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Gluteus Minimus – Pain & Trigger Points

The gluteus minimus is, as its name implies, the smallest of the gluteal muscles and is therefore part of the muscles of your buttocks.

Like all the other muscles featured on this site, it can get overloaded, tense and develop trigger points.

As a result, your buttocks will hurt.  Often there is also sciatic pain, i.e. pain radiating down the leg of the affected side. A problem that troubles a lot of people.

Do you know that you can control this pain yourself? Provided that the pain stems from the gluteus.

On this page you will learn everything you need to know in order to free this muscle of pain and trigger points.

1. Pain Patterns, Symptoms & Differential Diagnoses

1.1 Pain patterns

If the gluteus minimus is tense, it is sensitive to pressure and locally painful. That means if you push into the muscle, it’ll hurt right there.

However, if the muscle carries trigger points , the pain might radiate to other areas. In this case to the leg of the affected side. The pain zones differ depending on where the trigger points are situated.

Here we distinguish between trigger points in the front and rear portion of the muscle.

Trigger points in the front portion of the muscle can send pain from the back of your buttock to the lateral side of your thigh, and all the way down to your ankle.

In rare cases, the pain can even radiate into your foot (not shown in the picture!).

Trigger points in the rear portion, on the other hand, lead to a different pain distribution. They cause pain below the iliac crest and at the back of the buttock.

Moreover, these points can lead to pain in the back of the thigh, the outer hollow of the knee and the upper half of the calf.

1.2 Symptoms and ailments

The tensions and trigger points described above often cause the affected person to feel pain at night when lying on the side, because of the body weight put on the muscle.

In addition, many affected persons complain of pain after having been in a sitting position for a long period of time. Standing up, and even walking can be unbearably painful.

You may not be able to find a pain-free position, which can be very stressful. Especially if you do not know that the gluteus minimus may be the cause of the pain.

1.3 Differential diagnoses

The pain described can also be caused by an inflamed bursa on the outside of the thigh – bursitis trochanterica – or by a pinched nerve – radiculopathy –  e.g. a spinal disc herniation.

In this case, it is recommended to consult an orthopaedist!

2. Origin, Insertion & Innervation

As always, the exact Latin names are not important for you. But you need to know that the muscle runs from your iliac wing to the lateral side of your thigh.

Nevertheless, in the following I provide the exact anatomical landmarks for all who are interested.

Origin:

  • Ala ossis ilii

Insertion:

  • Trochanter major

Innervation:

  • The muscle is innervated by the nervus gluteus superior L4, L5 & S1.

3. Function

Six functions can be distinguished:

  • Internal rotation of the hip
  • External rotation of the hip
  • Flexion of the hip
  • Extension of the hip
  • Abduction of the thigh
  • Stabilization of the hip in single leg stance

The anterior fibers of the muscle rotate the thigh inward, thus leading to an internal rotation of the hip, beside of providing its flexion.

1

Hip internal rotation

2

Hip flexion

The posterior fibers rotate the thigh outward/laterally, thus they provide external rotation and extension of the hip.

1

Hip external rotation

2

Hip extension

The muscle as a whole spreads the leg to the side, which is also called abduction, or stabilizes your hip while you stand on only one leg.

This prevents the body from tilting to the side where the leg has no contact with the ground.

1

Hip abduction

2

Stabilization of the hip in single leg stance

It becomes clear that the muscle contributes significantly to your gait, as all of its functions are required when walking.

So hopefully it now makes sense for you that walking causes pain if your gluteus minimus is tense and/or carries trigger points.

4. Gluteus Minimus – Trigger Point Activation

Overloading, but also lack of strain (“underuse”) are the most common factors for tension, trigger points and thus also for pain in the gluteus minimus.

Overload occurs mainly in sports. Especially in sports that require you to change direction many times or to stand frequently on one leg.

  • Handball
  • Basketball
  • Volleyball
  • Soccer
  • Jogging
  • Athletics
  • Ballet
  • Taekwondo

But keep in mind that even a long walk or hike might cause tension and trigger points. Especially if you are not used to these activities.

“Underuse” is found in our inactive lifestyle and is reflected by all sitting positions.

  • Desk work
  • Driving a car
  •  …

The anterior fibers of the gluteus minimus are permanently approached by the hip flexion associated with sitting.

Thus, the anterior portion of the muscle is shortened, while the posterior fibers are permanently stretched. Both is “unhealthy” for a muscle and sooner or later causes ailments.

In addition to under – and overuse, the following scenarios also often lead to trigger points.

  • Claudication
  • Iliosacral dysfunctions
  • Sitting on your wallet (in rear trouser pockets)

5. Palpation

Since it’s impossible for you to feel the muscle (as it lies so deep), I will show you its massage area in the following chapter.

6. Self-massage of the Gluteus Minimus

For the self-massage, you need a hard massage ball. It must also not be too large, otherwise you will not be able to penetrate deep enough into the tissue to reach the muscle.

Alternatively, you can massage it with your hands. However, this puts a lot of strain on your fingers and is only possible if you have very strong hands. Please be careful with your hands!

As a massage technique you can use all the techniques presented on this website.

  • Ischemic compression
  • Precise massage strokes / rolling movements (with the ball)
  • Pressure-motion technique

On this page, I will explain how to loosen the muscle with precise massage strokes whilst lying down.

6.1 Self-massage of the anterior fibres with a massage ball

The area you are massaging is situated between the greater trochanter and the iliac crest. Please don’t be scared, you will understand where to place the ball,  I promise.

  • The greater trochanter is the bony eminence/knob that you can feel on the upper outside of your thigh. Try to feel this protrusion.
  • The iliac crest is the border on the upper side of your pelvis.
  • Exactly between these two points there’s muscle tissue, and deep inside, there are the anterior fibers of the gluteus minimus situated.

Note: The gluteus medius also is situated in this area and you will inevitably massage the two at a time. But that is not a problem!

  • Lay down on the floor and place the ball between your greater trochanter and the iliac crest. Flex your other leg. Your lower arm is raised up.
  • Slowly roll to the side and shift some weight onto the ball. Your lower arm and the upper leg control how much weight you place on the ball.
  • Move your hips over the ball with small movements – up and down and forward and backward. This way seek for painful points in the muscle.
  • As soon as you find one, roll over it a few times. Always from just before to just behind the painful spot.
  • Move very slowly and maintain a calm and deep breathing pattern – this will help you to relax during the massage.

6.2 Self-massage of the back fibers with a massage ball

To massage this area, place the ball between the iliac crest and the greater trochanter, but this time a little further back.

  • Lie down on your back, flex both legs and place the ball on your buttocks.
  • Move some weight onto the ball and seek for painful points.
  • Control the pressure with your legs.
  • Massage each tension with small rolling movements.
  • To get really deep into the gluteus minimus, you can move your other leg over the leg of the side to be massaged, or even lay it down on it.
  • Attention: This makes the massage extremely intensive and puts a lot of pressure on your pelvis. Start this very slowly and increase intensity over a period of several weeks.

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. The Lower Extremities. Baltimore, MD: Williams & Wilkins, 1993. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print