Pain in the lower back, sacrum, buttock, hip, thigh, knee, and lower leg can be caused by problems with the gluteus medius and gluteus minimus. Watch the video to the end to learn the causes of this pain, exercises to eliminate discomfort at home, and helpful tips to prevent recurrence of pain. I’m Dr. Chernov, enjoy watching!
Gluteus Medius & Minimus Anatomy
The gluteus medius and minimus are two small muscles in the human body that play a crucial role in pelvic elevation and maintaining an upright position. The gluteus minimus attaches to the outer surface of the ilium at the top and to the greater trochanter of the femur at the bottom.
The gluteus medius is approximately twice as large, located above the gluteus minimus and attaching in the same locations but at a greater distance. Both of these muscles are located under the gluteus maximus.
Gluteus Medius & Minimus Pain Syndrome
Despite their small size, the gluteus medius and minimus muscles can cause significant problems, causing pain in the lower back, buttocks, hip joints, and legs.
Specific areas of tension, or trigger points, located in the anterior portion of the gluteus medius muscle refer pain along the iliac crest, lower spine, and on the corresponding side along the sacrum.
Trigger points located in the medial portion of the muscle cause pain in the buttock and upper outer thigh.
Trigger points located in the posterior portion of the muscle refer pain to the lower back, along the iliac crest, iliosacral joint, and buttock.
Trigger points located in the anterior portion of the gluteus minimus muscle cause pain in the lower outer quadrant of the buttock, outer thigh, knee, and lower leg. Trigger points located in the posterior portion of the gluteus minimus muscle cause pain in the buttock, particularly in the lower inner quadrant, as well as in the posterior thigh, knee, and lower leg.
Pain from trigger points in the gluteus medius and minimus can be persistent and excruciating. It intensifies when rising from a deep chair, straightening the torso, walking, and standing for long periods.
Hip pain causes limping, resulting in a characteristic gait in which the person avoids putting weight on the affected leg and sometimes even prefers to use a cane to relieve the strain on the affected muscles.
Carrying a heavy object in one hand or carrying a child, an injury, a sudden fall, prolonged or fast walking, especially on uneven surfaces, or intense running, tennis, hockey, soccer, and other sports can severely strain the gluteal muscles and cause characteristic pain. Lying on the affected side can cause such intense pain that turning onto that side during sleep can wake the person up.
Being overweight or being pregnant in late pregnancy often causes lower back and hip pain. Excessive hip flexion while sleeping on the side in the fetal position or excessive forward lean while sitting can also cause pain.
Compression of the gluteal muscles, decreased blood flow, and activation of trigger points can be caused by prolonged sitting with a wallet or other bulky item in the back pocket of your trousers.
Gluteus Medius and Minimus Muscle Tests
Perform two tests to determine the condition of your gluteus minimus and medius muscles.
Lie on your left side and bend your right leg at 90 degrees at the hip. If your muscles are healthy, your knee will touch the floor.
If your knee is slightly above the floor, this indicates limited hip adduction, which may be caused by tight gluteus medius and minimus. Roll onto your right side, repeat the test on the other side, and compare the results.
Perform the second test. Sit in a chair and try to slowly cross your right leg over your left, then repeat the test on the other side.
If you have a problem with your gluteus minimus and medius, you will either be unable to cross one leg over the other or will experience increased pain, typical of these muscles.
INSTANT Relief from SI Joint, Hip, Glutes & Leg Pain
Since the gluteus medius and minimus perform the same functions and are located in the same location, the differences between these two muscles are not very significant from a treatment perspective. To relieve pain and trigger points at home, you need to apply mechanical force to the muscles and then do stretching exercises.
Use a large massage foam roller or a two-liter bottle filled with warm water. Lie down on the floor and massage the area of the right gluteus medius and minimus from the iliac crest to the greater trochanter of the femur for several minutes.
Move slowly back and forth along the muscle fibers, breathe smoothly through your nose, and try to relax the muscles as much as possible. Turn to the other side and slowly massage the opposite side for several minutes.
