Gluteus Medius and Minimus are two muscles situated at either side of your pelvis. They attach your pelvis and sacrum to your femur (long leg bone) (Figure 1).
Their action is to abduct (see Figure 2) and to medially rotate the hip. More importantly for a runner, they serve to stabilise the pelvis during the stance phase (when your foot is on the ground) of your running gait. This stabilisation action is extremely important for two main reasons:
1. It keeps your pelvis and associated areas of your body in the best possible position for the large prime movers (muscles that propel you) to contract and drive you forward.
2. It keeps your pelvis in a position where it is least likely to be injured.
The major injury seen to these muscles is tendonitis at their attachment sites on the femur. They may also develop trigger points (small contractures in a muscle) that refer pain (send pain to another part of the body) down the lateral (outside) aspect of your leg, lateral knee, shin and lateral ankle.
However, more important are the many possible consequential injuries that may occur when this muscle becomes fatigued and/or weak. ITB friction syndrome (lateral knee pain common in runners), trochanteric bursitis (lateral hip pain), lower back, groin and many other possible symptoms may occur due to improper activity of your Gluteus Medius/Minimus.
Assessment of this muscle in a home environment is difficult. However, if you have a mirror, then can you perform a basic assessment by following the below instructions. A weak gluteus Medius/Minimus is often seen in hopping or even basic one-legged standing. Try standing on one leg in front of a mirror and look to see if the hip you are standing on is adducting (see Figure 3). Then compare to the other side. If you are not sure, try hopping on one leg and observe whether your hip is adducting when you land on that leg. The more you adduct, the more likely it is that you have a weak Gluteus Medius / Minimus and poor pelvic stability.
Treatment is to strengthen the weak Gluteus Medius/Minimus. Interestingly, runners will often be sent home with Gluteus Medius/Minimus exercises for many different pelvic and lower limb injuries. The use of these strengthening exercises can prevent further injuries and help avoid that next trip to your physical therapist. Moreover, good pelvic stability acts as a performance enhancer – so get into them!
Find yourself a step and follow the instructions:
- Put the foot of the weak hip on a step with the other leg hanging off the side
- Lower the foot that is not planted below the level of the step and then hitch this side up beyond the step level (See Figure 4).
- Repeat this until you feel fatigue/burn in the side of your hip (Gluteus Medius/Minimus)
- Swap sides, repeating each side three times.
With consistency, people with positive findings of hip/pelvic weakness should be able to reverse these within 3-4 weeks. When you have strengthened this group, do not forget to keep topping them up once per week to keep the strength.
Stretching this muscle is very difficult and somewhat debatable. Try stretching a portion of this muscle by following Figure 5.
One of the better ways to treat this muscle is to self massage it. You can do this by lying on a tennis ball directly on the muscle (See Figure 6).