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The side lying leg lifts (or side lying leg raises) exercise is a corner stone of many Physical Therapy exercise programs because it plays an important role in keeping our hip and knees strong. Let’s cover how to do these exercises correctly. But before we do that, we should discuss the benefits of side lying leg lifts.

Side Lying Leg Lifts Benefits

The side lying leg lifts exercise has many benefits. I recommend side lying leg raises to my clients because they improve:

  • Daily functions (for example, climbing stairs, squatting to pick up an item, walking and running).
  • Balance and fall risk reduction.
  • Hip and knee strength.

Why You Should Consider the Side Lying Leg Lifts Exercises

The side lying leg raise exercise is an important preparation for bone building exercises such as the band walks, squats, jumps, and others.

The side lying leg lift exercises presented in this blog are in the Beginner, Active and Elite Levels of Exercise for Better Bones.

I chose the side lying leg lifts for the Beginner and Active exercises because it is very easy to “cheat” when doing a leg lift exercise in a standing position. Standing exercises are more osteogenic (that is, more effective at building bone) than exercises in a lying position.  The side lying leg raises exercises in the Beginner and Active levels ensure you activate the correct muscles so that they support you in your daily activities. I would rather you do these two exercises well and improve the strength of these muscles than have you do more “advanced” standing exercises poorly and work the wrong muscles.

Once you have mastered these Beginner and Active exercises and learn which muscles to activate, then I encourage you to progress to the Standing Band Walks. The Standing Band Walks exercise is part of the Athletic program.

The Elite Level side leg lift is a great exercise that incorporates core stability, upper body weight bearing (you can never get enough of that) while further building the strength of our hip abductors.

Lying Leg Lifts and Lying Leg Raises

Side lying leg lifts are often called side lying leg raises, lying leg lifts or side leg lifts. I use each of these terms interchangeably in this post.

Hip Joint Anatomy

The two main bones of your hip joint are the:

  • Head of your femur (thigh).
  • Acetabulum (socket) of the pelvis.

The neck of the femur connects the shaft of your femur to the head. This area is important for many people with osteoporosis because it is often at risk of fracture.

There are twenty-two muscles surrounding your hip joints. Each one of them keeps your back, hips and knees happy and healthy. In this post, we are particularly interested in three of these muscles: the Gluteus Medius, the Gluteus Minimus, and the Tensor Fascia Lata.

When we rest our hands above and to the outside of our back pockets, we can feel our hip abductor muscles:

  • Gluteus Medius.
  • Gluteus Minimus.
  • Tensor Fascia Lata.

The first two hip abductor muscles,  the Gluteus Medius and the Gluteus Minimus, attach the pelvic bone to the femur (leg) bone.

The movement of a leg away from the midline of the body strengthens our hip abductor muscles. This movement is referred to as abduction. One of the objectives of the side leg lifts exercises is to strengthen the three muscles mentioned above.

Gluteus Medius and Gluteus Minimus are close to the largest of the buttock muscles, the Gluteus Maximus. The Gluteus Maximus is a hip extensor muscle that provides movement of the leg that extends your thigh.

The graphic on the right illustrates each of the gluteal muscles. Please note that the artist has separated the individual muscles and that, in fact, they are layered on top of each other.

gluteus minimus maximus medius • melioguide physical therapy

Hip Strength and Knee Osteoarthritis

Many of us who are concerned about our bones and the risk of falling are also concerned about our joint health. The good news is that working on your hip abductor strength can help both!

In the past two decades researchers, such as Nigel Arden and his team, have shown that individuals with knee osteoarthritis (OA) and knee pain “have an increased risk of both non-vertebral and hip fracture. This is not explained by the increased risk of falls, but is more likely to be due to the severity of falls sustained. Knee pain and osteoarthritis should be regarded as independent risk factors for fracture.” (1)

Building strong hips muscles “reduces the load on the knee. The reduced load on the knee limits the intensity of the fall and diminishes the chance of a fracture.” (1)

Hip strengthening exercises, specifically of the hip abductor, help support the knee joint. A second research team had a study group of patients with knee OA complete a home hip abductor strengthening program. The team found that the group of exercisers with knee OA demonstrated significant improvement in hip abductor strength. Functional performance on the sit-to-stand test improved in the osteoarthritis group compared with the control group. (2)

The research team also reported that the “osteoarthritis group reported decreased knee pain after the intervention.” (2) A win-win all around!

