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18th July 2013
Gluteus Medius
Article by Jennifer Kirchner, Physiotherapist
What do knee pain, hip pain and thigh pain all have in common?
The answer may surprise you. After all, how can one structure
possibly affect three different spots on your leg? That one
structure is the Gluteus Medius. Gluteus Medius is one of the
three muscles that makes of the group of muscles known as the
Gluteals, or ‘gluts’ as most would refer to them. The other two
muscles in this group are the Gluteus Maximus and Gluteus
Minimus. This bulk of muscle attaches your pelvis to your thigh
and is involved in the majority of thigh and hip movements.
So how is Gluteus Medius involved in so many of your thigh and
hip movements? This muscle a fan-shaped muscle, which means
that the area where the muscle originates from (the pelvis) is wide, while the area into
which the muscle attaches (the outer thigh) is narrow. This gives the muscle the ability to
move the thigh to the front, side and back. It also helps to support your upper body on top
of your leg when you are walking, running, dancing, or even just standing still; without it,
you would fall over!
Have you ever seen someone excessively swinging
their hips as they walk (figure B)? That is Gluteus
Medius dysfunction at its best! In a normallyfunctioning Gluteus Medius, the hip is supported, and
the back and trunk remain upright (figure A).
Over time, if this muscle continues to be used
improperly it weakens. Its supporting muscles start to
overwork and result in pain or injury. There is a thick
band of tissue that runs down the outside of your thigh
called the Ilio-tibial Band, or IT band. It attaches to a
muscle at the top called Tensor Fascia Latae, which
lays over part of your hip, and attaches to other tissues
surrounding the outside of your knee joint. So how
does this make your hip or knee hurt? There are many different conditions that can arise as
a result of a deficient Gluteus Medius. Three common issues include:
1. Hip Bursitis: As gluteus Medius weakens, the IT band and Tensor fascia Latae take over.
The IT band can become very taught, causing a palpable ‘band’ over the outside of your
thigh which can compress a small fluid-filled bursa (sac) on the outside of your hip. The
constant irritation of the bursa is known as ‘Bursitis’ and can be very painful and red in
appearance.
2. Patello-Femoral Knee Pain: A weak gluteus Medius reduces the stability through the
lower limb. Instead of holding the thigh in abduction when in standing (figure A – hips
18th July 2013
level in single leg balance), it allows the opposite hip to drop and the standing leg to
slightly turn in (figure B). Subsequently, the knee can bend inwards into what is known
as a ‘valgus’ position. The quads muscle on the inner knee, known as the VMO, weakens
and allows the knee cap to be pulled off its natural track. This can be painful for the
runner.
3. Ilio-Tibial Band Friction Syndrome: Weakness in the Gluteus Medius allows the opposite
hip to drop (figure B) when walking or running. This causes the IT band to rub across the
bony surface of the thigh, causing friction. The band becomes tighter over time,
therefore increasing the tension over the bony thigh.
As you can see now, the Gluteus Medius is a very important muscle that must work properly
and work together with the other muscles of the pelvis and thigh to ensure that the leg is
supported and moving efficiently to avoid pain and injury!