The most neglected muscles and how to train them

You’ve heard of the bench press or the squat but what exercises are great for the most neglected muscles in your body?

In today’s article, we will discuss and demonstrate the most neglected muscles in your body, why you should train them and exercises to target them.


Shin muscles:

Why do you need to train this?

Shin muscles such as Tibialis Anterior are important but rarely trained. The first reason that they should be focused on is that the shin muscles control the ankle joint and this control is key when hitting the ground in walking and running. There is something called ground reaction force, which is the force that the ground essentially sends back into you. This force is equal and opposite to the force applied to it. This is why loads like 12.5 times bodyweight go through your Achilles tendon when you run! (Maffulli et al 2004).

This load control at the ankle can impact the knee joint too! If your foot plantarflexes at the ankle faster to the ground then the knee will move forwards faster and this will, in turn, place more loading into the front of your knee, which can cause overload and knee injuries.

Another role of the Tibialis Anterior is to work with the Tibialis Posterior to control pronation of the foot. Shin splints are often from an overload to the Tibialis Posterior so if the Tibialis Anterior is stronger then this can sort of ‘help the Tibialis Posterior out’, making shin splints less likely to occur!

This exercise will strengthen muscles on the front of the shin especially the Tibialis Anterior and, in turn, this will lower the chance of injury, as mentioned above.

Tibialis Raises


Neck Spinal Erectors:

Why do you need to train this?

How many people do you see in the gym training their necks? What? NONE! 

Why is this? Why do we see fit to train everything below the neck? If we had a bad knee, we would strengthen the area, right? So what makes the neck different to the knee in this regard?

The short answer is nothing!

Many people suffer from neck pain, even myself at one point! I actually used this exercise to great effect for my neck after a car accident and I have seen many patients with similar good results. However, this is not exclusive to injury. It can be good for injury prevention too! Why do you think boxers, rugby players and F1 drivers train their necks?

That’s right, to reduce the risk of neck injury and in fact, it also reduces the chance of concussion too!

Weighted neck extensions


Neck side flexors:

Why do you need to train this?

Just like the neck extensors, you don’t see anybody in the gym training their necks.

The reasons to train this movement are the same as above but essentially you are targeting the sides of your neck. Interestingly, neck pain seems to be more prevalent in people with smaller neck muscle sizes, according to Ghamkhar et al (2019), and this exercise will strengthen and build muscle in the neck, which will reduce the chance of getting a bad neck!

Weighted Neck Side Flexions


Deep Neck Flexors:

Why do you need to train this?

This is an interesting one because at university we were taught that magically you could strengthen your deep neck flexors without using resistance. Now if you are very weak, then yes, this may work but if not, to get stronger you need to progressively overload the muscles involved and this is why weighted neck flexions are so good. The deep neck flexors are considered to be weak and underdeveloped in most people and certainly in people with neck pain (Amiri et al 2018). So strengthening the deep neck flexors with progressive load can certainly help to minimise the risk of neck issues and help people with neck pain.

Weighted Neck Flexions


Gluteus Medius:

Why do you need to train this?


These are sometimes obsessed over by physiotherapists but in normal gym settings people seem to think mostly about the Gluteus Maximus for aesthetic reasons but the Gluteus Medius is a very important muscle to be strong.

Why is this?

Don’t just think of the area that the muscle is located, remember that the body works as a unit, in synchronicity. Due to this, areas of weakness will create excessive loads or abnormal movements elsewhere. So for the Gluteus Medius, Smith et al (2014) found that there is a delay in the onset of contraction & a shorter duration of contraction of the Gluteus Medius in sufferers of Achilles tendinopathy. So if you want to prevent getting a bad Achilles then train your Gluteus Medius!

Anything else?

Yes, of course, there is! Dragoo et al (2012), found that training the Gluteus Medius helps infrapatellar fat pad disorders of the knee and truthfully training them could help many issues of the knee!

Side plank off the bottom leg


Erector Spinae:

Why do you need to train this?

We have been led to believe that when you lift you should lift with a straight back as this is stronger and this is less likely to cause back injury, but does it really? In a study done by Arjmand et al (2005), they had people lift in three different ways. They were asked to lift with a back position that was either straight, bent or natural ‘freestyle’. They found that the freestyle technique, which was actually slightly flexed, was optimal when it came to internal spinal loading and it was found that have more optimal active and passive muscle forces. So a very small degree of spinal flexion, which isn’t straight, is stronger and has less spinal loads.

Again, people will, of course, dispute this, but the reason is obvious when you think about it! For example, if you perform your deadlift with strict form and a straight back for a decade, gradually building your weight up then you are strong in this straight position. Have you developed any strength in the rounded position? Not really! So if you happen to bend your back in the deadlift, say maxing out, then you would be at greater risk of injury due to exposing your back to a weaker position due to having never trained in the flexed position. If you did train the flexed spine for a decade and built the weight up slowly then your back would be very strong in this position too.

A great exercise for this idea is the Jefferson curl:

Jefferson curls


Serratus Anterior:

Why do you need to train this?

Muscles work together and this is certainly true around your shoulder blade. To get your arm above your head your shoulder blade needs to rotate outwards and this is done by 3 muscles all working together in unison. These muscles are Upper Trapezius, Lower Trapezius and Serratus Anterior. It is common for people to train the upper and lower Traps but who is training their Serratus Anterior?

