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Glut Medius, WE LOVE YOU

In the past 2 or 3 months, we have seen quite a few patients at the practice that, on evaluation, presented with weakness of the Gluteus Medius muscle. These patients’ main complaints were not pain in the Gluteus Medius muscle but more often complain of “runner’s knee” (also known as patella femoral pain syndrome/PFPS) or pain in the achilles tendon region.

This previously-neglected-now-much-talked-of muscle is, as millennials say, “the bomb” when it comes to rehab of the lower limb. Thus we give Glut Medius centre stage in this blog.

 Let’s take a look at some facts:

 Gluteus Medius is one of the three bilateral (one on each side of the body) buttock muscles essential to gait. Together they are the main movers when moving one’s leg backwards and to the side.

 

Origin and insertion

Gluteus Medius is a fan-shaped muscle that arises from the rim of the pelvis and inserts on the greater trochanter of each femur (that bony bump on the outside of you upper thigh bone).


Nerve supply

Both Gluteus Medius muscles are innervated by the Superior Gluteal nerve which is a branch of the large sciatic nerve.

     

Function
During walking, Gluteus Medius has the very important function of keeping the pelvis level (Moore). This allows one leg to stand securely on the ground while the other can swing forward to take a step.

Gluteus Medius also

  • brings the leg out sideways
  • does both inward and outward rotation of the leg, depending on which part of the muscle is being activated.

[If the front part of Gluteus Medius is active, it assists with inward rotation of the leg, as well as with forward bending of the hip. When the back part of the muscle is active, it assists with outward rotation of the leg and extending the leg backwards.]

 

Clinical significance
Gluteus Medius’ role in pelvic stability during gait, makes them important muscles for good, painfree gait.

Why strengthen? Think

  • improved lower limb balance 
  • improved lower limb control
  • greater muscle power 
  • greater muscle endurance
  • pain relief
  • injury prevention

 

Quicktest
We use a forward lunge to do a functional screening for weakness of the Gluteus Medius. 

How
Start standing upright with enough space to lunge forwards. Give a large step forward into a lunge and step back into starting position. 

Repeat a few time on each leg.

Key points
As the Gluteus Medius controls rotation of the leg as well as providing stability around the hips, watch for inward roll of the knee. A weaker Glutues Medius will be unable to keep the lunging leg’s knee cap facing forward. 

 

Exercises
Here are a few of our with favourites -

Running man
Stand with your back against wall, take a large step forward. 

Bend one knee and put your foot on the wall behind you, the other leg remains weight-bearing
(the weight-bearing leg is going to be doing most of the work). 

Mimic the motion of running by bending and straightening your weight-bearing knee, remember to add arm movements.

Clamshell
Position yourself lying on your side, hips and knees bent about 45 degrees, ankles stacked together.

Keep your feet together and lift your top knee to hip height. When lifting the top knee, don’t roll your pelvis backwards, keep the hip bones aligned

Wide stepping
Tie stretch band around your ankles.

Using very large steps, walk sideways for 10m, e.g. leading with you right leg. Return to your starting position but know lead with your left leg. Repeat 2 - 3 times.