Gluteus Medius Pain - the Butt of All Problems

Gluteus medius pain can be a frustrating experience, especially for those who lead active lifestyles. It is important to understand the factors contributing to gluteus medius pain, how it can be diagnosed, and what treatments are available.

WHAT IS THE GLUTEUS MEDIUS

The gluteus medius, together with the Gluteus Maximus and Gluteus Minimus, comprise the gluteal muscle group. This group of muscles is a very powerful muscle group of the human body, controlling many of the major movements of the hip. The gluteus medius (GM) serves to maintain pelvic stability, however weakness or inactivity of this muscle can produce harmful effects. This article will take you through some important information about the GM, and how to keep yours strong and functional.

WHAT IS THE ROLE OF THE GLUTEUS MEDIUS?

‍Among other things, the gluteus medius serves to maintain pelvic alignment during single-leg activities (jumping and landing, kicking etc.). When you consider that over 50% of the gait cycle is spent on one leg, which can be increased by over a further 30% during running, it is easy to appreciate the importance of this muscle in a healthy, functioning body.

A weak gluteus medius can result in what is called, 'Trendelenburg Sign', essentially the hip dropping down during stance phase of the gait cycle. This hip drop sounds relatively innocent, but remember that the human body, although separated into different muscle groups, functions as a chain. Although the GM seems like a relatively small muscle in isolation, a "chink" in this part of the chain can have significant effects on the rest of the body. Repeated misalignment of the pelvis during gait can lead to other problems in the lower body, such as spinal, knee and ankle misalignment. This not only increases risk of injury from overuse (e.g. tendinopathy) or incorrect landing (e.g. ACL), but can also decrease the body's ability to generate power during general and sporting activity.

WHAT CAUSES GLUTEUS MEDIUS PAIN?

The butt is used as the main cushion of the body at rest, as such it bears a lot of pressure. But unnecessary or unexpected physical or physiological situation can produce gluteus medius pain. The following are the most common causes for pain in the GM area.

• ‍Muscle strains or injuries: Butt pain can occur if the muscles in the buttocks area are overworked or strained. This can happen due to heavy lifting, running, or playing sports. The pain may be a dull ache or a sharp pain accompanied by muscle weakness or spasms.
• ‍Nerve irritation, such as sciatica: The sciatic nerve runs through the buttocks and down the leg. This is called sciatica and can be caused by a herniated disc, spinal stenosis, or other conditions. Anger or compression of this nerve can cause pain in the buttocks.
• ‍Herniated discs: A herniated disc occurs when the soft inner material of a spinal disc bulges out through a tear in the outer layer. This can put pressure on the sciatic nerve and cause pain in the buttocks and the leg.
• ‍Issues with the hips or lower back: The hips and lower back are closely connected to the buttocks, so problems with these areas can also cause pain. This can include conditions such as hip arthritis, bursitis, or sacroiliitis.
• ‍Prolonged sitting: Sitting for long periods can put pressure on the muscles and nerves in the buttocks, leading to pain and discomfort.
• ‍Arthritis and other joint-related ailments: Arthritis is a condition that causes inflammation and stiffness in the joints and can affect the hips and lower back, leading to pain in the buttocks. 
• ‍Injury: Trauma or damage to the buttocks area can cause pain.

HOW CAN I RELIEVE GLUTEUS MEDIUS PAIN?

There are several ways to relieve and treat gluteus medius pain. The easiest and most natural way is through rest. Resting the affected area and applying ice to the pain can help reduce inflammation and pain.

Also, gentle stretching and exercises can help strengthen the buttocks' muscles and improve flexibility, which can help alleviate pain.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help to reduce inflammation and pain.

But preventions is always better than looking for a cure, and the best way to prevent gluteus medius pain is to strengthen your muscles.

‍HOW CAN I STRENGTHEN MY GLUTEUS MEDIUS?

‍The gluteus medius can be developed through many single-leg exercises within a gym program. It is important to ensure that your GMs are strong and active, to avoid the potential consequences described above. Several examples are described below:

• Hip drops. Stand on one leg. Drop the hip of the non-supporting leg down, then straighten the hips, driving the movement from the hip of the supporting leg.
• Crab steps. Tie a resistance band around your knees. Stick your tail out and bend your knees (in a "mini-squat" fashion), stay low, and step out to the side.
• TRX lunge. Holding onto the TRX, keeping the lower leg of your supporting leg still, sit back into a lunge, maintaining an even alignment of your hips. Push through your heels and return to the start position.
• Bulgarian lunge. Place one foot behind you on a higher surface, like a step, and the other foot on the ground. Hold a weight in the opposite hand to the supporting leg to offset your weight distribution (this will make your GM work harder to stabilise your hips). Keeping your lower leg still, drop down into a lunge, and push back up with your weight through your heels.

Consulting a physiotherapist will be worthwhile when your but pain becomes a chronic ailment. A physical therapist can help design an exercise program to specifically target the muscles and joints causing the pain.

TIPS TO REMEMBER

In summary here are some points to remember when you regularly experience GM or butt pain.

• ‍‍The GM is an important player in the stability and alignment of the pelvis during single-leg movement
• Over 50% of the gait cycle is spent on one leg, which can be increased by 30% or more during running
• Weakness or inactivity of the GM can lead to injuries of the lower back, hip, knee or ankle
• Exercises such as hip drops, crab steps, TRX lunge and Bulgarian lunge can help develop and activate the GM.

As we have discussed various factors can cause gluteal or butt pain. These include a sedentary lifestyle, muscle strain and overuse, sciatica, hip issues, herniated discs and arthritis. A combination of rest, stretches and exercises can help strengthen the glutes and relieve the pain.

It is important to seek medical advice if you experience persistent gluteal pain.

Need more help? Our physiotherapist are ready and able to assist you if you have any questions, call us on 9783 9990 or book online.