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MuscleHipintermediateDraft

Gluteus mediusMusculus gluteus medius

Thick, fan-shaped muscle on the outer side of the pelvis that abducts the hip and keeps the pelvis level when you stand on one leg.

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LatinMusculus gluteus medius
Origin
  • Outer surface of the ilium between the iliac crest and posterior gluteal line above and the anterior gluteal line below
  • Gluteal aponeurosis (its own covering fascia)
Insertion
  • Oblique ridge on the lateral surface of the greater trochanter of the femur
Action
  • All fibres: abduct the hip
  • All fibres: keep the pelvis level when standing on one leg (stop the opposite side from dropping)
  • Anterior fibres: flex and medially rotate the hip
  • Posterior fibres: extend and laterally rotate the hip
NerveSuperior gluteal nerve (L4–S1)

Palpation

  1. Client side-lying with the upper leg supported on a pillow, or prone; stand behind the client.
  2. Place your fingers on the outer pelvis in the space between the iliac crest and the greater trochanter.
  3. Feel the firm, fan-shaped muscle here; its back third lies under gluteus maximus, but the front two-thirds is covered only by fascia.
  4. Ask the client to lift the top leg towards the ceiling (hip abduction) against light resistance; the muscle firms clearly under your fingers.

Landmarks: Iliac crest · Greater trochanter · Anterior superior iliac spine · Posterior superior iliac spine

The gluteus medius sits on the outside of the pelvis, just below the Iliac crest. It does most of its work in walking: each time one foot leaves the ground, the gluteus medius on the standing side holds the pelvis level. Clients who walk, run or stand a lot commonly report tenderness along the area just below the crest. Side-lying is a comfortable position for working it with Compression and Circular friction.

It is the middle layer of the three gluteal muscles. Gluteus maximus covers its back third, and Gluteus minimus lies directly underneath it. At the front it sits beside Tensor fasciae latae. All three (medius, minimus and TFL) abduct the hip, so they are hard to separate by feel. As a rough guide, fibres just behind the Anterior superior iliac spine belong to TFL, and the broad fan above the Greater trochanter is gluteus medius.

Sources describe its rotation actions differently. The usual textbook version, used above, is that the front fibres rotate the hip inwards and the back fibres rotate it outwards. Wikipedia’s “Lateral rotator group” article instead says gluteus medius and minimus rotate the hip outwards when the hip is flexed and inwards when it is extended.

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

  • Gluteus minimus — The smallest and deepest of the three gluteal muscles, lying under gluteus medius, that abducts and medially rotates the hip.
  • 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

  • Adductors — Group of five muscles on the inner thigh, running from the pubic bone and sitting bone to the femur and tibia, that pull the legs together.

Used in routines

Sources

  1. Wikipedia: Gluteus medius
  2. Wikipedia: Superior gluteal nerve