For individuals experiencing gluteus minimus pain and are unsure where to start to deal with it, can a physical therapist, chiropractor, or general practitioner help diagnose lower extremity pain and develop an appropriate treatment plan?

Gluteus Minimus Muscles

The gluteus minimus is the smallest muscle of the gluteal muscles. Combined with the gluteus maximus and gluteus medius, these muscles make up the glutes. The glutes help form the buttocks shape, stabilize the hips, rotate the legs, and raise the thighs. The gluteus minimus and medius specifically support the gluteus maximus’s ability to raise the leg to the side and rotate the thigh inwards. (ScienceDirect. 2011)

Anatomy

• The gluteus minimus muscles are triangular and lie underneath the gluteus medius near the rotators of the hip joints. The muscles start in the lower ilium region, the upper and largest area of the hip bone that makes up the pelvis and attaches to the femur/thigh bone.
• The fibers on the top part of the muscle are thick and compact, while the lower fibers are flat and spread out.
• The superior gluteal nerves and blood vessels separate the gluteus minimus and the medius.
• The gluteus medius muscles start on the upper ilium region, which covers the gluteus minimus muscle entirely. The location of the gluteus minimus muscles envelopes the sciatic notch or the area in the pelvis that houses the piriformis muscle, superior gluteal vein, and superior gluteal artery, which provide a certain amount of protection.

Function

Movement depends on the location of the femur. The gluteus minimus muscle’s function is to:

1. Flex
2. Rotate
3. Stabilize

• When the thigh is extended, it helps abduct or swing the leg out away from the body.
• When the hip bones are flexed, the gluteus minimus rotates the thigh inward with the help of the gluteus medius.
• The movements are done with the support of the muscle fibers, which contract to move the thigh in both directions. (ScienceDirect. 2011)
• The gluteus minimus and the medius also stabilize the hips and pelvis during movement and when resting.

Associated Conditions

One of the most common injuries is muscle wearing and tearing, which can cause pain over and around the greater trochanter. This is known as greater trochanteric pain syndrome or GTPS, a condition usually caused by a gluteus medius or minimus tendinopathy, which can include inflammation of the surrounding bursae. (Diane Reid. 2016) For a gluteus minimus tear, the pain/sensations will be felt outside the hip, especially when rolling or applying weight on the affected side. A tear can happen suddenly with no particular activity causing the tear to occur aside from normal use and stress on the muscle. Physical activities like walking may be painful.

Rehabilitation

Treatment depends on the severity of the condition. Usually, rest, ice, and over-the-counter medication can help reduce swelling and pain symptoms. For pain symptoms that are not subsiding, it’s recommended to see a healthcare provider who can run an MRI or X-ray to see the condition of the muscle and rule out other causes of pain. The healthcare provider will refer the patient to a physical therapy team that can evaluate the strength of the gluteus minimus and provide a list of exercises and stretches to help repair the muscle while conditioning the surrounding muscles. (SportsRec. 2017) Depending on the level of pain, sometimes the healthcare provider will prescribe a cortisone injection to the gluteus minimus muscle in conjunction with physical therapy. This will help alleviate the pain so that the physical therapy exercises can be done comfortably, allowing the gluteus maximus muscle to heal properly and strengthen. (Julie M. Labrosse et al., 2010)

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The Science of Motion Chiropractic Care

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References

ScienceDirect. (2011). Gluteus minimus muscle.

Reid D. (2016). The management of greater trochanteric pain syndrome: A systematic literature review. Journal of orthopaedics, 13(1), 15–28. doi.org/10.1016/j.jor.2015.12.006

SportsRec. (2017). Physical therapy exercises for the gluteus minimus.

Labrosse, J. M., Cardinal, E., Leduc, B. E., Duranceau, J., Rémillard, J., Bureau, N. J., Belblidia, A., & Brassard, P. (2010). Effectiveness of ultrasound-guided corticosteroid injection for the treatment of gluteus medius tendinopathy. AJR. American journal of roentgenology, 194(1), 202–206. doi.org/10.2214/AJR.08.1215