Small gluteal muscle

Gluteus minimus - m. gluteus minimus

When all its fibers contract simultaneously, the thigh is abducted. When the leg is free, its anterior fibers rotate the thigh inward. When the anterior fibers contract, the thigh rotates inward (pronates) as does the gluteus medius. When only the posterior fibers of this muscle contract, the thigh rotates outward. Together with the gluteus medius, it stabilizes the pelvis when walking.

Origin: outer surface of the iliac wing between the Linea glutea anterior et inferior

Attachment: Trochanter major

Innervation: spinal nerves L4-S1 - sacral plexus - n. gluteus superior

Diagnosis: Trigger points may be located in the anterior and posterior portions of the muscle. They lie beneath the gluteus maximus, medius, and tensor fasciae latae. Therefore, it is very difficult to palpate areas of tension, but local tenderness may be felt. When the gluteus maximus and medius are completely relaxed, taut fibers may occasionally be palpated deep in the buttock. Sometimes a pattern of referred pain may be obtained by prolonged pressure on the trigger points. To examine trigger points in the anterior portion of the muscle, the patient lies supine with the hip maximally extended, but still comfortable. A pillow may be placed under the knee if necessary. The anterior superior iliac spine is identified. The tensor fasciae latae is identified by asking the patient to rotate the thigh medially (pronate) against resistance; it is palpated just under the skin. The anterior fibers of the gluteus minimus can be palpated anteriorly and posteriorly to the tensor fasciae latae, just beneath the anterior superior spine. In some patients, they may be obscured by a thin layer of gluteus medius fibers. In some patients, the muscle may be obscured by the gluteus medius behind the tensor fasciae latae. Thus, palpation of the anterior border of the tensor fasciae latae is more effective than the posterior border. To examine the trigger points in the posterior portion of the gluteus minimus, the patient lies on the healthy side with the overlying thigh adducted and slightly flexed at 30°. The inferoposterior (medial) border of the gluteus minimus is defined by the location of the piriformis line. The piriformis muscle begins 1 cm cranial to the superior border of the palpable greater trochanter (attachment of the piriformis tendon) and extends to the superior end of the palpable border of the sacrum just below the sacroiliac joint, where the piriformis muscle enters the pelvic cavity. Trigger zones are located above this line above its midline and at the border of the middle and lateral thirds.

Referred pain. Pain from gluteus minimus trigger points can be long-lasting and quite severe. Anterior and posterior gluteus minimus trigger points cause referred pain down the posterolateral leg to the ankle. Trigger points in the anterior gluteus minimus cause referred pain to the posterolateral buttock, outer thigh, and knee. Referred pain from anterior trigger points does not extend below the ankle, although rarely pain may extend down the dorsum of the foot. Anterior poria trigger points cause referred pain to the inferomedial buttock, as well as the back of the thigh and calf, and occasionally to the back of the knee.

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