Gluteus Maximus: Pain & Trigger Points

The gluteus maximus is your big buttock muscle. It is very hard and tense in almost every person with back pain and actually contributes to it.

This muscle can cause problems and pain, especially if you are not well trained, if you have a sedentary lifestyle, or if you use the muscle excessively.

On this page you will learn everything you need to know to successfully relieve and eliminate pain in the gluteus.

1. Pain Patterns, Symptoms & Differential Diagnoses

1.1 Pain patterns

Tensions in the gluteus maximus lead to local pain in the buttocks.

Even with trigger points, the muscle does not refer pain to other areas, such as do trigger points in the gluteus medius.

In addition to the classic trigger points in this muscle, tension in the iliac crest often result in pain in the lower back and “stiffness” in this region.

However, with a self-massage and long-term strengthening exercises, the problems can be controlled “relatively easily”.

Trigger Points and illustration of pain patterns

gluteus-maximus-triggerpunkt
1
gluteus-maximus-schmerzen-480px
2
gluteus-maximus-triggperpunkte-II
3

1.2 Symptoms and ailments

Besides the kinds of pain shown above, which can also occur at rest, people with tensions and trigger points in the gluteus maximus often report that the pain is particularly severe and gets worse when:

  • Sitting.
  • Walking uphill.
  • Climbing stairs.

This is because the already strained muscle is put under even more mechanical stress as you either lengthen its fibers or use it heavily in its function.

What is more, it is often very painful and can lead to cramps in the buttocks if you shorten the muscle and then tense it vigorously.

This happens over all when doing strengthening exercises for your bottom. Here you usually stretch your hip and contract strongly your bottom, hence also the gluteus.

2. Origin, Insertion & Innervation

The anatomical fixed points of this muscle are fairly complicated. For you, it is enough to know that the muscle extends from your iliac crest, sacrum and coccyx to the lateral side of your thigh.

3. Functions of the Gluteus Maximus

The functions of the muscle are diverse.

  • External rotation
  • Abduction
  • Adduction
  • Hip extension
  • Hip stabilization of the standing leg during the gait cycle

Note on hip extension: Our ischiocrural musculature (muscles on the back of the thigh) work closely with the gluteus and is usually more involved in hip extension than the gluteus. It gets very active especially when…

… the hip stretching is done out of a hip flexion.

  • Climbing up mountains and stairs with the body slightly inclined forward.

… the thighs are fixed.

  • Missionary position during sexual intercourse

… the hip extension is done out of a hip flexion and knee flexion.

  • Cross lifting or lifting heavy objects with straight back and bent knees

… the hip extension is accompanied by a back extension.

  • Leg strike during crawl swim
  • Lifting of the stretched leg in prone position
Hüfte-flexion-aussenrotation
1

External rotation (here in combination with hip flexion)

Hüfte-abduktion
2

Abduction

Hüfte-adduktion
3

Adduction

Hüfte-extension
4

Hip extension

4. Gluteus Maximus – Trigger Point Activation

Tensions and trigger points in the gluteus maximus are usually caused by overloading or underloading:

  • Sudden contraction with simultaneous extension of the muscle. In this case, the hips and knees are bent while the buttocks are tensed. Example: Cushioning a fall.
  • Lunges to the side. Example: Tennis.
  • Permanent activity. This is only “harmful” if the muscle is not used to it and you are not performing any balancing activities. Examples: Mountaineering, climbing stairs, strength training, …
  • Constant stretching. This includes all activities in which you either sit or bend forward for a longer period of time. Your gluteus maximus is stretched by hip flexion, for example when driving a car, working at a desk, hairdressing, assembly-line work, etc.

5. Palpation

Feeling these muscles will not be a problem for you. Just stand upright and contract your buttocks. Now feel the entire muscle with your hand.

That is, from your coccyx, through the sacrum, the iliac crest, to the outside of your thigh and down to your ischium.

6. Self-massage of the Gluteus Maximus

For the self-massage of the gluteus maximus, I recommend a hard massage ball. I use a cork massage ball.

There are several options how to perform the massage, depending on the level of intensity you require.

You can carry it out standing up (i.e. with the ball against the wall), or also in a lying position.

The standing variant is certainly the less intensive and especially suitable for you if the muscle reacts very sensitively to pressure.

  • Bend your knees and place the ball on the muscle.
  • Now lean against a wall.
  • Systematically roll over the entire area of your bottom and seek for painful points.
  • Especially at the iliac crest and in the outer middle of the buttocks, i.e. at the ischium, tensions are often present.
  • Roll over each painful spot a few times very slowly.

Other possible massage positions

gluteus-maximus-massageball
1

Massage in the area of the buttocks

gluteus-maximus-triggerpunkt-massage
2

Massage on the iliac crest

6.1 Self-massage whilst lying down

I will now show you the massage in a lying position, as it is very effective, apart from allowing to control quite well the massage pressure. As always, make sure you work very concentrated and slowly!

  • Lie on the floor and place the ball directly under your iliac crest.
  • Roll over this area very slowly.
  • Every painful point you find is worked on with a few rolling movements.

Now we go into the fleshy part of the muscle.  The way you massage this area is the same as described above. However, I must point out that the sciatic nerve might be exposed to slight pressure.

Personally, I’ve never had a problem with that before. But in people with very a weakly developed buttock musculature, the nerve is exposed to stronger pressure, since there is less musculature which could serve as a buffer zone.

If you put the nerve under pressure for too long, it may cause you some pain in the following one to two weeks. Possibly, this pain transmits to the leg and even if it is temporary, it is highly unpleasant.

Therefore: Start slowly with the massage, i.e. keep its duration and pressure low, especially at the beginning, and wait for the reactions of your body. This way you are on the safe side!

References

  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print