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Journal of Varna Medical College

Gluteal amnesia and neuromuscular inhibition: clinical significance and evidence-based approaches to assessment and intervention

Donka Nikolova, Nikolay Nedev

Abstract

Gluteal amnesia (GA) is a clinical phenomenon characterised by reduced neuromuscular activation of the gluteal muscles — primarily m. gluteus maximus and m. gluteus medius — resulting from prolonged sitting, motor dysfunction, or neurological inhibition. Despite the widespread use of the term in clinical practice, its pathophysiological basis and the evidence base for diagnosis and treatment remain insufficiently systematised.

The aim of this review is to analyse available scientific evidence on the mechanisms of neuromuscular inhibition in GA, its clinical significance in the context of low back pain, knee and hip instability, and sports injuries, and to present evidence-based methods of assessment (electromyography, clinical tests, instrumental diagnostics) and intervention (motor re-education, activation exercises, neurological facilitation).

The review includes 47 publications from PubMed, Scopus, and PEDro databases for the period 2000–2024. Results confirm the clinical significance of gluteal inhibition and the need for targeted assessment and reactivation protocols. The presented interventions demonstrate moderate to high effectiveness in selected populations.


Keywords

gluteal amnesia, neuromuscular inhibition, m. gluteus maximus, electromyography, kinesitherapy, motor re-education

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References

Попова М, Димитрова Т, Стамова В. Влияние на седящата професия върху морфологията и функцията на нервната тъкан. Management & Education / Управление и Образование. 2025;21(5):137

Стоянова-Борисова З, Стамова В. Прилагане на кинезитерапевтичен метод в спа процедурите с цел въздействие върху болката и превенция от задълбочаването й. Management & Education / Управление и Образование. 2019;15(5):139

Adler SS, Beckers D, Buck M. PNF in Practice. 4th ed. Berlin: Springer; 2014.

Boren K, Conrey C, Le Coguic J, Paprocki L, Voight M, Robinson TK. Electromyographic analysis of gluteus medius and gluteus maximus during rehabilitation exercises. Int J Sports Phys Ther. 2011;6(3):206-23. PubMed PMID: 22034614.

Contreras B, Vigotsky AD, Schoenfeld BJ, Beardsley C, Cronin J. A comparison of gluteus maximus, biceps femoris, and vastus lateralis EMG activity in the back squat and barbell hip thrust. J Appl Biomech. 2015;31(6):452-8. doi: 10.1123/jab.2014-0301.

Cook G. Movement: Functional Movement Systems. Aptos: On Target Publications; 2010.

Ducas J, Marineau E, Abboud J. Task-dependent neuromuscular adaptations in low back pain: a controlled experimental study. Front Hum Neurosci. 2024;18:1459711. doi: 10.3389/fnhum.2024.1459711.

Ferber R, Kendall KD, Farr L. Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome. J Athl Train. 2011;46(2):142-9. doi: 10.4085/1062-6050-46.2.142.

Freeman S, Mascia A, McGill SM. Arthrogenic neuromuscular inhibition: a foundational investigation of existence in the hip joint. Clin Biomech. 2013;28(2):171-7. doi: 10.1016/j.clinbiomech.2012.11.012.

Fukuda TY, Rossetto FM, Magalhaes E, et al. Short-term effects of hip abductors and lateral rotators strengthening in females with patellofemoral pain syndrome: a randomized controlled clinical trial. J Orthop Sports Phys Ther. 2010;40(11):736-42. doi: 10.2519/jospt.2010.3246.

Georgiev, Y. (2025). Development of upper limb strength in 8-10-year-old children practicing karate. Acta Scientifica Naturalis, 12(1), 39–48. https://doi.org/10.2478/asn-2025-0005)

Giggins OM, Persson UM, Caulfield B. Biofeedback in rehabilitation. J Neuroeng Rehabil. 2013;10:60. doi: 10.1186/1743-0003-10-60.

Heiderscheit BC, Sherry MA, Silder A, Chumanov ES, Thelen DG. Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. J Orthop Sports Phys Ther. 2010;40(2):67-81. doi: 10.2519/jospt.2010.3047.

Hodges PW, Tucker K. Moving differently in pain: a new theory to explain the adaptation to pain. Pain. 2011;152(3 Suppl):S90-S98. doi: 10.1016/j.pain.2010.10.020.

Jayaratne K, Standen C, Hahne A. Physical therapy management of patients with chronic low back pain and hip abductor weakness. J Man Manip Ther. 2017;25(5):258-66. doi: 10.1080/10669817.2016.1229656.

Khayambashi K, Fallah A, Movahedi A, Bagwell J, Powers C. Posterolateral hip muscle strengthening versus quadriceps strengthening for patellofemoral pain: a comparative control trial. Arch Phys Med Rehabil. 2014;95(5):900-7. doi: 10.1016/j.apmr.2013.12.022.

