What is gluteus maximus

Gluteus maximus is the largest of the three gluteal muscles and most superficial of gluteal muscles ¹. Gluteus maximus makes up most of the shape and form of your buttock and hip area. The gluteus maximus is a thick fleshy muscle with a quadrangular shape. Gluteus maximus is a large muscle and plays a prominent role in the maintenance of keeping the upper body erect. Gluteus maximus is also a site of intramuscular injection. Gluteus maximus overlies large sciatic nerve; covers ischial tuberosity only when standing; when sitting, moves superiorly, leaving ischial tuberosity exposed in the subcutaneous position.

Gluteus maximus principal function is the major extensor of the hip and it also externally rotates and abducts your thigh. Hip extension is an important action in daily activities (standing, stepping and walking) and sporting actions (running, sprint-running and jumping).

Gluteus maximus is innervated by the inferior gluteal nerve (L5–S2). Gluteus maximus dysfunction is most likely due to inferior gluteal nerve dysfunction; this would cause difficulty in rising from a seated position, climbing up stairs and loss of hip extension. The most common cause of inferior gluteal nerve dysfunction is a posterior hip dislocation. Another etiology is incorrect intramuscular (IM) injection placement. Intramuscular (IM) injection placement should be in the upper outer quadrant of the buttock. Otherwise, both the inferior and superior gluteal nerves are at risk of injury ². Paralysis of the gluteus maximus does not affect walking on a plane surface ¹. The gluteus maximus only contracts during a part of the stance phase. This phase occurs when the heal strikes the ground to when the foot is flat. The gluteus maximus works by resisting further flexion of the hip and initiate extension. The gluteus maximus actively functions when climbing upstairs or lifting from a seated position ³.

The gluteal muscles are a grouping of muscles that make up the buttock area. These muscles include:

• Gluteus maximus
• Gluteus medius
• Gluteus minimus

Figure 1. Gluteus maximus anatomy

Gluteus maximus origin and insertion

Gluteus maximus originates from the dorsal ilium, sacrum, and coccyx.

The gluteus maximus has two insertion points: superficial fibers to the greater trochanter and a band of the fascia lata (iliotibial tract) and the deep fibers that insert into the gluteal tuberosity of femur between the adductor magus and vastus lateralis. It originates in the gluteal surface of the ilium ⁴.

The gluteus maximus also has associations with three bursae ⁵. These include:

• The trochanteric bursa – separates the gluteus maximus from the greater trochanter
• Ischial bursa – separates the gluteus maximus from the ischial tuberosity
• The gluteofemoral bursa – separates the iliotibial tract from the vastus lateralis

Gluteus maximus blood supply and lymphatics

The gluteus maximus receives vascular supply by both the inferior and superior gluteal artery. These vessels enter the gluteus maximus at the center of the muscle. The inferior gluteal artery proceeds to descend along the greater trochanter of the femur. It accompanies the descent of the sciatic nerve, which proves to be critical as rupture of the inferior gluteal artery can cause gluteal compartment syndrome and sciatic nerve palsy ⁶. The artery supplies the superficial skin and anastomoses with the perforating arteries of the lower limb. The inferior gluteal artery is also susceptible to pseudoaneurysm formation following intramuscular injection ⁷.

Gluteus maximus innervation

The innervation of the gluteus maximus muscle is from the inferior gluteal nerve. The inferior gluteal nerve originates from the ventral rami of L5, S1, and S2. Classically, the inferior gluteal nerve was thought not to provide cutaneous innervation. However, the recent literature describes findings of cutaneous branches of the nerve which might contribute toward gluteal pain during lumbar disk herniation. Surgeons must also be aware of this nerve as injury might result in compression ulcers and various pain syndromes ⁸.

Gluteus maximus function

Gluteus maximus principal function is the major extensor of the thigh and it also externally rotates and abducts your thigh. Although a powerful extensor, gluteus maximus only acts when force is necessary. Gluteus maximus is most effective when thigh is flexed and force is necessary, as in rising from sitting, climbing stairs, straightening from a bending position, walking up stairs or on a hill and running. Gluteus maximus also acts on the pelvis, supports it and the trunk which is vital when a person is standing on one leg. By attaching to the tensor fascia lata, the gluteus maximus also steadies the femur ⁹. Gluteus maximus is generally inactive during standing and walking.

The gluteus maximus works with the semitendinosus and semimembranosus muscles to extend the hip. The muscle also works in conjunction with the iliopsoas, piriformis, and the obturator muscles to externally rotate the hip.

