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MuscleHipsuperficialDraft

Gluteus maximusMusculus gluteus maximus

The largest and most superficial buttock muscle, and the main extensor of the hip.

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LatinMusculus gluteus maximus
Origin
  • Outer surface of the ilium behind the posterior gluteal line, and the iliac crest just above it
  • Lower part of the back of the sacrum and the side of the coccyx
  • Thoracolumbar fascia (aponeurosis of the erector spinae)
  • Sacrotuberous ligament
  • Gluteal aponeurosis (the fascia covering gluteus medius)
Insertion
  • Upper fibres and superficial lower fibres: iliotibial tract (IT band) of the fascia lata
  • Deep lower fibres: gluteal tuberosity of the femur
Action
  • All fibres: extend the hip (for example, standing up from a squat or climbing stairs)
  • All fibres: laterally rotate the hip
  • Upper fibres: abduct the hip
  • Lower fibres: adduct the hip
  • Through the iliotibial tract, helps steady the extended knee
  • Working from below, steadies the pelvis and trunk on the femur, especially when standing on one leg
NerveInferior gluteal nerve (L5–S2)

Palpation

  1. Client prone with a bolster under the ankles; stand beside the hip.
  2. Place your palm flat over the buttock, between the sacrum and the greater trochanter, and feel the thick, rounded muscle mass.
  3. Trace the upper border from the posterior iliac crest and sacrum diagonally down and out towards the greater trochanter.
  4. Ask the client to squeeze the buttock or lift the straight leg a few centimetres off the table (hip extension); the whole muscle firms under your hand.

Landmarks: Iliac crest · Posterior superior iliac spine · Sacrum · Greater trochanter · Ischial tuberosity

The gluteus maximus is the big muscle that gives the buttock its shape, and it covers most of the other hip muscles. In a prone routine you meet it first: broad Effleurage, palm or forearm Compression and Petrissage all suit it, and clients who sit for long periods commonly report that the area feels tight. Work through it slowly before reaching the deeper Gluteus medius, Piriformis and the other Deep hip rotators.

Its fibres run diagonally from the Sacrum and back of the pelvis down and out past the Greater trochanter. Most of the muscle ends in the iliotibial tract (IT band), which it shares with Tensor fasciae latae, so tension here can be felt down the outside of the thigh. The upper and lower fibres pull in different directions: the upper fibres help abduct the hip and the lower fibres help adduct it.

Do not confuse it with the hamstrings. The gluteus maximus stops at the gluteal fold (the crease under the buttock); the Hamstrings begin at the Ischial tuberosity under that crease and run down the back of the thigh.

Techniques

  • Effleurage — Long, gliding strokes with the whole palm that spread the medium, warm the tissue and link the other strokes together.
  • Petrissage — Kneading strokes that compress, lift and squeeze the muscle away from the bone, working the tissue between the hands.
  • Compression — Pressing straight down into a muscle with the palm, fist or forearm, holding briefly, then releasing and moving on.
  • Circular friction — Small circles made with the finger or thumb pads that move the skin over the deeper tissue without sliding, to work a specific spot.
  • Passive stretching — The therapist gently moves a relaxed limb to lengthen a muscle to a point of mild stretch and holds it there, with no effort from the client.

Works with

  • Hamstrings — Group of three muscles on the back of the thigh, running from the sitting bone to below the knee, that bend the knee and extend the hip.
  • Adductor magnus — Large, triangular inner-thigh muscle with an adductor part and a hamstring part, which pulls the thigh inwards and helps extend the hip.
  • Deep hip rotators — Six small, deep muscles behind the hip joint, running from the pelvis to the top of the femur, that laterally rotate the hip and steady the head of the femur in its socket.
  • Tensor fasciae latae — Small muscle at the front of the outer hip, just below the ASIS, that tightens the iliotibial band and helps flex, abduct and medially rotate the hip.

Opposes

  • Iliopsoas — Deep hip flexor made of psoas major and iliacus, running from the lumbar spine and inside of the pelvis to the lesser trochanter of the femur, and the strongest flexor of the hip.
  • Rectus femoris — Spindle-shaped muscle down the middle of the front of the thigh, the only quadriceps muscle that crosses the hip, so it both flexes the hip and straightens the knee.

Used in routines

Sources

  1. Wikipedia: Gluteus maximus
  2. Wikipedia: Inferior gluteal nerve
  3. Wikipedia: Iliotibial tract