Many people focus on glute exercises for appearance, but experts say strong gluteal muscles are essential for movement and stability. Dr. Larry Balle, an orthopedic sports medicine specialist at Houston Methodist, explains that many individuals have some degree of glute weakness because these muscles are often neglected in regular workouts.
“Most people do have some form or some level of a glute weakness because it’s not something that they work on,” says Dr. Balle. “And you know, I hear from patients saying, ‘I work out my glutes all the time.’ And I’ll say, ‘OK, but an Instagram influencer workout where you’re doing hip thrusts on the floor is not what we’re talking about when we talk about strengthening weak glutes.'”
The gluteal muscles include the gluteus maximus, minimus, and medius—the latter being described by Dr. Balle as “the workhorse.” These muscles play a significant role in stabilizing movement and maintaining posture whether standing or sitting.
“They help provide hip stability and hip strength as far as abduction,” Dr. Balle says. “So when you’re walking or when you’re climbing stairs, these muscles are some of the main stabilizers and drivers that keep your hip and your body in the appropriate location.”
Weakness in the glutes can present as tightness, limited range of motion, or pain in areas such as the back, hips, or pelvis. Functional pain can occur due to improper muscle use rather than structural issues.
“Functional pain is when you’re not having pain from a structural issue, you’re having pain because you can’t use the right muscles with movement, and that makes other things hurt,” Dr. Balle says.
A common sign of weak glutes is hips dipping while walking—often linked to weakness in the gluteus medius.
“Most of the time, it’s the gluteus medius that’s the biggest culprit,” Dr. Balle says. “The main sign is that a person’s hips will dip when they’re walking, it looks like the hips are swaying. That’s actually a sign of hip weakness, and particularly, the gluteus medius being weak.”
When one part of the body compensates for another’s weakness over time, this imbalance can lead to injuries elsewhere such as runner’s knee (patellofemoral syndrome), IT band syndrome, plantar fasciitis, Achilles tendinitis or tendinopathy, and patellar tendinitis. These conditions often affect athletes who repeat similar movements for long periods without cross-training.
“Weakness is on a spectrum, and even something that’s super mild as far as glute weakness can cause patellofemoral syndrome [runner’s knee], which is the way the kneecap rides on the thigh bone,” Dr. Balle says. “I’ll talk to patients, and they will say, ‘You’re talking about my hip, I’m talking about my knee,’ and I tell them ‘Well, the knee bone is connected to the thigh bone, the thigh bone is connected to the hip bone, right?'”
Other mechanical issues like hip arthritis or femoral acetabular impingement (FAI) may also be associated with weak glutes rather than direct injury to those muscles.
To check for weak glutes at home, Dr. Balle recommends trying Trendelenburg’s sign test: standing on one leg with your knee bent parallel to the ground while observing if your hips tilt or you lose balance—signs that could indicate weakness.
“To do the test, have someone stand, then bring a single leg up to the position where their knee bends… If their knee comes up and their hips tilt… that’s usually a sign of glute weakness,” he explains.
For those concerned about persistent symptoms or mobility issues related to their glutes or general movement patterns should consult with their doctor.
Strengthening these muscles involves more than isolated movements; it requires comprehensive exercises targeting stability and core strength:
1. Hip stability exercises using single-leg movements while keeping hips level.
2. Dynamic core strengthening activities such as kettlebell swings.
3. Hip abduction exercises like monster walks using resistance bands.
Dr. Balle warns against focusing too much on one muscle group at risk of creating further imbalances: “There is a level of overdoing it where the gluteus medius becomes too large… instead of having balanced strength.”
He also advises caution when selecting online workouts: credentials matter more than popularity.
“I have this question from younger patients all the time because they tell me like…’Oh I can just watch Instagram and YouTube,'” Dr. Balle says. “And I tell them…if [the instructor] does not have a doctor of physical therapy (DPT) or master of athletic training (MAT) designation after their name…whatever they’re suggesting is probably not appropriate.”
If lingering pain occurs after exercise—especially if it lasts several days—it should be evaluated by a medical professional regardless of age group.
“If you’re in pain or sore after some kind of exercise —and we’re talking only a few days for younger populations under age 21— it needs to be evaluated,” Dr. Balle says.”But if you’re older and sore for longer than five to seven days…we also probably need to look at it…”
“The window is not necessarily the same…for everyone…but if pain or soreness is lingering it needs to be evaluated.”
