Gluteus Maximus: Difference between revisions
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== Description == | == Description == | ||
[[File:Gluteus maximus.png|thumb|Gluteus Maximus|right| | [[File:Gluteus maximus.png|thumb|Gluteus Maximus|right|314x314px]] | ||
It`s the largest and heaviest muscle in the body,It`s the most superficial of all gluteal muscles that is located at the posterior aspect of hip joint it`s not only that it`s also the largest muscle at the hip representing 16% of the total cross sectional area (TCSA).<ref name=":0">CLINICAL ORIENTED MOORE </ref><ref>A literature review of studies evaluating gluteus | |||
maximus and gluteus medius activation during | |||
rehabilitation exercises | |||
</ref> | |||
Its size allows it to generate a large amount of force. The muscle evolved from an adductor of the hip which is still seen in lower primates today. The development of the muscle's function is associated with the erect posture and changes to the pelvis. It now functions to maintain the erect posture as one of the muscles that extends the hip joint. | |||
The fibres of Gluteal maximus are largely perpendicular to each other and line up in the direction of pull giving it it's quadrilateral shape and course appearance. There are two layers to the muscle which pass down to the insertional attachment.<ref name="pala">Palastanga N, Soames R. Anatomy and Human Movement: Structure and Function. 6th ed. London, United Kingdom: Churchill Livingstone; 2012.</ref> | |||
'''N.B''' Glutes maximus covers all of the gluteal muscles except for the antero_superior third of the Glutes medius. this uncovered part of glutes medius is the safe are at which we apply buttocks dorso gluteal intramuscular injection . | |||
= | '''N.B''' The ischial tuberosity can be felt deep to the lower part of the Glutes Maximus , When the thigh is flexed the lower border of Glutes Maximus moves superiorly , exposing the ischial tuberosit subcutaneously .Therefore you don`t sit on your Glutes Maximus muscle but you sit on the ishial tuberosity , ischial bursae , subcutaneous fat and skin.<ref name=":0" /> | ||
== Origin == | |||
* Posterior gluteal line of the ilium and portiom of the bone superior and posterior to it .<ref name=":1">manual muscle test | |||
</ref> | |||
* Posterior surface of the lower part of sacrum .<ref name=":1" /> | |||
* Side of the coccyx .<ref name=":1" /> | |||
* Aponeurosis of erector spinae .<ref name=":1" /> | |||
* Sacrotuberous ligaemnt . <ref name=":1" /> | |||
* Gluteal aponeurosis . <ref name=":1" /> | |||
The deeper fibres form an aponeurosis which attaches to the '''gluteal tuberosity''' of the femur.<ref name="pala" /> | === Insertion === | ||
* The lager '''proximal portion of the muscle''' and the superficial fibers of '''distal portion of the muscle''' ,Which forms a Three-quarters of the fibres inserts into the Iliotibial tract and indirectly by the lateral intermuscular septum into linea aspera of femur .<ref name=":0" /> | |||
* The deeper fibres of '''the distal portion of the muscle''' form an aponeurosis which attaches to the '''gluteal tuberosity''' of the femur.<ref name="pala" /> | |||
=== Nerve supply === | === Nerve supply === | ||
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== Function == | == Function == | ||
* Gluteus maximus acts to extend and laterally rotate the [[Hip Anatomy|hip joint]]. Futhermore, upper fibres can abduct the hip whereas the lower fibres can adduct. | |||
Gluteus maximus acts to extend and laterally rotate the [[Hip Anatomy|hip joint]]. Futhermore, upper fibres can abduct the hip whereas the lower fibres can adduct. | * As a powerful extensor of the hip joint, the gluteus maximus suited to powerful lower limb movements such as stepping onto a step, climbing or running but is not used greatly during normal walking. Gluteus maximus and the hamstrings work together to extend the trunk from a flexed position by pulling the pelvis backwards, for example standing up from a bent forward position. Eccentric control is also provided when bending forward. Superior fibers of the gluteus maximus can extend the knee through its attachment to theIliotibial tract. | ||
* Gluteus maximus has several stability roles: balancing the pelvis on femoral heads thus maintaining upright posture, the attachment throught the iliotibial tract supports the lateral knee, and lateral rotation of femur when standing assists raising the medial longitudinal arch of the foot. | |||
