Gluteal Muscles

What exactly are glutes?

The glutes, also known as the gluteal muscles, are one of the largest and most important muscle groups in the body, forming the buttock region. These muscles provide support to the spine and pelvis, and play important roles in walking, running, standing, climbing, and many other lower limb activities.

Anatomy

The gluteal muscle group comprises three muscles: the gluteus maximus, gluteus medius, and gluteus minimus. 

Name origin: The term “Glute” originated from the Greek word “Gloutos,” meaning buttock and the three muscles are named with their Latin origins. 

Gluteus maximus comes from Latin, where ‘Maximus’ means ‘greatest or largest’, indicating it is the largest muscle. 

Gluteus medius is also from the Latin, where ‘Medius’ means ‘middle’, indicating that it is present between maximus and minimus. 

Gluteus minimus takes its origin from Latin, where ‘Minimus’ means ‘the smallest’, as it is the smallest in the group.

Where are your glutes located?

These muscles are located in the posterior aspect (back) of the pelvis and hip, forming the buttock region. The largest of these is the gluteus maximus muscle. The Gluteus medius and minimus are located deep, underneath the maximus. 

Beneath these three muscles, we have other deep external rotators of the hip, including piriformis, obturator internus, gamelli, and quadratus femoris.

Structure

Structurally, the glute muscles are organised in three layers, 

  • The gluteus maximus is in the superficial layer, 
  • The gluteus medius is in the intermediate layer, and
  • The gluteus minimus is in the deep layer. 

Gluteus maximus

The gluteus maximus is the largest muscle in the human body. This quadrilateral muscle slopes down obliquely across the hip, covering all the muscles underneath and contributing largely to the overall shape of the buttock. 

Proximal attachment: Posterior surface of the iliac crest, sacrum, coccyx, sacrotuberous ligament, and the thoracolumbar fascia. 

Distal attachment: Gluteal tuberosity of the femur and iliotibial band. 

Nerve innervation: The inferior gluteal nerve, a branch of the sacral plexus (L5, S1, S2) 

Blood supply: The superior and inferior gluteal arteries, branches of the internal iliac artery.

Gluteus medius:

The Gluteus medius is the broad, fan-shaped muscle situated between the gluteus maximus and minimus. It lies in the lateral aspect of the upper part of the buttock region, serving as the primary stabiliser of the hip and pelvis. 

Proximal attachment: External or outer surface of the ilium between the anterior and posterior gluteal lines, below the iliac crest. 

Distal attachment: Lateral surface of the greater trochanter of the femur. 

Nerve innervation: The superior gluteal nerve, a branch of the sacral  plexus (L5, S1, S2) 

Blood supply: The superior gluteal artery, a branch of the internal iliac artery. 

Gluteus minimus:

The gluteus minimus is the smallest and deepest muscle in the gluteal group. It is fan-shaped and lies directly beneath the gluteus medius and closely resembles it in structure and function. 

Proximal attachment: External or outer aspect of the ilium, between the anterior and inferior gluteal lines. And partly from the edge of the greater sciatic notch. 

Distal attachment: Anterior surface of the greater trochanter of the femur. 

Nerve innervation: The superior gluteal nerve, a branch of the sacral plexus. (L5, S1, S2) 

Blood supply: The superior gluteal artery, a branch of internal iliac artery.

Muscle fibre orientation and force production:

Gluteus Maximus

  • Fibre Orientation: Multipennate, oblique fibres toward the iliotibial band and gluteal tuberosity.
  • Force Production: High force generation due to a large physiological cross-sectional area (PCSA) is helpful for powerful hip extension, external rotation, and stabilisation.

Gluteus Medius

  • Fibre Orientation: Convergent (Fan-shaped) muscle. Fibres spread broadly over the lateral ilium and converge on the greater trochanter.
  • Force Production: Moderate force. But it is efficient for hip abduction and pelvic stabilisation during single-leg stance, allowing directional control of the femur.

Gluteus Minimus

  • Fibre Orientation: Convergent (Fan-shaped) muscle- similar to the gluteus medius, but small and thin.
  • Force Production: Moderate force, as it has a smaller PCSA, so weaker than medius or maximus. It is optimised for fine control and stability of the pelvis and hip joint

Function

All three muscles in the gluteal group primarily function on the hip joint. They provide a wide range of mobility and stability in the hip joint and pelvis. 

