Massage & Bodywork

January | February 2014

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education FUNCTIONAL ANATOMY Gluteus Medius By Christy Cael 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 GLUTEUS MEDIUS Attachments • rigin: External surface of the ilium, between the O anterior and posterior gluteal lines • nsertion: Posterosuperior angle and lateral I surface of the greater trochanter of the femur Actions • Abducts the hip • lexes and internally rotates the hip F (anterior fibers) • xtends and externally rotates the hip E (posterior fibers) Innervation • Superior gluteal nerve • L4–S1 It pays to be ABMP Certified: www.abmp.com/go/certifiedcentral 51

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