The posterior part of the gluteus medius muscle sits deep within the gluteus maximus muscle. Its lower part covers the small gluteus muscle.
The proximal insertions of the muscle are on the anterior 3/4 of the iliac crest and the distal ones on the greater trochanter.
The innervation is through the L4-L5-S1 roots via the superior gluteal nerve.
The main function of this muscle is to ensure the stability of the pelvis during unipodal support (when walking). It is the strongest thigh abductor muscle.
Myofascial syndrome of the gluteus medius muscle: the lumbago muscle
This muscle can have three “trigger points” (in green) along the iliac crest responsible for referred pain involving the posterior part of the iliac crest, the sacrum and the posterior and lateral parts of the buttock (in red).
Affected patients complain of pain when walking, have difficulty lying down on the affected side. The flat support on the back is also uncomfortable because there is pressure on the trigger points.
Various activities can trigger these pain points:
- sports trauma
- injection of drugs into the muscle
- Lower limb length discrepancy (usually greater than 10 mm)
- prolonged walking on soft ground (sand)
- Existence of an anomaly of the foot type Morton’s foot
- The myofascial syndrome of the gluteus medius can be confused with that of the gluteus maximus.
- Damage or blockage of the sacroiliac joint may also be responsible for this table
- a posterior articular syndrome of the lumbar levels can also give referred pain in this area.
- Similar pains are described after lumbar spine surgery
Like all myofascial syndromes, treatment is based on stretching and massage.
At night, when sleeping in the lateral decubitus position, a pillow will be placed between the two knees.
Prolonged sitting should be avoided, especially with legs crossed.
Self-massages with a tennis ball along the muscle while lying on your back to allow enough pressure on the muscle can be very effective.
If the problem persists, an X-ray of the pelvis will be made looking for an inequality in the length of the lower limb. A consultation with a podiatrist is also highly recommended.