One of the most discussed issues in the “hip first” WeChat circle and QQ group is what to do if you are “lame” after surgery. Human muscles are divided into three types: skeletal muscle, cardiac muscle and smooth muscle. The skeletal muscles are the driving force of the locomotor system. Under the control of the nervous system, the skeletal muscles contract and pull the bones to produce movement. There are more than 600 skeletal muscles in the human body, which are widely distributed. Each skeletal muscle, regardless of its size, has a certain shape, structure, location and auxiliary devices, and is rich in blood vessels and lymphatic vessels distribution, and is innervated by certain nerves. Therefore, each skeletal muscle can be regarded as an organ. Among these skeletal muscles, there is a very important muscle called the gluteus medius. The gluteus medius is of great importance in maintaining a normal walking posture. During walking, the gluteus medius stabilizes our pelvis so that our upper body does not sway when we walk. If the gluteus medius muscle is not strong, it will not be able to pull the pelvis, and the leg will feel shorter when walking because the pelvis is tilted. Almost all patients with postoperative “limp”, or postoperative claudication, have reduced strength of the gluteus medius muscle, or “lack of strength”. Why do they limp? After osteotomy, the muscles that used to control the movement of joints and maintain the dynamic balance of the body in our body change as a result of the surgery. After the operation, the leg on the side of the operation cannot bear weight for 6-8 weeks and cannot bear weight for 3 months because it has to prevent the change of the position of the acetabulum after the osteotomy re-rotation. So, is it true that when the gluteus medius muscle is stronger, the walking posture will be better? Yes, most patients will have a significant improvement. So how can we improve the muscle strength of the gluteus medius? First, we need to know where the gluteus medius is. On the outside of our upper thigh, you can feel a protruding bone that moves with the hip joint (if you can’t feel it, it means you should lose weight), which is the greater trochanter (part of the femur). A little behind it is where the gluteus medius is located. From the picture below, you can see that the gluteus medius is fan-shaped and quite large and thick. To exercise the gluteus medius, you must first activate it. That is to make the gluteus medius actively contract. Previously, we advocated the exercise method: repeatedly emphasize the patient to take the side lying position, do the side leg lift exercise, insist on 10 seconds for each leg lift, and do dozens of them in the morning, in the afternoon and in the evening. However, through my recent study, I found that this way of training the gluteus medius is flawed. Why is it flawed? Because, when we do the side leg raise without learning to train the gluteus medius specifically, in addition to the gluteus medius at work, there are two other muscles that are activated at the same time, namely the psoas square and the extended fascial tensor, and these three muscles work together to make the lower limb lift. In the lateral raise, the psoas square and the vastus lateralis are used more, while the gluteus medius, which should be trained the most, is activated the least. Therefore, this defect is mainly missing in blindly doing the lateral raise, without fully exercising the gluteus medius. If we learn to train the gluteus medius, we will get twice the result with half the effort: the gluteus medius alone is strong enough to lift the lower limb high, but we mostly can’t manage it well. Still side lying position, or side leg lift, but, when lifting the leg to the rear of the body, never more than the midline of the body to reach forward. This will limit the work of the extended fascial tensor muscle to the maximum. At the same time, use the thumb of one hand to touch the lumbar region and a few other fingers to touch the gluteus medius, then carefully experience which muscle is contracted when lifting the leg. Then slowly look for the feeling of contraction of the gluteus medius, while letting the lumbar muscles try not to exert themselves. This process may require a little patience, but the experience of finding a sense of muscle contraction is very important, only to let the gluteus medius muscle really work, the training effect can show the water. A “trick” of “tricks”: you need to prepare a pair of ring elastic band, then maintain the side position, bilateral hip knee bend, heel together, both knees with a ring elastic band set. Next, the upper knee joints up as far as possible, keep the heels together, the body do not lean back, try to tighten the abdomen, maintain this position for 1 minute. Do this for 20 minutes every morning, noon and night. All the movements for training the gluteus medius are also suitable for healthy people without joint problems.