Gluteus Medius Muscle
Action – abduction of hip
flexion and medial rotation of hip (anterior fibres)
extension and lateral rotation of hip (posterior fibres)
stabilises the pelvis and prevents the free limb from sagging during gait
Origin – outer ilium (between anterior and posterior gluteal lines)
Insertion – greater trochanter on the femur (superior and lateral surface)
Nerve – superior gluteal nerve (L4, L5, S1)
Gluteus medius fans out across the hip in a similar way, as the deltoid muscle does to the shoulder. As a result it has many actions on the movement of the hip. It is partially covered by gluteus maximus, but can be felt on the side below the hip bone when moving your straight leg to the side away from the opposite leg.
The muscle plays a key role in normal gait (walking or running) by stabilising the pelvis when the opposite leg is off the ground. If weak, the pelvis can drop towards the opposite side in what is known as a ‘Trendelenburg gait’.
Gluteus medius can be injured from falling, blunt trauma such as those experienced in contact sports, repetitive stress from hip extension activities or long periods sitting or sleeping in one position. Pain in the region should be differentiated from other pathologies such as trochanteric bursitis, lumbar, sacroiliac or hip joint dysfunction, or trigger point referral from muscles in the low back.
Pictured above you can see the typical referral pattern of the gluteus medius trigger points. There are generally 3 points that can have an affect on different regions. Ranging from the muscled itself, sacroiliac joint (SIJ), upper hamstring (sometimes to the side of the leg more) and over the sacrum.
That feeling of general stiffness or tightness across the upper glutes and sacrum on both sides, could be caused by trigger points in the gluteus medius.
Lie on your side with the lower leg slightly bent, top leg straight with toes pointed slightly towards the floor. Raise the straight top leg as far as possible (it may only be 20-30 degrees) without rocking through the hips, pause for 2 seconds and slowly lower back down. As you continue you should start to feel your gluteus medius fatigue.
Lie on your back, knees bent and feet on the ground. Place the ankle of the side to be stretched to just above the knee of the opposite leg, then use your hands to pull this opposite leg towards your chest. You should feel the stretch on the side/back of the hip that is being stretched.
Laying on the side you want to work on. Propped up on your forearm with your bottom knee bent and your top foot on the floor just behind your bent knee.
Place the ball on the floor underneath your gluteus medius and lower yourself onto the ball. Roll on the ball until you find a tender spot. Once on a tender spot, hold there. Do some nice breathing into the belly. Let your body sink onto the ball. (You can adjust the pressure using your forearm and the foot on the floor) After about 20 secs or so you should feel the discomfort start to subside. Once this happens, move onto the next tender spot.
As always, consult your local Myotherapist to make sure the above techniques are suitable for your situation.
Contributors: Ben Lewis & Jesse Kingsbury