The Gluteus Medius Muscle in the Hip

by Paula Allia PT, DHSc, MTC, OCS

By: Paula Allia

Strengthening of the legs is important at every age. During the strengthening process the leg muscles are involved in all activities of locomotion. Some muscles work isometrically, others work in a shortening contraction or lengthening contraction.

These muscles through the neuromuscular system coordinate to assist, stabilize, or control desired activities. All of this is taken for granted, yet many have muscular imbalances. These imbalances then affect the rhythm of movement. Most do not even recognize the changes until dysfunction occurs. Thus, it is pertinent to strengthen properly to execute any action.

The hip joint is the most proximal joint in the lower extremity, and it plays a substantial role in support for the lower back and pelvis while moving the leg. Hip mobility exists in three planes of motion. First is the leg moving forward and back for propulsion (flexion-extension). Second is the side-to-side movement (abduction-adduction). Third, the hips can rotate and turn in and out (Internal rotation-external rotation).

All three of these planes of motion are utilized throughout the day in all activities from basic walking or crawling to jumping to playing sports and more.

The gluteal muscles (in the buttocks region) are extremely important. They attach at the pelvis and proximally on the femur (the upper leg bone).

Hip strengthening should be done in strength and endurance training. Some muscles favor speed while others are more non-fatigable. Exercising the large back and side muscles of the hip to work efficiently is necessary to support the back and guide the leg properly to avoid stress at the knee. The gluteus Medius deserves special attention because it is often strengthened incorrectly.

Hip strengthening of the abductors (moving the leg out to the side) is performed by the gluteus medius muscle up on the posterior lateral aspect of the buttocks. It is a tricky muscle in that the front portion not only abducts the leg out to the side but it also contributes to flexion and lateral rotation of the hip.

The posterior fibers of this same muscle abduct as well as extend and laterally rotate the hip. When there is tightness or an imbalance of the front portion of this muscle, the posterior fibers are relatively weaker. This can cause abnormal internal rotation at the hip which in turn can abnormal rotations at the knee.

Day-in day-out there is no wonder why there are so many people that need hip and/or knee replacements. If a muscular weakness in the gluteus medius is present, one may present with an abnormal gait. Normal gait should only have a small postural sway, but this weakness can produce a pronounced lateral pelvis shift or a waddle to one side.

Many demonstrate waddling with steps from either leg which may indicate weakness in both gluteus medius muscles. There is no doubt having good flexibility in the musculature surrounding the hip and proper strength will allow for a prolonged quality of activities with less wear and tear.

There are many exercises for the gluteus medius. Being more self aware is key to helping all day long. First, observe yourself walking toward a mirror. There should not be a swish side to side with steps. Work on walking straight and contracting the glute muscles while propelling forward.

Lying on one side and lifting a leg up and slightly back within the toe lifting up toward the ceiling is particularly helpful to get the posterior fibers of the muscle. Remember, this is a common weakness that exists that can be corrected to avoid further imbalances and compensatory movements. In this position the front portion of this muscle tends to kick in in conjunction with another muscle (tenor fascia latae), particularly if they are tight. These muscles may need to be stretched out first to allow for the posterior fibers to strengthen without the more forward resistance.

If working with a trainer, have them address specific concerns of the hip. Proper training will certainly provide better outcomes for longevity, stability of the hip, and activity.