Hip Abductor Strength and Trendelenburg Gait

The most robust of the hip abductors are your, Gluteus Medius and Gluteus Minimus muscles. Their job is to keep our pelvis level whenever we transfer your weight onto one leg. Weakness in either of these muscles causes you to walk with a limp, reduces your ability to balance on one leg, and increases your risk of falling.

If not care is not taken and the weakness progresses, a Trendelenburg gait can develop. Trendelenburg gait is a dysfunctional walking pattern that the body assumes because the muscles become too weak to hold the pelvis level. In order to reduce the load on the weakened hip abductors, an individual will often shift their torso over their stronger leg. Note that there are many other conditions that can cause a Trendelenburg gait. (3)

If you or someone you love walks with a Trendelenburg gait, please seek medical attention and do not self diagnose.

Hip Abductor Strength and Balance

A study published in the journal, Osteoporosis International, in 2014 showed that stronger hip abductors improves your balance. The authors found that your ability to stand on one foot reduces your fall risk. (4)

Femoral Neck Strength

The femoral neck is located in the hip area. A stronger femoral neck reduces the risk of fracture for individuals with osteoporosis. You can learn more by reading my blog post on the femoral neck.

Trigger Points in the Hip Abductors

Trigger points in the hip abductor muscles are a common cause of low back, buttock and leg pain.  It is important that you do not have trigger points in these muscles before you start working on exercises that will place more demand on them.  For more information on how you can self treat your tripper points, I highly recommend The Trigger Point Therapy Workbook, 3rd edition by Clair and Amber Davies. (5)

In their book, the Davies’ wisely share this tip: “as a safeguard for the Gluteus Medius muscles, don’t stand on one leg to put on your pants. You can easily strain a muscle when you catch your foot in a pants leg and unexpectedly have to catch your balance. Sit down to get both feet through, then stand to finish pulling your pants up. It may seem a little silly at first, but it’s a habit that becomes increasingly valuable with passing years.”

Many of my clients are afflicted with tenderness in their Gluteus Medius and Minimus muscles.  I advise them to restrict their balance training to the exercises I gave them and not to when they put on their pants, shoes, boots, socks, etc.

Lastly, when doing side lying leg lifts, your therapist may ask you to do the lift with your knee cap pointing gently towards the sky (hip external rotation). This external rotation of your thigh places you in a position to strengthen the posterior portion of your Gluteus Medius. (6)

trigger-point-therapy-workbook-cover

Side Lying Leg Raises

The three variations of the side lying leg raises exercise are:

  1. Side Leg Lifts
  2. Use a Weight with Side Lying Leg Raise
  3. Perform Side Leg Lifts on Stability Ball

The specific side leg lift variation I recommend depends the client’s current level of fitness and their health goals.

Let’s start with the first Side Leg Lifts exercise.

Side Leg Lifts

The side leg lifts exercise is a beginner level Strength exercises in the Exercise for Better Bones program. This exercise targets the abductor muscles (the muscles of your upper hip and buttocks) and the hip bones.

Directions

Here are the step-by-step directions you should follow to complete this exercise.

Exercise Mat or Carpet for Support

An exercise mat or a comfortable carpet is advisable when doing the side lying leg raise exercise.

Use a Small Towel at Your Waist

Have a small towel that you’re going to place at your waist so that when you lie down on your side, the towel fills in the space.

Use Your Arm or Pillow to Support Your Head

Use either your arm or a pillow for support underneath your head.

