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Gluteus Medius Muscle – Origin, Nerve Supply, Functions

The gluteus medius muscle’s primary function is as a hip abductor, and the muscle also assists in medial and lateral rotation of the hip. The gluteus medius muscle finds its origin at the dorsal ilium just below the iliac crest. The gluteus medius muscle is susceptible to the development of myofascial pain syndrome. Such pain most often occurs as a result of repetitive microtrauma to the muscle from activities such as running on soft surfaces and overuse of exercise equipment or other repetitive activities that require hip abduction.

The gluteus medius, one of the three gluteal muscles, is a broad, thick, radiating muscle. It is situated on the outer surface of the pelvis. Its posterior third is covered by the gluteus maximus, its anterior two-thirds by the gluteal aponeurosis, which separates it from the superficial fascia and integument.

Origin

The gluteus medius muscle arises with a broad insertion from the gluteal surface of the ilium. The area of attachment is large and it spans between the anterior and posterior gluteal lines. The muscle belly takes an anteroinferior course towards the proximal femur, gradually tapering in size and giving off a narrow tendon.

The tendon passes over the anterosuperior side of the greater trochanter, being separated from it by the trochanteric bursa of the gluteus medius. Afterward, the muscle inserts to the lateral side of the greater trochanter of the femur.

Insertion

Gluteus medius is divided into three portions similar to the deltoid muscle of the shoulder joint

Fibers of the posterior portion pass forwards and downwards.
Fibers of the middle portion pass downwards.
Fibers of the anterior portion pass backward and downward. All Fibers combine to form a flattened tendon which attaches to the posterior and lateral part of the superior portion of the greater trochanter of the femur.

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Gluteus Medius

The gluteus medius muscle is fan-shaped and lies between the gluteus maximus and the minimus. It is similar in shape and function to the gluteus minimus.

Attachments: Originates from the gluteal surface of the ilium and inserts into the lateral surface of the greater trochanter.
Innervation: Superior gluteal nerve.

Functions

The gluteus medius muscle is important in stabilizing the ipsilateral hip in the stance phase of gait. When patients are unable to maintain pelvic neutrality, the energy cost of ambulation increases. We speculate that patients with weakness in the gluteus medius will subsequently develop low back pain, buttock pain, or trochanteric bursitis pain.

The anterior part acting alone helps to flex and internally rotate the hip.
The posterior part acting alone helps to extend and externally rotate the hip
The anterior and posterior parts working together abduct the hip and stabilize the pelvis in the coronal plane.^[rx]
Abducts and medially rotates the lower limb. During locomotion, it secures the pelvis, preventing pelvic drop of the opposite limb. (Note: the posterior fibers of the gluteus medius are also thought to produce a small amount of lateral rotation).
When the proximal attachment of gluteus medius is fixed, the muscle can contract as a whole or it can contract with its anterior fibers only. In the former case, the axis of the movement goes through the hip joint and muscle pulls the greater trochanter superiorly and abducts the thigh. In the latter case, as the axis of the movement tilts anteriorly, the muscle causes the internal rotation of the thigh.
When the distal attachment of the gluteus medius is fixed, the muscle pulls the ilium inferiorly, which results in the slight ipsilateral pelvic tilt and consequential raising of the pelvis on the opposite side. This action is important during walking, as it allows the raised leg from the opposite side to be moved towards the next step. Moreover, the strong tension generated within the muscle contributes to the stabilization of the pelvis and trunk during the gait cycle.

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References