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'''Original Editor '''- [[User:George Prudden|George Prudden]],  
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== Introduction ==
= Description[[Image:Gluteusminimus.jpg|thumb|right]] =
[[File:Gluteus minimus muscle08.png|alt=|thumb|250x250px|Gluteus minimus muscle.]]
Gluteus minimus [[muscle]] is the smallest one of the three [[Gluteal Muscles|gluteal muscles]], it lies deep to the [[Gluteus Medius|gluteus medius]] muscle. The gluteus minimus is similar to the gluteus medius in function, structure, [[Neurone|nerve]] and [[blood]] supply.<ref name=":0">Greco AJ, Vilella RC. [https://www.ncbi.nlm.nih.gov/books/NBK556144/ Anatomy, Bony Pelvis and Lower Limb, Gluteus Minimus Muscle.] InStatPearls [Internet] 2020 Apr 11. StatPearls Publishing.</ref>


The gluteus minimus, as its name suggests, is the smallest of the three gluteal muscles and lies beneath the other two muscles in the buttock region. This muscle shares almost identical functioning with the gluteus medius muscle, namely stabilizing the pelvis during walking or running and abducting the thigh when the leg is not weight bearing.<ref name="4">Trigger Point Therapist. Gluteus Minimus Trigger Points: A Small Muscle with a Big Mouth. http://www.triggerpointtherapist.com/blog/gluteus-minimus-pain/gluteus-minimus-trigger-points-small-muscle-big-mouth/</ref>&nbsp;The gluteus minimus is one of the secondary muscles that can produce hip extension.<ref name="1">Healthline. Gluteus minimus. www.healthline.com/human-body-maps/gluteus-minimus</ref>  
The gluteus minimus acts in synergy with the gluteus medius to abduct and internally rotate the thigh, and contributes to the stabilisation of the [[Hip Anatomy|hip]] and [[pelvis]]<ref>Ken hub [https://www.kenhub.com/en/library/anatomy/gluteal-muscles Gluteal muscles] Available: https://www.kenhub.com/en/library/anatomy/gluteal-muscles (accessed 12.1.2022)</ref>.[[File:Gluteus minimus attachments.png|350x350px|alt=|thumb|Gluteus minimus of right side: outline and attachment-areas.]]


= Anatomy  =
=== Origin ===
External surface of the [[ilium]], between the anterior and inferior gluteal lines.<ref name=":1">Standring S, Ellis H, Healy J, Johnson D, Williams A, Collins P, Wigley C. Gray's anatomy: the anatomical basis of clinical practice. American Journal of Neuroradiology. 2005 Nov;26(10):2703.</ref>


This muscle is located deep and somewhat anterior to (in front of) the gluteus medius. It is a broad and triangular muscle. The gluteus minimus and gluteus medius are separated by deep branches of the superior gluteal neurovascular bundle, a group of nerves and blood vessels. The gluteus minimus emerges from the external surface of the ilium, part of the large pelvic bone, between the base and the front of the gluteal lines, bony ridges on the ilium that are used to mark the attachments of different gluteal muscles. It inserts into the greater trochanter of the femur, which is a bony prominence located at the top of the thigh bone, near the hip joint.<ref name="1" />  
=== Insertion ===
Gluteus minimus muscle is fan-shaped, it inserts at the anterolateral aspect of the greater trochanter of the [[femur]].<ref name=":1" />


Like the gluteus medius, the minimus has a fan-like (or radial) structure with two fiber divisions; the thicker and compact anterior fibers and the flatter, but more spread out, posterior fibers.<ref name="4" />  
=== N'''erve Supply'''===
Superior gluteal nerve ('''L4''', '''L5''', '''S1''')<ref name=":0" /><ref name=":1" />


