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Gluteus Medius — Brookbush Institute | Brentbrookbush.com

 

Human Movement Science & Functional Anatomy of the:

Gluteus Medius

by Brent Brookbush MS, PES, CES, CSCS, ACSM H/FS (c) Primal Pictures Origin: External surface of the ilium between the iliac crest and the posterior gluteal line dorsally, and the anterior gluteal line ventrally and gluteal aponeurosis just lateral to the gluteus maximus (11). Insertion: Oblique ridge on the lateral surface of the greater trochanter of the femur (11).
  • The anterior and middle fibers of the gluteus medius are relatively superficial, only covered by the crural fascia.  The posterior fibers slip underneath the lateral border of the gluteus maximus.  Just anterior to the gluteus medius is the tensor fasciae latae.  Deep to the gluteus medius is the gluteus minimus.
    • Palpation of the gluteus medius may be accomplished by exploring the lateral ilium.  If you place your thumb on the PSIS (Posterior Superior Iliac Spine) and your index finger just posterior to the ASIS (Anterior Iliac Spine), and then with your other hand find the bony protuberance below the iliac crest that is your greater trochanter - you will create the shape of a piece of pie between your fingers.  This "piece of pie" outlines the gluteus medius.  Palpating the area you can feel the density of this muscle and the density of the muscle just below, the gluteus minimus.  By cuing abduction, internal rotation and external rotation you can feel various fibers contract under your fingers.  By doing this same exercise in prone and cuing extension, you can feel the lateral border of the gluteus maximus, and the gluteus medius fibers the disappear underneath it (12).
Nerve: Superior gluteal nerve via the sacral plexus and originating from nerve roots L4, L5, and S1 Action: Primary abductor of the Hip.  (The gluteus medius makes up 60% of total abductor cross section area (3).)
  • Anterior fibers internally rotate and may flex the hip
  • Posterior fibers externally rotate and may extend the hip
In the illustration below, note how the superior gluteal nerve courses superior to the piriformis and is "sandwiched" between the gluteus medius and minimus.  Although serious superior gluteal nerve neuropraxia is relatively rare it is worth noting the anatomy and sites for potential entrapment. Do not forget the nerve roots and the potential

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