Gluteus maximus action

In athletes, the gluteus maximus muscle is among the most important to train due to its action of extension of the hip joint which translates to explosive movements ¹. A 2018 study looked at the correlation between gluteus maximus muscle to quadriceps femoris ratio in faster athletes compared to slower athletes. Results yielded that the larger the ratio, the faster the athlete ¹⁰.

Another 2018 study suggests that associated hip muscles may become more atrophied after hip arthroplasty, but larger cohorts would be needed to clarify the results ¹¹. Variability in the neuromuscular activity of the gluteus maximus in patellofemoral pain syndrome compared to healthy individuals was also documented ¹².

Gluteus maximus exercises

Though several different gluteus maximus exercises exist, a comprehensive understanding of which exercises best target the gluteus maximus and the magnitude of muscular excitation associated with each exercise is yet to be established ¹³. The findings from this review ¹³ provide an indication of gluteus maximus excitation generated by a variety of hip extension body weight exercises, which may assist practitioners in making exercise selection decisions for programming.

Figure 2. Gluteus maximus workout

Table 1. Summary of all different gluteus maximus exercise studies reviewed

Author and date	Subjects (Sex, age, height, mass)	Methodology (MVIC position and electrode site placement)	Hip extension exercises	Mean ± SD EMG excitation (%MVIC)
Worrell, Crisp, LaRosa 14	Group 1: 6 males, 7 females (22 ± 8.6 years; 171 ± 15 cm; 69.1 ± 14.1 kg) Group 2: 13 males, 6 females (27.5 ± 5 years; 175 ± 9 cm; 73.3 ± 15.3 kg)	Prone hip extension against manual resistance at 0 ° of hip flexion. Placement half-way between the second sacral prominence and the greater trochanter of the femur.	Lateral step up (20 cm height)	20 ± 11 group 1 16 ± 7 group 2
Zeller, et al. 15	9 males (20.3 ± 1 years; 182 ± 5 cm; 78.8 ± 4.0 kg) 9 females (22 ± 8.6 years; 170 ± 6 cm; 64.3 ± 5.5 kg)	Prone hip extension against manual resistance with knee flexed at 90 ° Placement not specified.	Single leg squat	62.7 ± 43 male 81.2 ± 28 female
Ayotte, et al. 16	16 males, 7 females (31.2 ± 5.8 years; 173.1 ± 10.1 cm; 77.0 ± 13.9 kg)	Supine hip extension against fixed resistance pad placed proximal to the popliteal fossa from 30 ° hip flexion. Placement 1/3rd of the distance from the second sacral vertebra to the greater trochanter.	Forward step up (15.2 cm height) Lateral step up (15.2 cm height) Retro step up (15.2 cm height) Single leg mini squat (15.2 cm depth) Single leg wall squat, other leg knee extended	74 ± 43 56 ± 29 59 ± 35 57 ± 43 86 ± 43
Ekstrom, Donatelli, Carp 17	19 males, 11 females (27 ± 8 years; 176 ± 8 cm; 74 ± 11 kg)	Prone hip extension against manual resistance applied above the knee with knee flexed to 90 ° Placement between the lateral edge of the sacrum and the posterosuperior edge of the greater trochanter.	Bridge Lateral step up (20.3 cm height) Lunge Quadruped hip extension with arm raise Single leg bridge	25 ± 14 29 ± 13 36 ± 17 56.2 ± 22 40 ± 20
Ekstrom, Osborn, Hauer 18	27 males, 32 females (age range 21-35 years)	Prone hip extension against manual resistance applied just above the knee with knee flexed at 90 ° Placement between the lateral edge of the sacrum and the posterosuperior edge of the greater trochanter.	Bridge Bridge with knees extended and feet on a swiss ball	27 ± 13 20 ± 14
Farrokhi, Pollard, Souza, et al. 19	5 males, 5 females (26.7 ± 3.2 years)	Prone hip extension against strap resistance positioned superior to the knee joint with the knee flexed to 90 ° Placement midway between the second sacral vertebra and the greater trochanter.	Lunge Lunge with trunk extension Lunge with trunk flexion	18.5 ± 11.0 19.3 ± 11.8 22.3 ± 12.0
Boudreau, Dwyer, Mattacola, et al. 20	22 males, 22 females (23.3 ± 5.1 years; 174.5 ± 9.1 cm; 74.6 ± 16.5 kg)	Standing hip extension against strap resistance placed around the distal third of the thigh with knee flexed to 90 ° Placement half the distance between the greater trochanter of the femur and the spinous process of the second sacral vertebra along an oblique angle at the level of the greater trochanter.	Forward step-up and over (20.3 cm height) Lunge Single leg squat	16.5 ± 11.7 21.7 ± 14.7 35.2 ± 24.0
