T, et al. Effect of limited hip flexor length on gluteal activation during an overhead squat in female soccer players. J Athl Train 2014;49(3 Suppl):S-83.

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