Logan Steele
The gluteus medius is a large fan-shaped muscle located in the posterior hip. It is one of the three muscles in the gluteal region, along with the gluteus maximus and gluteus minimus. The gluteus medius acts on the hip joint, producing two movements: its anterior part internally rotates the thigh, while the contraction of the whole muscle abducts the thigh. Additionally, the gluteus medius stabilizes the pelvis while standing or walking. The muscle is innervated by the superior gluteal nerve and receives its blood supply from the deep branch of the superior gluteal artery. Injury to the gluteus medius is rare but can occur through muscle or tendon tears from falling or playing sports.
| Characteristics | Values |
|---|---|
| Location | Lateral aspect of the upper buttock, below the iliac crest |
| Appearance | Fan-shaped |
| Function | Works with other muscles on the side of the hip to pull the thigh out to the side in a motion called hip abduction; stabilises the pelvis and maintains the trunk upright when standing on one leg, running, and walking |
| Innervation | Superior gluteal nerve (L4-S1), which stems from the sacral plexus |
| Blood supply | Deep branch of the superior gluteal artery |
| Tendon supply | Trochanteric anastomosis |
| Related injuries | Muscle and tendon tears, trochanteric bursitis |
| Related exercises | Bodyweight and resistance exercises, hopping on one foot |
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What You'll Learn
Location and anatomy
The gluteus medius is a large fan-shaped muscle located in the posterior hip. It is one of the three muscles of the gluteal region, along with the gluteus maximus and gluteus minimus. The gluteus maximus covers all of the gluteal muscles except for the anterosuperior third of the gluteus medius. This uncovered part of the gluteus medius is where buttocks dorsogluteal intramuscular injections are applied.
The gluteus medius is a middle gluteal muscle, located deep to the gluteus maximus and superficial to the gluteus minimus. Only the posterior third of the gluteus medius is covered by the gluteus maximus, while the larger anterior portion is covered by the deep fascia of the hip. The posterior margin of the muscle lies anterior to the piriformis muscle, and sometimes it may be blended with it. The gluteus medius is related to the branches of the superior gluteal artery and nerve, which run between the adjacent surfaces of the gluteus medius and minimus muscles.
The gluteus medius is located on the lateral aspect of the upper buttock, below the iliac crest. The superior part of the muscle is broad, narrowing towards its insertional tendon, giving it a fan-shaped appearance. The muscle fibres of the gluteus medius take distinct courses based on their position: the fibres of the posterior portion pass forwards and downwards; the fibres of the middle portion pass downwards; and the fibres of the anterior portion pass backwards and downwards. All fibres combine to form a flattened tendon which attaches to the posterior and lateral part of the superior portion of the greater trochanter of the femur.
The gluteus medius is stimulated by the superior gluteal nerve, which arises from lumbar levels four and five, and sacral level one. The blood supply to the gluteus medius muscle comes from the deep branch of the superior gluteal artery. The tendon, however, is mainly supplied by the trochanteric anastomosis.
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Functions and importance
The gluteus medius is a large fan-shaped muscle located in the posterior hip. It is one of the three muscles that make up the gluteal region, along with the gluteus maximus and gluteus minimus. The gluteus medius acts on the hip joint, producing two movements: internal rotation of the thigh and abduction of the thigh.
The gluteus medius is an important muscle for several reasons. Firstly, it plays a crucial role in stabilising the pelvis and trunk during walking, running, and single-leg weight-bearing. When one leg is off the ground, the gluteus medius prevents the pelvis on the unsupported side from dropping, allowing the other leg to swing forward for the next step. This helps to maintain a normal gait and prevents issues such as a collapsing kinetic chain, where the knee turns and bends inwards.
Additionally, the gluteus medius helps to control the position of the pelvis, hips, knees, and ankles. It works in synergy with the gluteus minimus to produce hip rotation and stabilise the hip joint. The gluteus medius also assists in flexion and medial rotation of the hip.
Furthermore, the gluteus medius is important in preventing and managing lower extremity problems. Weakness in this muscle can lead to abnormal rotation of the thigh during walking, running, and jumping, which can place excessive stress on the knee and ankle and increase the risk of injury. Specific exercises can be performed to strengthen the gluteus medius and improve its function, which is especially important for individuals who sit for long periods, as this can weaken the muscle.
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Injuries and treatment
The gluteus medius is a large fan-shaped muscle located in the posterior hip, extending from the ilium to the proximal femur. It is one of the muscles of the gluteal region, which includes the gluteus maximus, gluteus minimus, and tensor fasciae latae muscles. The gluteus medius acts on the hip joint, producing two movements: internal rotation of the thigh and abduction of the thigh. It also helps to stabilise the pelvis during walking or running, preventing the pelvis on the opposite side from dropping.
While injury to the gluteus medius is rare, it can occur due to falling or playing sports. Prolonged sitting can also lead to gluteus medius pain. Tears in the gluteus medius muscle are generally caused by degeneration of soft tissue through normal wear and tear and are most common in women between the ages of 50 and 70, with women being 10 times more likely to suffer this injury than men. The disproportionate rates of gluteus medius tears in women may be due to pelvic anatomy and hormonal changes associated with menopause, particularly the reduction in estrogen levels, which weakens soft tissue structures.
Gluteal tendinopathy, which can be caused by tendon overuse or underuse, can also affect the gluteus medius. This condition causes chronic hip pain and can impact activities of daily living, sleep, and quality of life.