== Origin (proximal) attachments  ==
== Blood Supply ==
It is supplied by deep branch from superior gluteal artery<ref name=":0" /><ref name=":1" />[[File:Hip Abduction Test.png|alt=|right|frameless]]
== Action ==
Its main action is '''hip abduction'''.
# It stabilises the pelvic during single limb support in the [[gait]], as it is activated on the supported side, to keep the pelvic from dropping on the opposite swing side.
# Its anterior segment medially rotates the thigh.<ref name=":0" />
[[File:Gluteus minimus muscle.png|right|frameless|400x400px]]


Outer (external) surface of ilium, between the anterior and inferior gluteal lines.<ref name="2">Get Body Smart. Gluteus Minimus Muscle. http://www.getbodysmart.com/ap/muscularsystem/thighmuscles/posteriormuscles/gluteusminimus/tutorial.html</ref>
== Clinical relevance ==


== Insertion (distal) attachments  ==
* Weakness in the gluteus minimus results in [[Trendelenburg Gait|trendelenburg gait]], where the pelvic drops on the unsupported side.


Anterior surface of the greater trochanter of femur.<ref name="2" />  
*[[Lateral Step Down Test|Lateral step down test]] is used to assess quality of movement around lower [[Kinetic Chain|kinetic chain]].<ref name=":2">Whiler L, Fong M, Kim S, Ly A, Qin Y, Yeung E, Mathur S. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963550/#B18 Gluteus medius and minimus muscle structure, strength, and function in healthy adults: brief report.] Physiotherapy Canada. 2017;69(3):212-6.</ref><ref name=":3">Piva SR, Fitzgerald K, Irrgang JJ, Jones S, Hando BR, Browder DA, Childs JD. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1557500/ Reliability of measures of impairments associated with patellofemoral pain syndrome.] BMC musculoskeletal disorders. 2006 Dec 1;7(1):33.</ref>


== Nerve and blood supply ==
* Gluteus minimus tendinopathy often results in [[Greater Trochanteric Pain Syndrome]] (GTPS).  


A bursa is interposed between the tendon and the greater trochanter.&nbsp;Between the gluteus medius and gluteus minimus are the deep branches of the superior gluteal vessels and the superior gluteal nerve (L5, S1).&nbsp;The deep surface of the gluteus minimus is in relation with the reflected tendon of the rectus femoris and the capsule of the hip joint.<ref name="3">Wikipedia, the free encyclopedia. Gluteus minimus muscle. www.wikipedia.org/wiki/Gluteus_minimus_muscle</ref><br>  
* Gluteus minimus [[Trigger Points|trigger points]] : Gluteus Minimus is a multipennate muscle with multiple anterior, middle, and posterior trigger points referring strong pain in the [[Lumbar Anatomy|lumbar spine]] and ends at the [[Ankle and Foot|ankle]], following a similar pain pathway of [[Sciatic Nerve|sciatic nerve]] but without the neurological symptoms of the [[Sciatica|sciatic]] nerve such as weakness and numbness.<ref name=":0" /> The 4 minute video below is titled - Gluteus Minimus Pain and Trigger Points
{{#ev:youtube|sJhNTsMi0-U|300}}<ref>TrPTherapist. Gluteus Minimus Pain and Trigger Points
. Available from: http://www.youtube.com/watch?v=dMH0bHeiRNg [last accessed 18/12/2022]</ref>
== Assessment ==
[[File:Trendelenburg Gait.gif|alt=|thumb|Trendelenburg Gait]][[Trendelenburg Sign|Trendelenburg sign]] is used to assess the strength of the hip abductors (gluteus medius and gluteus minimus). It is done by asking the patient to do single limb support on the tested leg, while observing the patient from behind to observe the pelvic alignment. If the pelvic drops or deviates from the midline it is indicative of hip abductors weakness.<ref name=":2" />


= Function  =
== Physical Therapy Management ==
[[File:Hip exercises 2.png|right|frameless]]
The gluteus minimus is composed of two distinct segments (anterior and posterior) with two different roles. The anterior segment reduces the stresses on the hip anterosuperior structures and the posterior segment stabilises the head of the femur. Atrophy in the anterior segment is associated with increased risk of [[Falls in elderly|falls]], aging and [[Total Hip Replacement|total hip replacement]].