Distefano, Blackburn, Marshall, et al. 21	9 males, 12 females (22 ± 3 years; 171 ± 11 cm; 70.4 ± 15.3 kg)	Prone hip extension against manual resistance with knee flexed at 90 ° Placement 1/3rd of the distance between the second sacral vertebra and the greater trochanter.	Lunge Lateral lunge Transverse lunge Single leg deadlift Single leg squat	44 ± 23 41 ± 20 49 ± 20 59 ± 28 59 ± 27
Lewis, Sahrmann 22	11 females (27.7 ± 6.2 years; 165.2 ± 3.6 cm; 62.3 ± 6.9 kg)	Prone hip extension against manual resistance with knee flexed at 90 ° Placement on the muscle belly.	Prone hip extension from hip flexion of 30 ° Prone hip extension from hip flexion of 30 ° with verbal cues to activate the glutes Prone hip extension from hip flexion of 30 ° with verbal cues to activate the hamstrings	9.7 ± 2.9 21.6 ± 9.8 11.2 ± 5.2
Sakamoto, et al. 23	16 males, 15 females (24.5 3.5 years; 170.0 ± 9.0 cm; 66.9 ± 11.9 kg	Prone hip extension against manual resistance with knee extension Placement 1/3rd of the distance between the second sacral vertebra and the greater trochanter.	Prone hip extension with knee extension Prone hip extension with 90 ° knee flexion Prone hip extension with lateral hip rotation and knee extension Prone hip extension with lateral hip rotation and knee flexion	12.7 ± 8.6 23.1 ± 21.2 22.5 ± 10.4 21.2 ± 12.0
Lubahn, Kernozek, Tyson, et al. 24	18 females (22.3 ± 2.3 years; 166.82 ± 9.2 cm; 61.1 ± 7.1 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement on the muscle belly.	Forward step up (Height unknown) Single leg squat Squat	36.4 ± 18.6 47.4 ± 21.2 21.7 ± 15.8
Boren, et al. 25	24 (Anthropometrical details not provided)	Prone hip extension against a strap with the knee flexed at 90 ° Placement not specified.	Forward step up (20 cm height) Lateral step up (15 cm height) Plank with bent leg hip extension Skater squat Single leg bridge Single leg deadlift Single leg squat Quadruped bent leg hip extension DOM Quadruped bent leg hip extension non-DOM	54.7 63.8 106.2 66.2 54.2 58.8 70.7 59.7 21.0
Bouillon, Wilhelm, Eisel, et al. 26	20 males, 20 females (22 ± 1 years; 170 ± 10 cm; 65 ± 13 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement inferior and medial to a line drawn between the PSIS and the posterior greater trochanter.	Lateral lunge Lunge	12 ± 3 11 ± 2.5
Nakagawa, et al. 27	20 males (23.5 ± 3.8 years; 176 ± 6.1 cm; 74.6 ± 9.1  kg) 20 females (21.8 ± 2.6 years; 163 ± 7.3 cm; 59.4 ± 7.3 kg)	Prone hip extension against strap with the knee flexed at 90 ° Placement parallel to the mid–muscle belly.	Single leg squat	24.6 ± 2.7 females 18.9 ± 8.9 males
Tateuchi, Taniguchi, Mori, et al. 28	10 males, 6 females (24.3 ± 5.2 years; 165.7 ± 7.9 cm; 59.0 ± 8.0 kg)	Prone hip extension against manual resistance. Placement halfway on the line extending between the sacrum and greater trochanter.	Prone hip extension from 30 ° hip flexion to 10 ° hip extension	10.9 ± 3.3
De Ridder et al. 29	8 males, 6 females (24.7 ± 3.2 years; 172.9 ± 6.4 cm; 64.5 ± 12.5 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement midway between the posterosuperior iliac spine and the ischial tuberosity.	Prone back/torso extension Reverse hyperextension	44.9 concentric 33.1 eccentric 30.3 concentric 20.3 eccentric
Kang, et al. 30	18 males, 12 females (22.8 ± 2.9 years; 170.3 ± 4.1 cm; 66.9 ± 10.8 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement halfway between the greater trochanter and second sacral vertebra in the middle of the muscle and at an oblique angle.	Prone hip extension with knee flexion with hip abducted 0 ° Prone hip extension with knee flexion with hip abducted 15 ° Prone hip extension with knee flexion with hip abducted 30 °	20.2 ± 8.6 23.4 ± 9.9 29.6 ± 11.5
Lee, Ko, Lim 31	20 males (22.9 ± 2.1 years; 174.4 ± 3.9 cm; 70.0 ± 6.2 kg)	Side-lying hip abduction against strap resistance with the hip in 90 ° abduction. Placement 1/3rd of the distance between the second sacral vertebra and the greater trochanter.	Lunge Lunge with compression pelvic belt Single leg deadlift Single leg deadlift with compression pelvic belt Single leg squat Single leg squat with compression pelvic belt	11.5 ± 6.9 13.9 ± 7.7 27.9 ± 18.4 36.3 ± 21.9 30.5 ± 19.4 35.5 ± 21.7
Webster, Gribble 32	1 male, 8 females (22.9 ± 4.5 years; 164 ± 6.5 cm; 65.4 ± 10 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement half-way between the second sacral prominence and the greater trochanter of the femur.	Single leg squat with rotation Transverse lunge	78 ± 45 58 ± 3