Next, take a tennis ball or special massage balls with a diameter of 8 or 12 centimeters and again massage the gluteus medius and the gluteus minimus underneath, paying particular attention to the characteristic trigger point areas. If you find a tight or painful area of the muscle, stop and apply pressure to it for 15-30 seconds, then massage the muscle again. Be sure to repeat this exercise on the other side.
It’s more comfortable to work the gluteus medius and minimus while lying on the floor on a large massage ball. However, if this exercise causes you unbearable pain, do the same exercise against a wall, adjusting the intensity of the massage.
Gluteus Medius & Minimus Massage
You can also enlist the help of a massage therapist or a friend. Lie on your side and place a pillow between your legs. Bend your top leg slightly at the hip. Ask a person nearby to massage first the right, then the left gluteus medius and minimus muscles with their thumbs for several minutes, pausing for 15-30 seconds over the trigger point area.
To significantly intensify the pressure on the trigger points, you can use your elbow. Start by applying gentle pressure with your elbow, then gradually increase the intensity.
Afterward, be sure to stretch.
Gluteus Medius & Minimus Stretch
The primary function of the gluteus medius and minimus, in addition to pelvic stabilization, is hip abduction. The anterior and posterior fibers of these muscles also contribute to internal and external rotation of the thigh at the hip joint. Therefore, to stretch these muscles, you need to adduct the hip.
Lie on your left side on a table or couch. Place a blanket or small pillow under your pelvis. First, tense your right gluteus medius and minimus for 5 seconds by lifting your right leg up, or try lifting your right leg up while applying downward pressure with your left heel.
Then relax and allow your right leg to lower. To intensify the stretch, you can apply additional pressure with your left foot. Hold the final position for one minute, breathing smoothly and deeply through your nose. This exercise stretches the anterior and central fibers of the gluteus medius and minimus. To further stretch the posterior fibers of the glutes, move closer to the front edge of a table or couch, lift your right leg up for 5 seconds, and then lower your right leg back down, holding the final position for one minute.
After performing 2-3 repetitions of this exercise, be sure to turn onto your other side and stretch your left gluteus minimus and medius.
A similar exercise can be performed standing against a wall. Leaning your hands against the wall, extend your right leg back and to the left. Bending your left leg and lowering your pelvis, stretch your right gluteus medius and minimus for one minute. Then repeat this exercise on the other side.
You can also hold a chair, grasp the back of the chair with your hands, and place your right foot on the seat. Press your right knee with your right hand and slowly lower your right thigh down.
Hold the final position for one minute. Slowly return to the starting position and repeat the exercise on your left leg.
You can stretch your glutes while sitting on the floor. Bend your right knee and place your right foot behind your left knee. Grasp your right knee or thigh with your left hand. Rotate your torso to the right and strongly adduct your right thigh. After holding this position for a minute, repeat the exercise on the other side.
A similar exercise can be performed lying on your back.
Yoga also offers a number of more challenging, yet even more effective, exercises that intensely stretch the gluteus minimus and medius muscles, such as kapotasana (pigeon pose), garudasana (eagle pose), agni stambhasana, and vatayanasana. However, all of these require extensive preparation.
After completing any of the stretching exercises described above, it’s important to engage your gluteal muscles. To do this, perform several cycles of active movements, adducting and abducting your leg. A wonderful addition to completing the entire gluteus medius and minimus workout is warming the gluteal area with a hot, moist compress.
When driving, the right foot is almost always on the accelerator pedal, which leads to constant tension in the right gluteal muscles. Use cruise control whenever possible and change your foot position frequently. If you’re traveling long distances, take breaks every 200-300 kilometers to stretch your muscles. If you spend a lot of time sitting at a computer, get up every 15-20 minutes, walk around the room, or do exercises that improve blood flow to the gluteal muscles or stretch.
Before injecting any medications into the gluteal muscles, it’s essential to examine them for trigger points, as intramuscular injection of some medications can activate trigger points and cause rapid pain.
Trigger points in the quadratus lumborum can cause trigger points in the gluteus medius and minimus. I highly recommend watching the video about this muscle, as well as the videos about other muscles in the “pain relief” playlist. If you enjoyed this video, I’d be happy if you’d give it a like or comment, and share it with your friends who suffer from lower back, buttock, and leg pain. Stay healthy!