The gluteus medius is a large, fan-shaped muscle located on the external surface of the ilium. Compared to the more superficial gluteus maximus, the gluteus medius is located laterally and superiorly on the pelvis, originating exclusively on the ilium. The tensor fascia latae and the gluteal aponeurosis cover the anterior portion of the gluteus medius, so it is easiest to access it between the gluteus maximus and the gluteal aponeurosis, high on the ilium.
The gluteus medius parallels the deltoid muscle of the shoulder in shape, fiber direction, and function. Both are laterally oriented, act on a ball-and-socket joint, and have a broad origin and specific insertion. These muscles are capable of multiple actions, including abduction, extension, flexion, and internal and external rotation, but the primary action of both is abduction. The gluteus medius specifically assists with the other motions, while acting as a prime mover for hip abduction.
 Proper activation of the gluteus medius is key in maintaining alignment of the pelvis over the lower extremity during single leg stance. Tension in the iliotibial band and activation of the gluteus medius pulls the pelvis over the femur (origin toward insertion), preventing the pelvis from dropping away from the weight-bearing leg. This activation is key to normal gait and maintaining healthy alignment between the trunk and lower extremity.
An overstretching and weakness of the gluteus medius may occur in clients with true leg length discrepancy or in those who chronically support weight on one leg. Postural deviations, such as posterior pelvic tilt and those associated with Morton’s toe (a shortened great toe relative to the length of the second toe), may also contribute to dysfunction in the gluteus medius. Unilateral lower extremity activities, like driving or sitting with the legs crossed, may also trigger this issue. Note that several other issues may refer pain to the gluteus medius, including sacroiliac or lumbar facet dysfunction, and should be explored.
Weakness in the gluteus medius may be observed during postural assessment. With the client standing on one leg, observe the ability to keep the pelvis centered over the knee and foot. Check both sides and note any pain or discomfort. Clients may also complain of pain when positioned sidelying, whether on the affected side, or on the unaffected side with the affected side stretched.
 Christy Cael is a licensed massage therapist and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at functionalbook@hotmail.com.

Gluteus Medius
Attachments
• Origin: External surface of the ilium, between the anterior and posterior gluteal lines
• Insertion: Posterosuperior angle and lateral surface of the greater trochanter of the femur
Actions
• Abducts the hip
• Flexes and internally rotates the hip
(anterior fibers)
• Extends and externally rotates the hip
(posterior fibers)
Innervation
• Superior gluteal nerve
• L4–S1

Palpating the Gluteus Medius
Positioning: client prone.
1. Standing at the client’s side facing the hip, locate the lateral edge of the iliac crest between the gluteus maximus and the tensor fascia latae.
2. Slide your fingertips distally toward the greater trochanter, while pressing into the external surface of the ilium.
3. Passively rotate the femur externally to improve contact with
anterior fibers.
4. Resist as the client performs abduction of the hip to assure
proper location.

Client Homework—Tree Pose
1. Stand up tall with the feet slightly apart and the arms relaxed at the sides.
2. Maintaining good posture, fix your gaze at a single spot and shift your weight onto one foot.
3. Press your weight evenly into the ball and heel of your supporting foot, as you lift your other foot up and place the sole against the upper, inner thigh of the supporting leg.
4. Balance on the supporting leg, while maintaining a level pelvis and soft knee.
5. Bring your hands toward your chest and press the palms together.
Editor’s note: The Client Homework element in Functional Anatomy is intended as a take-home resource for clients experiencing issues with the profiled muscle. The stretches identified in Functional Anatomy should not be performed within massage sessions or progressed by massage therapists, in order to comply with state laws and maintain scope of practice.

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