Bolgla, et al. 33	18 males (24.3 ± 3.4 years; 180 ± 10 cm; 81.2 ± 9.7 kg) 16 females (24.0 ± 1.5 years; 165 ± 10 cm; 59.9 ± 8.8 kg)	Prone hip extension against strap with the knee flexed at 90 ° Placement parallel alignment over the belly.	Single leg wall slide, other leg knee flexed Single leg mini-squat Lateral step down (20 cm height) Forward step down (20 cm height)	21.6 male 32.0 female 20.3 male 26.6 female 8.4 male 24.6 female 19.0 male 27.2 female
Hollman, Galardi, Lin, et al. 34	41 females (18-36 years)	Prone hip extension against strap with the knee flexed at 90 ° Placement at one-half the distance between the sacrum and greater trochanter.	Single leg squat	20.9-23.8
Emami, Arab, Ghamkhar 35	10 males (22.5 ± 3.8 years; 177 ± 7 cm; 74.1 ± 8.0 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement at the midpoint of a line running from S2 to the greater trochanter.	Prone hip extension with knee extension	18.3 ± 12.1
MacAskill, Durant, Wallace 36	14 males, 20 females (21.5 ± 1.7 years; 170.5 ± 11 cm; 67.6 ± 7.5 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement 1/3rd of the distance between the second sacral vertebra and the greater trochanter.	Forward step up (15 cm height) Lateral step up (15 cm height)	28.7 ± 18.7 31 ± 19.9
Park, Yoo 37	18 males (21.9 ± 2.2 years; 175.1 ± 5.3 cm; 66.6 ± 8.4 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement at half the distance between the trochanter and the sacral vertebrae in the middle of the muscle on an oblique angle.	Back/torso extension with extended knees and hands across chest Back/torso extension with extended knees and hands behind head Back/torso extension with flexed knees 90 ° and hands across chest Back/torso extension with flexed knees 90 ° and hands behind head	28.3 ± 14.5 26.5 ± 13.6 34.8 ± 20.6 36.6 ± 22.6
Suehiro, et al. 38	21 males (20.2 ± 0.4 years; 171.1 ± 5.0 cm; 64.3 ± 10.5 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement halfway between the greater trochanter and the second sacral vertebra.	Prone hip extension with 90 ° knee flexion and neutral hip position Prone hip extension with 90 ° knee flexion and 15 ° hip abduction Prone hip extension with 90 ° knee flexion and 15 ° hip abduction and 20 ° hip external rotation	14.1 ± 9.4 22.5 ± 13.6 41.0 ± 23.6
Kim, Kim 39	14 males, 16 females (24.7 ± 3.2 years; 167.5 ± 8.2 cm; 61.5 ± 6.9 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement 1/3rd the distance between the second sacral vertebrae and the greater trochanter.	Prone hip extension to 10 ° Prone hip extension to 10 ° with abdominal drawing-in Prone hip extension to 10 ° with pelvic tilt > 15 ° Prone hip extension to 10 ° with abdominal drawing-in with pelvic tilt > 15 °	23.9 ± 18.5 24.4 ± 14.3 32.5 ± 21.3 45.9 ± 33.7
Kim, Yoo 40	18 males (23.3 ± 1.8 years; 177.4 ± 5.3 cm; 74.2 ± 7.2 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement not specified.	Prone hip extension with upper body on table Prone hip extension with body on floor	62.3 ± 27.1 56.5 ± 20.2
Mills, Frank, Goto, et al. 41	20 females (Anthropometrical details not provided)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement 1/3rd the distance between the second sacral vertebrae and the greater trochanter	Squat	12.4 ± 6.3
Yoon, Lee, An 42	15 subjects (26.7 ± 3.7 years; 167.1 ± 9.2 cm; 58.1 ± 11.7 kg)	MVIC position not specified Placement not specified	Prone hip extension from 0 ° hip flexion Prone hip extension from 15 ° hip flexion Prone hip extension from 30 ° hip flexion	19.7 ± 7.9 22.5 ± 9.4 18.9 ± 7.8
Youdas, Hartman, Murphy, et al. 43	13 males (23.4 ± 1.3 years; 180 ± 10 cm; 79.7 ± 10.6 kg) 13 females (23.5 ± 1.2 years; 170 ± 10 cm; 63.7 ± 7.4 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement on the muscle belly, parallel to the line of action.	Bridge Bridge with feet on swiss ball Single leg bridge Single leg bridge with foot on bosu Bridge with hamstring curl Bridge with feet on swiss ball and hamstring curl	16.4 13.0 32.6 28.4 18.5 10.9
Choi, Bak, Cho, et al. 44	14 males, 13 females (27.8 ± 5.8 years; 166.4 ± 10.1 cm; 66.2 ± 13.4 kg)	MVIC position not specified Placement between the sacrum and greater trochanter	Bridge Single leg bridge Single leg bridge (raised leg abducted to 30 °)	41.5 ± 16.4 47.3 ± 16.0 46.7 ± 12.0