They work in all three planes of movement in the hip joint, while providing extensive stability to this important, weight-bearing, ball-and-socket joint.

What do your glute muscles do?

All the three muscles are in the posterolateral aspect of the hip joint, hence they’ll help with extension, abduction of the hip joint. However, the extent to which they contribute to the action varies. The gluteus maximus performs the lateral rotation alone and the other two can do both medial and lateral rotation owing to the orientation of these muscles.

Concentric (shortening) action:

Standard mover action:(distal attachment moving towards proximal) 

  • Gluteus maximus: Extension, abduction, external rotation of the hip joint, indirectly assists in the extension of the knee joint through the iliotibial band.  
  • Gluteus medius and minimus: Abduction, flexion and internal rotation by the anterior fibers, extension and external rotation by the posterior fibers.  

Reverse mover action:(proximal attachment moving towards distal) 

  • Gluteus maximus: Posterior pelvic tilt, contralateral pelvic rotation
  • Gluteus medius and minimus: Depresses same-side pelvis, anterior pelvic tilt by anterior fibers and posterior pelvic tilt by posterior fibers

Eccentric (lengthening) action:

  • Gluteus maximus: Controls and slows down flexion, medial rotation, and adduction of the thigh. 
  • Gluteus medius and minimus: Control and slow down adduction, flexion, medial rotation and lateral rotation.

Isometric function:

  • Isometric stabilisation of the pelvis, hip and subtalar joint. Additionally gluteus maximus provides stabilisation to the knee joint through the iliotibial band.  

What is the difference between buttocks and glutes?

The buttocks refer to the region of the body located on the posterior aspect of the pelvis. It is a visible, rounded, fleshy portion made of muscles (gluteal group), fat, skin and other connective tissues. 

While glutes (otherwise known as the gluteal muscles) refer to the group of three muscles situated in the buttock area, which are gluteus maximus, medius and minimus. 

Functionally, the buttocks provide cushion when we sit, and the glute muscles are responsible for movements of the pelvis, hips and thighs. and they play a vital role in everyday activities as well as sports activities of the lower limb. 

So, the glutes are the muscles present in the buttock region.

Are the glutes and hips the same?

No, glutes and hips are not the same. Hip refers to an anatomical area or a joint located in the anterolateral aspect of the upper part of the thigh or pelvis, while glute refers to the group of muscles situated in the posterolateral aspect of the pelvis. 

The gluteal muscles primarily act on the hip (femoroacetabular) joint, which is a ball-and-socket type joint, facilitating movements such as extension, abduction, and rotation.

Thus, while the glutes and hips are closely related in function and location, they are distinct anatomical structures.

Are the glutes the largest muscle?

Yes, glutes- specifically the gluteus maximus is the largest muscle in the human body. It covers most of the buttock area with attachments at multiple sites such as ilium, sacrum, coccyx, thoracolumbar fascia,  and sacrotuberous ligament. 

It has a thick, dense structure and the largest physiological cross-sectional area (PCSA), meaning more muscle fibers are packed within a given muscle volume. This feature makes the gluteus maximus one of the strongest and most powerful muscles in the body. It contains a high proportion of Type II (fast-twitch) fibers, which have larger diameter and designed for high-force generation required in activities like sprinting, climbing, and rising from sitting.

A common question is why it’s considered the largest when muscles like the latissimus dorsi and trapezius cover a wider surface area. The reason is that, although those muscles are broad, they are relatively flat and thin. The gluteus maximus, in contrast, is a thick, bulky muscle with greater volume and mass, which is why it is regarded as the largest muscle in the human body.

Conditions and Disorders

What health conditions or disorders can affect your gluteal muscles?

Greater trochantric pain syndrome:

It is a clinical umbrella term for lateral hip pain (located at the greater trochanter) arising from various structures surrounding the greater trochanter. This includes problem to the gluteal tendons, IT band, fascia, bursa, and other structures. 

Causes: The primary source of pain in GTPS is gluteal tendinopathy, which involves the tendons of the gluteus medius and minimus as they attach to the greater trochanter. Other sources include problems with the bursa and muscle weakness. 