As a powerful extensor of the hip joint, the gluteus maximus suited to powerful lower limb movements such as stepping onto a step, climbing or running but is not used greatly during normal walking. Gluteus maximus and the hamstrings work together to extend the trunk from a flexed position by pulling the | * Gluteus maximus works to offload the ischial tuberosities when supporting body weight in sitting by a static of dynamic contraction. | ||
* If the gluteus maximus is paralysed climbing stairs and running will become very difficult however, other muscles can extend the hip. Gluteus maximus can be trained to produce functional knee extension when quadriceps femoris is weak or paralysed.<ref name="pala" /> | |||
Gluteus maximus has several stability roles: balancing the pelvis on femoral heads thus maintaining upright posture, the attachment throught the iliotibial tract supports the lateral knee, and lateral rotation of femur when standing assists raising the medial longitudinal arch of the foot. | * Research has indicated that contraction of the deep abdominal muscles may assist with the contraction of gluteus maximus to assist with the control of anterior pelvic rotation.<ref name="kim">Kim TW, Kim YW.Effects of abdominal drawing-in during prone hip extension on the muscle activities of the hamstring, gluteus maximus, and lumbar erector spinae in subjects with lumbar hyperlordosis; J Phys Ther Sci. 2015 Feb;27(2):383-6</ref> Gluteal muscle weakness has been proposed to be associated with a number of lower limb injuries.<ref name="dist">Distefano LJ, Blackburn JT, Marshall SW, Padua DAGluteal muscle activation during common therapeutic exercises; J Orthop Sports Phys Ther. 2009 Jul;39(7):532-40</ref> | ||
Gluteus maximus works to offload the ischial tuberosities when supporting body weight in sitting by a static of dynamic contraction. | |||
If the gluteus maximus is paralysed climbing stairs and running will become very difficult however, other muscles can extend the hip. Gluteus maximus can be trained to produce functional knee extension when quadriceps femoris is weak or paralysed.<ref name="pala" /> | |||
Research has indicated that contraction of the deep abdominal muscles may assist with the contraction of gluteus maximus to assist with the control of anterior pelvic rotation.<ref name="kim">Kim TW, Kim YW.Effects of abdominal drawing-in during prone hip extension on the muscle activities of the hamstring, gluteus maximus, and lumbar erector spinae in subjects with lumbar hyperlordosis; J Phys Ther Sci. 2015 Feb;27(2):383-6</ref> Gluteal muscle weakness has been proposed to be associated with a number of lower limb injuries.<ref name="dist">Distefano LJ, Blackburn JT, Marshall SW, Padua DAGluteal muscle activation during common therapeutic exercises; J Orthop Sports Phys Ther. 2009 Jul;39(7):532-40</ref> | |||
== Anatomy Overview == | == Anatomy Overview == | ||
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| {{#ev:youtube|WHDdm0Yxh-o|400}} | | {{#ev:youtube|WHDdm0Yxh-o|400}} | ||
|} | |} | ||
== See also == | == See also == | ||
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<references /> | <references /> | ||
[[Category:Anatomy]] [[Category:Muscles]] [[Category:Hip Anatomy]] | [[Category:Anatomy]] | ||
[[Category:Muscles]] | |||
[[Category:Hip Anatomy]] | |||
[[Category:Musculoskeletal/Orthopaedics]] | [[Category:Musculoskeletal/Orthopaedics]] | ||
[[Category:Hip]] | [[Category:Hip]] | ||
Revision as of 21:34, 20 February 2019
Original Editor - Joanne Garvey
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Description[edit | edit source]
It`s the largest and heaviest muscle in the body,It`s the most superficial of all gluteal muscles that is located at the posterior aspect of hip joint it`s not only that it`s also the largest muscle at the hip representing 16% of the total cross sectional area (TCSA).[1][2]
Its size allows it to generate a large amount of force. The muscle evolved from an adductor of the hip which is still seen in lower primates today. The development of the muscle's function is associated with the erect posture and changes to the pelvis. It now functions to maintain the erect posture as one of the muscles that extends the hip joint.
The fibres of Gluteal maximus are largely perpendicular to each other and line up in the direction of pull giving it it's quadrilateral shape and course appearance. There are two layers to the muscle which pass down to the insertional attachment.[3]
N.B Glutes maximus covers all of the gluteal muscles except for the antero_superior third of the Glutes medius. this uncovered part of glutes medius is the safe are at which we apply buttocks dorso gluteal intramuscular injection .