Treatment for gluteus medius injuries may include:
- Physical therapy: Specific exercises can be prescribed to improve muscle function and promote healing. Physical therapy can also help to build strength, improve mobility, and reduce pain.
- Conservative treatment: This may include prescription anti-inflammatory medications, activity modifications, and careful use of cortisone injections.
- Surgical repair: If conservative management is not effective or not possible, surgery may be performed by an orthopedic surgeon trained in this procedure. The goal of surgery is to reduce pain and restore strength and function.
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Muscles it works with
The gluteus medius muscle is a crucial muscle in the human body, particularly for maintaining stability and facilitating lower body movement. This muscle works in conjunction with several other muscles to enable various functions. One of its primary roles is to abduct the hip, and it works alongside the gluteus minimus and gluteus maximus muscles to achieve this. These three muscles are often referred to as the "abductors" and are essential for activities such as walking, running, and maintaining balance. While the gluteus medius and minimus initiate hip abduction, the gluteus maximus provides powerful support for this movement, particularly when the demand on the abductors is high, such as during a single-leg stance.
Additionally, the gluteus medius muscle also collaborates with the piriformis muscle. The piriformis muscle contributes to hip rotation and helps stabilize the hip joint. Together, the gluteus medius and piriformis muscles ensure dynamic stability during one-legged stances and help control the medial rotation of the femur. Their coordinated action is vital for maintaining balance and facilitating smooth movements of the hip joint.
The quadratus lumborum, psoas major, and iliacus muscles also work in conjunction with the gluteus medius during specific movements. These muscles, along with the gluteus medius, contribute to the maintenance of pelvic stability and control of the pelvis's anterior tilt during various activities, such as walking or running. Their coordinated contractions help maintain posture and stabilize the core, particularly during dynamic movements.
Furthermore, the gluteus medius muscle is also involved in synergistic actions with the gluteus maximus and hamstring muscles during certain movements. For example, during the terminal swing phase of walking or running, the gluteus medius and maximus muscles work together to decelerate the swing limb, preparing it for initial contact with the ground. This coordinated action helps control the position of the pelvis and ensures a smooth transition during gait. The hamstrings also contribute to this movement, assisting in hip extension and ensuring dynamic stability.
The gluteus medius muscle is essential for various lower body movements and works in harmony with multiple muscles to achieve functional tasks. Its coordination with other muscles ensures stability, balance, and smooth, controlled movements of the hip and pelvis during dynamic activities. Understanding the muscles that work with the gluteus medius provides insight into the complex interplay of muscles that enables human locomotion and stability.
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Exercises to strengthen
The gluteus medius is a large fan-shaped muscle located in the posterior hip. It is one of the muscles on the side of the hip, connecting the thigh bone and the pelvis. It is important in walking, running, and single-leg weight-bearing as it stabilizes the pelvis while standing or walking, preventing the pelvis from dropping.
Weakness in the gluteus medius can cause knee, hip, or lower-back pathologies, and may result in adverse changes in kinematics, an increased risk of injury, and decreased sports performance. Therefore, it is important to strengthen the gluteus medius using various bodyweight and resistance exercises.
Clamshells
Clamshells are an excellent exercise to activate and strengthen the gluteus medius. To perform clamshells, lie on your side with your legs bent at a 90-degree angle. Keep your feet together and lift your top knee as high as possible while maintaining contact between your feet. Aim for 2-3 sets of 10-20 reps. You can also add a resistance band just above your knees for extra resistance.
Kettlebell Swing
The kettlebell swing is a powerful exercise for building gluteus medius strength. Stand with your feet shoulder-width apart and hold a kettlebell with both hands between your legs. Swing the kettlebell back between your legs and then forcefully drive your hips forward, swinging the kettlebell to chest height. The explosive hip movement engages the gluteus medius. Perform 3 sets of 10-15 reps.
Kettlebell Goblet Squats
Hold a kettlebell close to your chest and perform squats. This exercise strengthens the gluteus medius while also targeting the quadriceps and core. Aim for 3 sets of 10-12 reps.
Side Plank
If you find the side plank too difficult, you can modify it by bending your knees to shorten the lever. As your endurance and strength improve, you can progress by lifting the top leg. Ensure that you do not hike up through the pelvis on the top leg, and that you maintain good alignment throughout the bottom leg and spine.
Standing Leg
Work on controlling your stance position, keeping your pelvis level and not twisted. You should feel some work in the gluteus medius in the stance leg as well. Attach tubing around your thighs or ankles, depending on your fitness level. Pull the tubing back and away from your body, engaging the gluteus medius to help pull the leg away from the body. Repeat to fatigue with good technique, performing 3-4 sets of 10-15 repetitions on each leg.
It is important to maintain proper form during these exercises to ensure you are targeting the right muscles and reducing the risk of injury.
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Frequently asked questions
The gluteus medius is a large fan-shaped muscle located in the posterior hip, extending from the ilium to the proximal femur. It is one of three gluteal muscles, the others being the gluteus maximus and gluteus minimus.
The gluteus medius acts on the hip joint, producing two movements. Its anterior part internally rotates the thigh, while the contraction of the whole muscle abducts the thigh. It also stabilises the pelvis while standing or walking.
Injury to the gluteus medius is rare, but it can happen, especially if you fall or play sports. Weakness in this muscle can cause hip pain, knee pain, and other lower extremity problems. It may also cause your thigh to angle inwards and rotate abnormally during walking, running, and jumping, increasing your risk of injury.
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