Get in Position

Lie on your left side, first. Comfortably bend your bottom knee. Your top knee is straight in a line behind you.

  • Make the same movement as if you are up against a wall.
  • Heel is in that same line as your torso, up against that wall.
  • Place the top hand right in front of yourself.
  • Allow yourself to roll into your hand ever so slightly so that if you had a light shining off your hip bone, it would be hitting the floor about six feet in front of you.

Keep a slight forward tilt of the pelvis. Don’t roll backward on this exercise.

side lying leg lifts

Now that You Are in Position …

In this position:

  • Take a breath in.
  • Exhale.
  • Lead with the heel.
  • Lift … count  “two, three”.
  • Lower leg back down.

If you find lift your leg up quite high, you can pretty well assure yourself that you’ve cheated.

side lying leg lift with weight

If we lift up high, we’re using our front hip flexors and quadriceps rather than our hip abductors. The hip abductors are attached close to a common fracture site, the femoral neck

We really want to get these Glute muscles working.  That really makes us much more stable when we walk and do a lot of exercises.

Again, follow these steps:

  • Hips slightly forward.
  • Focus on leading with the heel.
  • Hand in front.
  • Breath in.
  • Slowly, gently tighten your tummy as you lift the leg.
  • Hold and exhale.
  • Slowly lower leg back down.

Repeat, breath, and back down.

side lying leg lift • side leg raise

Tips

Here are a two tips that might help you when you practice the side leg lifts.

  1. If you hips are wider than your waist, you should place a small pillow or rolled towel in the space between your pelvis and rib gage as illustrated in the two immediate photos above.
  2. Your top heel should remain in contact with the wall throughout the exercise.

Physical Therapy Guidance

The video on the left provides additional guidance for Physical Therapists when they work with patients and want to use the side lying leg lift exercise.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?

A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day. You can look at the videos at anytime and as often as you like.

I cover important topics related to osteoporosis exercise including:

  • Can exercise reverse osteoporosis?
  • Stop the stoop — how to avoid kyphosis and rounded shoulders.
  • Key components of an osteoporosis exercise program.
  • Key principles of bone building.
  • Exercises you should avoid if you have osteoporosis.
  • Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
  • Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.

  • This field is for validation purposes and should be left unchanged.

Side Lying Leg Raise with Weight

The side lying leg raise with weight is a strength exercise that targets the abductor muscles and the hips. If you find this exercise too advanced, you should try the side leg lift exercise without weights (on the left).

Instructions

The side lying leg raise with weight is an intermediate level strength training exercise.

How to Get in Position

You’ll need a weight to place on your ankle and a small roll to go underneath your waist.

Lie on your right side and ensure that the towel is right at your waist fold.

  • Place your arm underneath your head or a pillow.
  • Bottom leg comfortably bent.
  • Top leg is in line with your trunk, and up against the wall. This will enable cuing for you to bring yourself back and keep your leg in that alignment with your torso.
side lying leg lifts

Perform the Exercise

In this position, roll your hips slightly forward.

If you had a headlight on your forehead, you’d want to be aiming toward about six feet in front of you so that you’re not blinding people coming into the room.

Keep your leg back, hold, two, three, and slowly back down. One more time, breath in, lift leading with the heel, two, three, and back down.

Consider Adjusting the Weight Location

If you find that you have a weight that only allows you to get through six repetitions, you’re going, take the weight and start with it higher up the leg.

You may want to purchase a weight that’s a little bit heavier and start with your leg lifts with the weight closer to the knee.

The shorter the lever — the closer the weight is to the muscle that’s working — the less heavy it’s going to feel.

It might be the right intensity for you initially. As you get stronger, you gradually move the weight away from the muscle you’re working so that, eventually, it’s back at your ankle.

side lying leg lift • side leg raise

Tips

Here are a few tips to help you with this exercise:

  1. If your hips are wider than your waist, place a small pillow or rolled towel in the space between your pelvis and rib cage.
  2. Your top heel should remain in contact with the wall throughout the exercise.
  3. The closer to the ankle the weight is located, the heavier it will feel.
  4. If you are unable to do the required number of repetitions with the weight at your ankle, start with it resting on your thigh above the knee and slide it down as you get stronger.

