A positive Trendelenburg test or sign can indicate weak hip abductors including your gluteus medius and minimus muscles. On the other hand, a positive Trendelenburg test can also indicate other problems such as arthritis. Therefore, consult your physician prior to starting an exercise program. Once you are diagnosed with weak hip abductors, start performing strength exercises including side-lying clams, hip hikes and lunges.
You perform the Trendelenburg test in a standing position with your feet shoulder width apart. Slowly lift one foot off the ground, balancing on your other foot. A positive test or Trendelenburg's sign is when the hip of your non weight-bearing leg drops or is lower than the other side. Your uneven hips indicate that the hip abductors on your weight-bearing leg are weak and cannot stabilize your pelvis.
Hip-abductor-strength exercises in a non weight-bearing position isolate your abductor muscles and require little to no hip stabilization. You do side-lying clams lying on your unaffected side with your legs together and your knees slightly bent. Slowly raise your top knee keeping your feet together. You can perform this exercise lying on your back, as well, with your knees bent and your feet on the floor
To increase the difficulty of these exercises, straighten your legs and abduct your entire leg, not just your knee. You can also wear a resistance band around your thighs. Perform two to three sets of 10 to 20 repetitions, three to five days a week.
In a standing or weight-bearing position, your abductors not only perform a movement but stabilize your hips. For a standing hip hike, balance single-leg on your affected or weak leg, either on the floor or a step. Slowly hike or raise the hip of your non weight-bearing leg and lower your hip back down.
For lateral-band walks, start with a band around your thighs and legs together. Take a step sideways with your weak leg and then step in with your other leg and repeat. Do not cross your legs or step too far out. Perform two to three sets of 10 to 20 repetitions, three to five days a week.
Functional abductor exercises are dynamic movements and require your hip abductors to effectively stabilize your pelvis so you do not fall during the exercise. Perform step-ups by stepping up onto the step using your weak leg in a forward step or in a side step.
For lunges, start in a staggered stance with your weak leg forward. Slowly lean into your front leg and lower yourself down, bending your front knee and hip. Keep your weight in your front heel and back toe. Progressions include single-leg squats and added resistance with free-weights or resistance bands. Perform two to three sets of 10 to 20 repetitions, two to three days a week.