Jeon, et al. 45	16 males (25.4 ± 4.2 years; 174.7 ± 2.8 cm; 73.1 ± 2.1 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement at the midpoint of the line extending between the greater trochanter and sacrum	Prone hip extension with upper body on table Prone hip extension with upper body on table and abdominals drawing-in Prone hip extension with upper body on table and flexed contralateral knee joint on a chair	43.9 ± 16.1 47.5 ± 19.8 66.4 ± 25.8
Lee, Song, Kwon 46	10 males, 10 females (21.1 ± 1.8 years; 168.7 ± 8.3 cm; 66.1 ± 12.3 kg)	MVIC method not specified. Placement at 50% on the line between the sacral vertebrae and the greater trochanter	Squat with 0 ° trunk flexion Squat with 15 ° trunk flexion Squat with 30 ° trunk flexion	6.1 ± 4.0 6.3 ± 4.0 8.0 ± 4.9
Selkowitz, Beneck, Powers 47	10 males, 10 females (27.9 ± 6.2 years; 170.5 ± 11.1 cm; 67.7 ± 14.1 kg)	Four conditions normalised to whichever contraction elicited greater EMG excitation: 1) Prone hip extension of 45 ° with the knee flexed at 90 ° against strap resistance. 2) Prone hip extension of 0 ° with the knee flexed at 90 ° against strap resistance. 3) Sidelying position with hip in 30 ° abduction and knee extended against strap. 4) As position 3 with hip in 45 ° flexion. Placement Gmax (S) inserted superior and lateral to the midpoint of a line drawn between the posterior superior iliac spine and the posterior greater trochanter, Gmax (I) inserted inferior and medial to the midpoint of the same line, such that it was 2.5 to 5.0 cm above the gluteal fold.	Bridge Forward step up Lunge Single leg bridge Squat Quadruped hip extension with knee extended Quadruped hip extension with knee flexed	17.4 ± 12.0 (S) 22.3 ± 10.1 (I) 22.8 ± 15.6 (S) 15.7 ± 6.0 (I) 20.1 ± 11.1 (S) 18.5 ± 6.2 (I) 34.6 ± 16.8 (S) 36.7 ± 10.0 (I) 12.9 ± 7.9 (S) 10.5 ± 7.1 (I) 28.5 ± 16.6 (S) 31.2 ± 16.5(I) 30.1 ± 12.5 (S) 34.3 ± 16.3 (I)
Chan, et al. 48	10 males, 10 females (21.1 ± 1.7 years; 166.8 ± 7.9 cm; 58.1 ± 9.2 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement 1/3rd of the distance from iliac crest to greater trochanter, starting from greater trochanter.	Prone hip extension up to 20 ° with 90 ° knee flexion Prone hip extension up to 20 ° with 90 ° knee flexion with abdominal bracing	14.8 concentric (S) 12.3 eccentric (S) 20.1 concentric (I) 11.7 eccentric (I) 19.7 concentric (S) 16.6 eccentric (S) 25.6 concentric (I) 36.0 eccentric (I)
Hollman, et al. 49	15 females (23.3 ± 1.7 years; 169.4 ± 8.3 cm; 62.6 ± 6.7 kg)	Prone hip extension against strap resistance with the knee flexed at 90 ° Placement halfway between the sacral vertebrae and the greater trochanter	Bridge Bridge with verbal and tactile cueing	16.8 33.0
Lehecka, et al. 50	12 males, 16 females (23.4 ± 2.3 years; 173 ± 11 cm; 72.6 ± 13.9 kg)	Prone hip extension against strap resistance with the knee flexed at 90 ° Placement anterosuperior to Gmax, inferior to the lateral aspect of the iliac crest on a line towards the greater trochanter on the muscle belly.	Single leg bridge. DOM leg 90 ° knee flexion with foot flat. Non-DOM leg knee extended Single leg bridge. DOM leg 135 ° knee flexion with foot flat. Non-DOM leg knee extended Single leg bridge. DOM leg 90 ° knee flexion with foot flat. Non-DOM leg knee relaxed in flexion and femur vertical Single leg bridge. DOM leg 90 ° knee flexion with dorsiflexed ankle. Non-DOM leg knee relaxed in flexion and femur vertical Single leg bridge. DOM leg 135 ° knee flexion with dorsiflexed ankle. Non-DOM leg knee relaxed in flexion and femur vertical	51.0 ± 28.1 47.4 ± 24.8 47.2 ± 28.1 49.1 ± 26.4 40.4 ± 24.6
Van Oosterwijck, et al. 51	4 males, 9 females (22.6 ± 2.1 years; 172 ± 7.3 cm; 61.3 ± 9.5 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement midway between the posterosuperior iliac spine and the ischial tuberosity).	Prone back/torso extension without lumbopelvic control strategy Prone back/torso extension with lumbopelvic control strategy Reverse hyperextension without lumbopelvic control strategy Reverse hyperextension with lumbopelvic control strategy	23.8 ± 10.1 32.4 ± 21.6 22.0 ± 7.7 38.8 ± 24.1
Youdas, et al. 52	13 males, 13 females (23.5 ± 1.2 years; 175.0 ± 10.0 cm; 71.7 ± 9.0 kg)	Prone hip extension against manual resistance with the knee flexed at 90 ° Placement parallel to the muscle’s line of action.	Single leg bridge Supine manual resisted hip extension	33.8 34.7