Krause Neto W, Krause JP, Gama EF. The impact of resistance training on gluteus maximus hypertrophy: a systematic review and meta-analysis. Front Physiol. 2025;16:1542334. doi: 10.3389/fphys.2025.1542334.

Macadam P, Cronin J, Contreras B. An examination of the gluteal muscle activity associated with dynamic hip abduction and hip external rotation exercise: a systematic review. Int J Sports Phys Ther. 2015;10(5):573-91. PubMed PMID: 26491608.

Macadam P, Feser EH. Examination of gluteus maximus EMG excitation associated with dynamic hip extension during body weight exercise: a systematic review. Int J Sports Phys Ther. 2019;14(1):14-31. PubMed PMID: 30746289.

Maffiuletti NA. Assessment of hip and knee muscle function in orthopaedic practice and research. J Bone Joint Surg Am. 2010;92(1):220-9. doi: 10.2106/JBJS.I.01207.

McGill SM. Back Mechanic: The Secrets to a Healthy Spine Your Doctor Is Not Telling You. Waterloo: Backfitpro Inc.; 2016.

Neto WK, Soares EG, Vieira TL, et al. Gluteus maximus activation during common strength and hypertrophy exercises: a systematic review. J Sports Sci Med. 2020;19(1):195-203. PubMed PMID: 32132843.

Neumann DA. Kinesiology of the hip: a focus on muscular actions. J Orthop Sports Phys Ther. 2010;40(2):82-94. doi: 10.2519/jospt.2010.3025.

Penney T, Ploughman M, Austin MW, Behm DG, Byrne JM. Determining the activation of gluteus medius and the validity of the single leg stance test in chronic, nonspecific low back pain. Arch Phys Med Rehabil. 2014;95(10):1969-76. doi: 10.1016/j.apmr.2014.06.009.

Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-30. doi: 10.7326/M16-2367.

Raju A, Jayaraman K, Nuhmani S, et al. Effects of hip abductor with external rotator strengthening versus proprioceptive training on pain and functions in patients with patellofemoral pain syndrome: a randomized controlled trial. Medicine (Baltimore). 2024;103(7):e37102. doi: 10.1097/MD.0000000000037102.

Reiman MP, Bolgla LA, Loudon JK. A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabilitation exercises. Physiother Theory Pract. 2012;28(4):257-68. doi: 10.3109/09593985.2011.604981.

Reiman MP, Thorborg K. Clinical examination and physical assessment of hip joint-related pain in athletes. Int J Sports Phys Ther. 2014;9(6):737-55. PubMed PMID: 25540703.

Rice DA, McNair PJ. Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Semin Arthritis Rheum. 2010;40(3):250-66. doi: 10.1016/j.semarthrit.2009.10.001.

Rogan S, Haehni M, Luijckx E, et al. Effects of hip abductor muscles exercises on pain and function in patients with patellofemoral pain: a systematic review and meta-analysis. J Strength Cond Res. 2019;33(11):3174-87. doi: 10.1519/JSC.0000000000002658.

Sanika V, Prem V, Karvannan H. Comparison of gluteus maximus activation to flexion bias exercises along with MET technique in subjects with anterior rotated sacroiliac joint dysfunction: a randomised controlled trial. Int J Ther Massage Bodywork. 2021;14(1):30-8. PubMed PMID: 33654504.

Selkowitz DM, Beneck GJ, Powers CM. Persons with patellofemoral pain exhibit altered hip abductor muscle recruitment while performing hip abductor exercises. Physiother Theory Pract. 2024;40(1):11-20. doi: 10.1080/09593985.2022.2101167.

Soomro RR, Karimi H, Gilani SA. Comparative efficacy of quadratus lumborum muscle energy technique with gluteus medius strengthening versus gluteus medius strengthening alone in sacroiliac joint dysfunction: a randomized controlled trial. Diagnostics (Basel). 2024;14(21):2413. doi: 10.3390/diagnostics14212413.

Ullah J, Adnan A, Ashfaq A, et al. Effects of clamshell versus gluteal bridge exercises on pain and disability in females with gluteal amnesia. J Health Wellness Community Rev. 2025;4(2). doi: 10.61838/jhwcr.4.2.84.

Van Dien JH, Reeves NP, Kawchuk G, Van Dillen LR, Hodges PW. Motor control changes in low back pain: divergence in presentations and mechanisms. J Orthop Sports Phys Ther. 2019;49(6):370-9. doi: 10.2519/jospt.2019.7917.

Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat. 2012;221(6):537-67. doi: 10.1111/j.1469-7580.2012.01564.x.




DOI: http://dx.doi.org/10.14748/jmk.v9i1.10668

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