Side Leg Lifts on Stability Ball

The Side Leg Lifts on Stability Ball is a strength exercise from the Exercise for Better Bones program specifically designed for the Elite Level. The exercise targets the hip abductor muscles. It also targets the bones in the wrist and hips. This exercise should only be done with the correct sized and safe burst resistant physio or exercise ball.

Instructions

The following are the instructions for the side lying leg lifts on a stability ball.

You need the ball to be the right size for you. If you’re not 100% sure please go refer back to the ball size recommendations.

  1. You want to be in side kneeling position.
  2. Place the ball right up against one hip.
  3. Take your hand and place it right underneath your shoulder.
  4. Tuck the ball with your elbow, so you’re tucking the ball with your hip and your elbow.
  5. Step on the outside of your ankle so your hand and your foot are in the same line.
  6. Other leg sits on top.
  7. If this is a new exercise for you, you can place your hand on the ball for a little additional stability.
  8. Your head is in line with your body, so it’s a nice neck strengthening exercise as well.
  9. Take a breath in and lead with your heel.
  10. Lift up towards the ceiling and back down.
  11. Again, lift up towards the ceiling and back down.
  12. If you want to make this exercise a little harder you can incorporate the arm and leg lift into the exercise.

Congratulations. You have mastered the elite level side leg lifts on a stability ball.

References

  1. Arden, NK, et al. Knee pain, knee osteoarthritis, and the risk of fracture. Arthritis Care & Research. Volume 55, Issue 4, Pages 610-615, 15 August 2006.
  2. Sled EA, et al. Effect of a home program of hip abductor exercises on knee joint loading, strength, function, and pain in people with knee osteoarthritis: a clinical trial. Physical Therapy, 2010 Jun;90(6):895-904. doi: 10.2522/ptj.20090294. Epub 2010 Apr 8.
  3. Hoppenfeld, Stanley Physical Examination of the Spine and Extremities. 1976 Appleton-Century-Crofts/NY.
  4. Lundin, H., Sääf, M., Strender, LE. et al. Osteoporos Int (2014) 25: 1305.
  5. Clair Davies and Amber Davies. The Trigger Point Therapy Workbook, 3rd ed.New Harbinger Publications 2013.
  6. Shirley Sahrmann.  Diagnosis and Treatment of Movement Impairment Syndromes. Mosby publishing 2002.

Exercise Recommendations for Osteoporosis

Exercise is an essential ingredient to bone health. If you have osteoporosis, therapeutic exercise needs to be part of your osteoporosis treatment program.

But what exercises should you do and which ones should you avoid? What exercises build bone and which ones reduce your chance of a fracture? Is Yoga good for your bones? Who should you trust when it comes to exercises for osteoporosis?

A great resource on exercise and osteoporosis is my free, seven day email course called Exercise Recommendations for Osteoporosis. After you provide your email address, you will receive seven consecutive online educational videos on bone health — one lesson each day. You can look at the videos at anytime and as often as you like.

I cover important topics related to osteoporosis exercise including:

  • Can exercise reverse osteoporosis?
  • Stop the stoop — how to avoid kyphosis and rounded shoulders.
  • Key components of an osteoporosis exercise program.
  • Key principles of bone building.
  • Exercises you should avoid if you have osteoporosis.
  • Yoga and osteoporosis — should you practice yoga if you have osteoporosis?
  • Core strength and osteoporosis — why is core strength important if you have osteoporosis?

Enter your email address and I will start you on this free course. I do not SPAM or share your email address (or any information) with third parties. You can unsubscribe from my mail list at any time.

  • This field is for validation purposes and should be left unchanged.

Osteoporosis Exercise Plan

Visit my Osteoporosis Exercise Plan page for more information on this topic.

