Gluteus Medius Weakness
By Drew Heideman, MPT, ATC, PES
Gluteus Medius Weakness
The gluteus medius is a very important muscle located on the outer side of the hip. It acts dynamically when the foot is fixed on the ground to stabilize the pelvis. Weakness is this muscle can contribute to several lower extremity injuries so its strength and muscular endurance are critical to pain-free activity.
The gluteus medius muscle originates on the iliac crest, or lateral hip bones and runs down to attach the greater trochanter or outer part of the femur. Its action in non-weight bearing positions is to abduct, which is to move the leg away from the midline of the body. It also assists in external rotation of the hip. During closed chain activity, where the foot is fixed on the ground, the muscle acts as a stabilizer of the trunk and pelvis.
This occurs repeatedly with all daily activities including walking, running, and jumping. The gluteus medius contracts to prevent the downward movement of the pelvis on the opposite side. Its contraction also prevents the knee from moving inwards toward the midline when squatting.
Weakness in this muscle will contribute so several deviations when walking, running or squatting. First, this weakness allows the hip to adduct or move too far to the midline and the knee to move into a valgus or bent-inward position. Secondly, weakness can contribute to internal rotation of the tibia on the foot causing an increased weight transfer to the inside of the foot known as pronation.
This abnormal positioning as illustrated in this picture can contribute to several overuse injuries over time. First, the inward movement of the hip into adduction can contribute to lateral hip pain or bursitis as the muscles compress the trochanteric bursa. This is more common in older patients.
Second, and most common in running athletes, is lateral knee pain. This occurs because of the bent-inward position of the knee. This allows the iliotibial band to shorten and rub across the lateral femur. It also contributes to the lateral tracking of the patella through an improper line of pull of the quadriceps muscle. Finally, weakness of the gluteus medius can contribute to excessive pronation of the foot and aggravate foot conditions such as plantar fasciitis.
The gluteus medius muscle is critical to mechanically efficient lower extremity movement. Weakness in this muscle can contribute to several mechanical deviations with everyday activity and eventually cause injury.
One way to alleviate pain associated with pain in this muscle is stretching. Read more about exercises and stretches for hip pain here.
There are several ways to strengthen this muscle and prevent injury. Ask your therapist to show you the best ways for your particular case.