Along with the gluteus medius and tensor fasciae latae, the gluteus minimus serves as the primary internal rotator of the hip joint. The gluteus minimus helps with abduction (movement away from the midline of the body) and medial (inward) rotation of the thigh at the hip. Together with the gluteus medius, it acts to stabilize the hip and pelvis when the opposite leg is raised from the ground. Meanwhile, the tensor fasciae latae helps to internally rotate the hip joint.<ref name="1" />  
Recommended [[Strength Training|strengthening]] exercises include:
* Exercises that strengthen anterior segment: resisted hip abduction-extension exercise.
* Exercises that strengthen posterior segment: single leg bridge, side lie abduction, the resisted hip abduction-extension exercise and single leg squat.
* Exercises that produced low activity in both segments: side lie clam.
* Low activity was generated in the anterior segment in the single leg bridge.<ref>Moore D, Semciw AI, McClelland J, Wajswelner H, Pizzari T. Rehabilitation Exercises for the Gluteus Minimus Muscle Segments: An Electromyography Study. Journal of sport rehabilitation. 2019 Aug 1;28(6):544-51.</ref>


The following muscle groups share similar biomechanical functionality with the gluteus minimus muscle and may become overloaded if that muscle is unable to perform its workload due to trigger point activity or injury.&nbsp;The gluteus medius and minimus muscles are functionally (and sometimes anatomically) one muscle group, so to say they are synergists is an understatement.&nbsp;The tensor fascia latae muscle assists in both hip abduction and medial rotation.<ref name="4" /><br>
== References ==
 
= Assessment =
 
=== Palpation ===
 
 
 
=== Power ===
 
 
 
=== Length ===
 
 
 
= Treatment =
 
=== Trigger points  ===
 
Clients with trigger point activity in the muscle group may report or demonstrate the following symptoms and clinical findings.
 
*Pain in buttock, hip, posterior and/or lateral thigh and calf regions
*Hip pain while walking (causing limp)
*Pain while rising from a chair
*Pain may be constant and excruciating, unaffected by positioning
*Hip adduction, such as sitting with the affected leg crossed over the other leg, is limited by pain
 
{{#ev:youtube|sJhNTsMi0-U}}
 
= Resources =
 
 
 
= See also =
 
= Recent Related Research (from&nbsp;[http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) =
<div class="researchbox"><rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1dwOEnJFpGXw0SHvMBS8hQCDlvE6Y9pKvUcRzTUJ1q8LDvgECd|charset=UTF-8|short|max=10</rss></div>
 
= References  =


<references />  
<references />  
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[[Category:Hip]] [[Category:Hip_abductor]]
[[Category:Anatomy]]
[[Category:Muscles]]
[[Category:Hip]]
[[Category:Musculoskeletal/Orthopaedics]]
[[Category:Hip - Anatomy]]  
[[Category:Hip - Muscles]]

Latest revision as of 05:39, 30 January 2024

Original Editor - George Prudden,

Top Contributors - Lucinda hampton, George Prudden, Elvira Muhic, Kim Jackson, Lilian Ashraf, Khloud Shreif, WikiSysop, Candace Goh, Evan Thomas and Joao Costa;

Introduction[edit | edit source]

Gluteus minimus muscle.

Gluteus minimus muscle is the smallest one of the three gluteal muscles, it lies deep to the gluteus medius muscle. The gluteus minimus is similar to the gluteus medius in function, structure, nerve and blood supply.[1]

The gluteus minimus acts in synergy with the gluteus medius to abduct and internally rotate the thigh, and contributes to the stabilisation of the hip and pelvis[2].

Gluteus minimus of right side: outline and attachment-areas.