N.B The ischial tuberosity can be felt deep to the lower part of the Glutes Maximus , When the thigh is flexed the lower border of Glutes Maximus moves superiorly , exposing the ischial tuberosit subcutaneously .Therefore you don`t sit on your Glutes Maximus muscle but you sit on the ishial tuberosity , ischial bursae , subcutaneous fat and skin.[1]
Origin[edit | edit source]
- Posterior gluteal line of the ilium and portiom of the bone superior and posterior to it .[4]
- Posterior surface of the lower part of sacrum .[4]
- Side of the coccyx .[4]
- Aponeurosis of erector spinae .[4]
- Sacrotuberous ligaemnt . [4]
- Gluteal aponeurosis . [4]
Insertion[edit | edit source]
- The lager proximal portion of the muscle and the superficial fibers of distal portion of the muscle ,Which forms a Three-quarters of the fibres inserts into the Iliotibial tract and indirectly by the lateral intermuscular septum into linea aspera of femur .[1]
- The deeper fibres of the distal portion of the muscle form an aponeurosis which attaches to the gluteal tuberosity of the femur.[3]
Nerve supply[edit | edit source]
The gluteus maximus is supplied by the inferior gluteal nerve (root L5, S1 and S2). Cutaneous supply is mainly provided by L2 and 3.[3]
Function[edit | edit source]
- Gluteus maximus acts to extend and laterally rotate the hip joint. Futhermore, upper fibres can abduct the hip whereas the lower fibres can adduct.
- As a powerful extensor of the hip joint, the gluteus maximus suited to powerful lower limb movements such as stepping onto a step, climbing or running but is not used greatly during normal walking. Gluteus maximus and the hamstrings work together to extend the trunk from a flexed position by pulling the pelvis backwards, for example standing up from a bent forward position. Eccentric control is also provided when bending forward. Superior fibers of the gluteus maximus can extend the knee through its attachment to theIliotibial tract.
- Gluteus maximus has several stability roles: balancing the pelvis on femoral heads thus maintaining upright posture, the attachment throught the iliotibial tract supports the lateral knee, and lateral rotation of femur when standing assists raising the medial longitudinal arch of the foot.
- Gluteus maximus works to offload the ischial tuberosities when supporting body weight in sitting by a static of dynamic contraction.
- If the gluteus maximus is paralysed climbing stairs and running will become very difficult however, other muscles can extend the hip. Gluteus maximus can be trained to produce functional knee extension when quadriceps femoris is weak or paralysed.[3]
- Research has indicated that contraction of the deep abdominal muscles may assist with the contraction of gluteus maximus to assist with the control of anterior pelvic rotation.[5] Gluteal muscle weakness has been proposed to be associated with a number of lower limb injuries.[6]
Anatomy Overview[edit | edit source]
Assessment[edit | edit source]
Palpation[edit | edit source]
Locate the iliac crest then move posterior along the crest to a small bony process called the posterior superior illac spine (PSIS). Place the palm of your hand with fingers pointing down and towards the midline of the body. The upper hand now covers the origin attachments and under the palm is the bulk of gluteus maximus.
Contraction of the muscle can confirm this. Gluteus maximus can be palpated whilst it acts during standing hip extension, a step-up, or whilst standing raise the medial borders of the foot.[3]
Power[edit | edit source]
- Hip extension in prone
- Body weight good morning
- Step up
- Functional tasks (steps, etc.)
Length[edit | edit source]
Treatment[edit | edit source]
Effective exercise to specifically target the gluteus maximus muscle includes the single leg squat and the singe leg prone dead lift. These exercises elicited the most significant activity in electromyography (EMG) when tested against other forms of exercise.[6]
Resources[edit | edit source]
See also[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 CLINICAL ORIENTED MOORE
- ↑ A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabilitation exercises
- ↑ 3.0 3.1 3.2 3.3 3.4 Palastanga N, Soames R. Anatomy and Human Movement: Structure and Function. 6th ed. London, United Kingdom: Churchill Livingstone; 2012.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 manual muscle test
- ↑ Kim TW, Kim YW.Effects of abdominal drawing-in during prone hip extension on the muscle activities of the hamstring, gluteus maximus, and lumbar erector spinae in subjects with lumbar hyperlordosis; J Phys Ther Sci. 2015 Feb;27(2):383-6
- ↑ 6.0 6.1 Distefano LJ, Blackburn JT, Marshall SW, Padua DAGluteal muscle activation during common therapeutic exercises; J Orthop Sports Phys Ther. 2009 Jul;39(7):532-40