Comments

February 22, 2018 at 8:56pm

Lizette

I am trying to design a routine with the exercises on your videos.
Do I have to follow a certain order?
How can I work out a 3 day plan with your exercises? I feel overwhelm with all the choices.
This was my routine today:
I started with 2 of the warm up exercises,(lateral lunge and Bird nod), the dumbbell walking lunge, followed by the squats with weights, the hip raises on the ball, the exercises for spine, swiss ball pull over with 2 dumbbells, steps push ups, side lying leg lift on stability ball.
I love them all. And with your instructions they are easy to follow.
CONGRATULATIONS for a great program.

March 5, 2018 at 10:12pm

Margaret Martin replies

Hi Lizette, The routines are designed for you. If you have my book there is a link to the programs and you can choose between a three times a week routine or a six times a week routine. It's all done for you. Have a look at them and download the one that works best for you.
Thank you for your kind words.
Margaret

February 22, 2018 at 8:58pm

Lizette

I also did 20 reps of each one.

March 5, 2018 at 10:13pm

Margaret Martin replies

Sets and reps are also listed in the programs. Happy working out. Go get stronger!!

August 25, 2018 at 3:25am

Diana Mackenzie

I have hyper mobility in some of my joints and find that increasing the weights causes pain, which can take a long time to heal. Would doing more reps with lower weights make any difference to my osteoporosis?

September 3, 2019 at 2:14pm

yogawithgaileee

Great article on side lying leg lifts. I also use the new resistance looped bands for my hip abduction work. I am so wiggly though, I use that ball up against the couch, so I don't go rolling backwards. I see you have no core balance challenges in that arena. Thank you!

September 8, 2019 at 3:13pm

Margaret Martin replies

Hi Gaileee, Thank you for your kind comments both on the article and my core strength. :) If you don't mind me suggesting. Keep your loop bands for band walks and use gravity for your ball work (go slower) or add an ankle weight as you build your core stability. Catching yourself by putting your top foot down in front of you is much easier without a band. All the best,
Margaret

September 3, 2019 at 11:22pm

Madeleine

I am presently in Seoul, SK, for 3 months. I am staying in a residence on the side of a small mountain so must climb a very steep hill to get home, and of course, go down it when leaving. I find that I labour greatly going up and the muscles in my shins are very sore when going down. There is a gym here where I'm staying so want to do exercises that will strengthen the muscles I need for climbing hills and stairs. Seoul. and indeed all South Korea, is very hilly, and most tourist spots require lots of stairs to see the sights. How can I build the muscles I need for this challenging environment. I am 77 and have been doing a variety of exercises over the years, but I find this place tough going!

September 8, 2019 at 3:03pm

Margaret Martin replies

Hi Madeleine, No need for a gym. The location of your accommodation has your workout built for you. If you plan to do longer hikes your best training would be to repeat your daily commute. I suggest you take time to massage your thigh muscles ( a rolling pin works well) and your shins (either use your hands or a small ball) also be sure to stretch your quadriceps and shins (choose among the three quadricep stretches in Exercise for Better Bones that provides you with a comfortable stretch and sit back into the ankle stretch (also shown in Exercise for Better Bones under the flexibility section).
Also, if you are not currently using poles, they would make your trekking much more comfortable and safe.

We travelled to Seoul and hiked in the mountains north of Seoul when I was 50 years younger than you are now. It was beautiful and hilly! I am impressed with your level of fitness. Thank you for sharing your story and your new challenge. Have a wonderful time.
Margaret

September 11, 2019 at 6:55pm

Patty

This is a very informative article on leg lifts and how to do them properly. Do you recommend doing leg lifts using resistance bands or are 1 -2 lbs ankle weights more beneficial? Thankyou.

September 23, 2019 at 8:59pm

Margaret Martin replies

Hi Patty, Thank you for your kind comments. I prefer the use of weights over bands. The resistance is more even throughout the lift in side lying. The bands are great to use with the standing band walks.
Margaret