Origin[edit | edit source]

External surface of the ilium, between the anterior and inferior gluteal lines.[3]

Insertion[edit | edit source]

Gluteus minimus muscle is fan-shaped, it inserts at the anterolateral aspect of the greater trochanter of the femur.[3]

Nerve Supply[edit | edit source]

Superior gluteal nerve (L4, L5, S1)[1][3]

Blood Supply[edit | edit source]

It is supplied by deep branch from superior gluteal artery[1][3]

Action[edit | edit source]

Its main action is hip abduction.

  1. It stabilises the pelvic during single limb support in the gait, as it is activated on the supported side, to keep the pelvic from dropping on the opposite swing side.
  2. Its anterior segment medially rotates the thigh.[1]
Gluteus minimus muscle.png

Clinical relevance[edit | edit source]

  • Weakness in the gluteus minimus results in trendelenburg gait, where the pelvic drops on the unsupported side.
  • Gluteus minimus trigger points : Gluteus Minimus is a multipennate muscle with multiple anterior, middle, and posterior trigger points referring strong pain in the lumbar spine and ends at the ankle, following a similar pain pathway of sciatic nerve but without the neurological symptoms of the sciatic nerve such as weakness and numbness.[1] The 4 minute video below is titled - Gluteus Minimus Pain and Trigger Points

[6]

Assessment[edit | edit source]

Trendelenburg Gait

Trendelenburg sign is used to assess the strength of the hip abductors (gluteus medius and gluteus minimus). It is done by asking the patient to do single limb support on the tested leg, while observing the patient from behind to observe the pelvic alignment. If the pelvic drops or deviates from the midline it is indicative of hip abductors weakness.[4]

Physical Therapy Management[edit | edit source]

Hip exercises 2.png

The gluteus minimus is composed of two distinct segments (anterior and posterior) with two different roles. The anterior segment reduces the stresses on the hip anterosuperior structures and the posterior segment stabilises the head of the femur. Atrophy in the anterior segment is associated with increased risk of falls, aging and total hip replacement.

Recommended strengthening exercises include:

  • Exercises that strengthen anterior segment: resisted hip abduction-extension exercise.
  • Exercises that strengthen posterior segment: single leg bridge, side lie abduction, the resisted hip abduction-extension exercise and single leg squat.
  • Exercises that produced low activity in both segments: side lie clam.
  • Low activity was generated in the anterior segment in the single leg bridge.[7]

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Greco AJ, Vilella RC. Anatomy, Bony Pelvis and Lower Limb, Gluteus Minimus Muscle. InStatPearls [Internet] 2020 Apr 11. StatPearls Publishing.
  2. ↑ Ken hub Gluteal muscles Available: https://www.kenhub.com/en/library/anatomy/gluteal-muscles (accessed 12.1.2022)
  3. ↑ 3.0 3.1 3.2 3.3 Standring S, Ellis H, Healy J, Johnson D, Williams A, Collins P, Wigley C. Gray's anatomy: the anatomical basis of clinical practice. American Journal of Neuroradiology. 2005 Nov;26(10):2703.
  4. ↑ 4.0 4.1 Whiler L, Fong M, Kim S, Ly A, Qin Y, Yeung E, Mathur S. Gluteus medius and minimus muscle structure, strength, and function in healthy adults: brief report. Physiotherapy Canada. 2017;69(3):212-6.
  5. ↑ Piva SR, Fitzgerald K, Irrgang JJ, Jones S, Hando BR, Browder DA, Childs JD. Reliability of measures of impairments associated with patellofemoral pain syndrome. BMC musculoskeletal disorders. 2006 Dec 1;7(1):33.
  6. ↑ TrPTherapist. Gluteus Minimus Pain and Trigger Points . Available from: http://www.youtube.com/watch?v=dMH0bHeiRNg [last accessed 18/12/2022]
  7. ↑ Moore D, Semciw AI, McClelland J, Wajswelner H, Pizzari T. Rehabilitation Exercises for the Gluteus Minimus Muscle Segments: An Electromyography Study. Journal of sport rehabilitation. 2019 Aug 1;28(6):544-51.


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