Merolla et al (2010) found that abnormal scapula movement and control created inefficient length-tension ratios for the Rotator cuff muscles meaning this could create a secondary functional weakness in the Rotator cuff in certain positions. So training the scapula muscles is important in rehab.

So, it is important to maintain a good balance between these three muscles and so you should definitely be training your Serratus Anterior! Below is a great exercise to train your Serratus anterior through shoulder elevation:

Serratus anterior off knees with swiss ball


Wrist and forearm in general:

Why do you need to train this?

Not many people train their wrists and forearms but they are part of your body and are the most useful parts of your body. It is common to overload your grip causing issues such as Tennis elbow, Golfers’ elbow and more and training these will lower the injury risk! These exercises are also good for rehab itself, the evidence has found that strength training of these areas, decreases the symptoms of things such as Tennis elbow (Hoogvliet et al 2013). Now some people may train their flexors and extensors but the wrist moves in other directions too and below are some great ways to train your wrist and forearms:

Wrist Radial Deviator Strengthening

Wrist Flexor strengthening of the Wrist and Forearm

Wrist extensor strengthening of the wrist and forearm

Pronation and supination elbow strengthening


Hip Flexors:

Why do you need to train this?

Nearly everything in the gym is a hip extension exercise but hips hip flexors get neglected, especially the Iliopsoas muscles! This will help to keep a good balance around the hip and weak hip flexors can be a cause of lower back pain and other conditions. Evidence shows that exercises specific to the iliopsoas should be the primary treatment for patients with iliopsoas syndrome according to Laible et al (2013).

Another great benefit of training your hip flexors is for activities such as running and sprinting. Here is a great way to train them:

Standing Banded marches Hip flexor strengthening


Hip Rotators:

Why do you need to train this?

Hip rotation limitation is heavily linked to osteoarthritis of the hip and so improving your range and strength of your hip rotation is a great way to minimise this risk!

(Tak et al 2017).

Hip rotation weakness has been linked to certain injuries so you should definitely be targeting them. Again in real life, we don’t move like robots in straight lines, we twist, we turn and your hip rotators control this so this is definitely training you to be fit for real life!

Hip internal rotation strengthening with exercise band

Hip external rotation strengthening with exercise band


Lower Trapezius (through elevation):

Why do you need to train this?

As with the earlier muscle Serratus Anterior, we mention that the 3 muscles move the shoulder blade to enable you to get your arms above your head. This is a great exercise as most other Lower Trapezius exercises don’t take the shoulder through elevation and this does! Another thing is that this will train you at your weakest point. Think about it, you usually rest at the overhead position but this really works you hard here!

Bent over overhead shoulder raises


Now, there are some others that I could include but this article is already getting a bit long, however, if you want to take a look at all of our exercises then check out the exercise page.

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If you need any further information or would like to book an appointment then call Hawkes Physiotherapy on 01782 771861 or 07866 195914.

  • Amiri, Mohsen, et al. “Ultrasonographic assessment of cross-sectional area of deep neck flexor muscles during a five-stage cranio-cervical flexion test in individuals with chronic neck pain and healthy controls.” European Journal of Physiotherapy 20.2 (2018): 116-121.
  • Arjmand, N., & Shirazi-Adl, A. (2005). Biomechanics of changes in lumbar posture in static lifting. Spine, 30(23), 2637-2648.
  • Dragoo, J. L., Johnson, C., & McConnell, J. (2012). Evaluation and Treatment of Disorders of the Infrapatellar Fat Pad. Sports Medicine, 42(1), 51-67.
  • Ghamkhar, Leila, and Amir Hossein Kahlaee. “Is forward head posture relevant to cervical muscles performance and neck pain? A case–control study.” Brazilian journal of physical therapy 23.4 (2019): 346-354.
  • Hoogvliet, Peter, et al. “Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis? A systematic review.” Br J Sports Med 47.17 (2013): 1112-1119.
  • Laible, Catherine, et al. “Iliopsoas syndrome in dancers.” Orthopaedic journal of sports medicine 1.3 (2013): 2325967113500638.
  • Maffulli, Nicola, Pankaj Sharma, and Karen L. Luscombe. “Achilles tendinopathy: aetiology and management.” Journal of the Royal Society of Medicine 97.10 (2004): 472-476.
  • Merolla, Giovanni, et al. “Supraspinatus and infraspinatus weakness in overhead athletes with scapular dyskinesis: strength assessment before and after restoration of scapular musculature balance.” Musculoskeletal surgery 94.3 (2010): 119-125.
  • Smith, Melinda M. Franettovich, et al. “Neuromotor control of gluteal muscles in runners with achilles tendinopathy.” Medicine & Science in Sports & Exercise 46.3 (2014): 594-599.
  • Tak, Igor, et al. “Is lower hip range of motion a risk factor for groin pain in athletes? A systematic review with clinical applications.” Br J Sports Med 51.22 (2017): 1611-1621.

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Online Physiotherapy

Put simply this is Physio done via either telephone or video over the internet. Skype and facetime are examples of this.

Contrary to popular belief online physiotherapy can be very effective and it can help the same injuries that face to face physio can help. I have helped many people with injuries such as disc prolapses, tennis elbow, neck pain and much more).