Symptoms: Pain in the lateral side of the hip, sometimes radiating down the thigh but not below the knee. Tenderness, pain on palpation, pain provoked by lying on the affected side, crossing legs, prolonged standing, and stair climbing.

Gluteal tendinopathy:

It is the inflammation, degeneration and tearing of gluteal tendons, especially gluteus medius and minimus. This usually happens at their attachment to the greater trochanter on the side of the hip, making this a common reason for lateral hip pain. 

Causes: It usually occurs from repetitive stress, poor hip control, or compression caused by activities like walking, running, or lying on one side.
Symptoms: Pain on the outer side of the hip, tenderness over the greater trochanter, pain when climbing stairs, standing on one leg, or lying on the affected side, and sometimes a limp or weakness during walking.

Gluteal muscle weakness/ Gluteal amnesia:

Gluteal amnesia, otherwise known as sleeping butt syndrome or dead butt syndrome, occurs when the glute muscles become weak and inactive.  

It is the muscle weakness, and the term amnesia is fantasised, indicating that the gluteal muscles forget to activate or contract properly, which is not true.  Ref

Causes: Prolonged sitting, sedentary lifestyle, or pain in the hips and back can inhibit muscle activation. Other causes include nerve injury (superior or inferior gluteal nerve), immobilisation or disuse, and age-related muscle loss.
These factors reduce glute activation and strength, leading to poor hip stability and movement control. 

Symptoms: hip or buttock pain, difficulty in everyday activities like sitting to standing, walking, climbing stairs, poor balance and hip stability, indicated by the Trendelenburg sign. 

Gluteal strains:

The gluteus maximus can sustain muscle strains during powerful hip extension or sprinting, which is less common than hamstring or adductor muscle strains. 

Causes: Sudden acceleration or explosive movement, direct trauma to buttock, or overstretching during sports 

Symptoms: Sharp buttock pain during movement, swelling or bruising, pain when contracting the glute, usually in hip extension, and weakness during stair climbing or sprinting.

Gluteal Nerve injury:

Injury or compression of the superior and inferior gluteal nerves will affect the glute muscles as they are innervated by these nerves. 

  • The Superior gluteal nerve innervates the gluteus medius, gluteus minimus, and tensor fasciae latae, which are responsible for hip abduction, medial rotation, and pelvic stabilisation during walking. 
  • Injury to this nerve leads to weakness of the gluteus medius and minimus, reducing pelvic and hip control seen during walking, a hallmark sign known as Trendelenburg gait. 

 

  • The inferior gluteal nerve innervates the gluteus maximus muscle, the primary hip extensor and external rotator. Any injury to the inferior gluteal nerve will result in gluteus maximus weakness, causing difficulty during many daily activities, such as getting up from a chair, running, and climbing stairs. 

Causes: improper intramuscular injection, pelvic or hip surgery, trauma to the hip and pelvis, and posterior dislocation of the hip.

IT band syndrome

It refers to an overuse injury to the iliotibial band (IT band), a thick band of connective tissue where the gluteus maximus and tensor fascia latae attach.  The IT band becomes tight and irritated, causing pain on the lateral aspect of the knee or hip. It’s common in runners and cyclists.

Causes: Repetitive knee flexion–extension (running, cycling), weak gluteal or hip stabiliser muscles, tight IT band or tensor fasciae latae (TFL), poor biomechanics. 

Symptoms: Sharp or burning pain on the outer side of the knee and hip, pain worsens with running downhill, climbing stairs, or prolonged activity, tenderness over the lateral femoral condyle or greater trochanter.

Pyriformis syndrome

Piriformis syndrome is the compression, entrapment, or irritation of the sciatic nerve as it passes below the piriformis muscle, fibrous band and surrounding structures. It is also known as Deep Gluteal Syndrome, Sciatic Nerve Entrapment, or pseudo-sciatica.

Causes:  Piriformis muscle hypertrophy, spasm, or fibrosis, prolonged sitting, trauma, injections, or anatomical variation. 

Symptoms: Deep buttock pain that might radiate down the posterior thigh ( mimicking sciatica), pain worsens with sitting, hip flexion, adduction, or internal rotation, and there are no neurological deficits below the knee.