Though several limitations exist within this review, some general observations can be made as follows:

1. Body weight hip extension exercises provided a wide range of gluteus maximus electromyography excitation ranging from 6.1% to 106.2% maximum voluntary isometric contraction (MVIC);
2. When pooled as an average, similar levels of excitation were found between force vectors though the range of excitation levels differed between vectors;
3. Unilateral exercises produced higher electromyography values compared to the bilateral version of the same exercise;
4. Females exhibited greater electromyography excitation than males in all hip extension exercises,
5. Verbal and tactile cues increase gluteus maximus electromyography excitation, while bracing and drawing-in the abdominals also increase excitation levels; and,
6. Hip extension exercises performed in greater degrees/angles of hip flexion, hip abduction or hip external rotation result in higher measured electromyography excitation levels.

The pooled averaged values for the same exercises should be interpreted as a guideline and caution should be used for interpreting their findings with further research into each exercise with the same methodology required to verify these results. Moreover, this review focused on body weight exercises, therefore, whether the loaded version of the same exercises in this review results in similar findings requires investigation. When strengthening a weaker muscle or muscle group, practitioners may wish to prescribe a gradual and progressive exercise program to ensure the targeted area is developed. Practitioners should initially consider exercises performed in the horizontal vector as they provide a large base of support and are less challenging compared to vertical vector exercises. Moreover, bi-lateral exercises should be mastered before prescribing unilateral versions. This may be of importance if individuals seek and implement a compensatory movement pattern when faced with weakness or dysfunction. Individuals may benefit from being prescribed exercises that they can perform with good technique without substitution. Subsequently, once this can be achieved, exercise difficulty can be progressed with more demanding exercises.

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