Gluteus Medius / Minimus Tears

What are the gluteus medius and minimus?

The gluteus medius and minimus are two key muscles located in the buttocks. Both muscles originate from the outer surface of the ilium (the uppermost hip bone) and insert onto the greater trochanter of the femur (the bony prominence on the side of the upper thigh bone). These muscles play pivotal roles in hip stability and movement. The gluteus medius and minimus work together to facilitate abduction (lifting the leg away from the body), internal and external rotation of the hip (twisting the leg), and stabilization of the pelvis during activities like walking, running, and maintaining balance. They also assist in controlling the movement of the thigh bone within the hip socket, contributing significantly to overall lower limb function and stability.

How do gluteus medius / minimus tears present?

Tears in the gluteus medius and minimus muscles can occur due to degeneration, overuse, repetitive stress, or sudden trauma.

Symptoms of gluteus medius and minimus tears typically include:

• Pain: Often experienced on the outer side of the hip or buttocks. The pain might worsen with activities like walking, climbing stairs, or sitting for extended periods.
• Weakness: Difficulty in moving the hip or performing activities that involve hip abduction (lifting the leg sideways).
• Tenderness: The affected area may feel tender to the touch and may present with pain when lying on the affected side.
• Difficulty with Activities: Reduced range of motion in the hip joint and challenges with certain movements or weight-bearing activities.
• Instability or Feeling of Giving Way: Some individuals might experience a sensation of instability or a feeling that the hip is giving way during movement.

These symptoms can vary in intensity and may worsen with continued activity, impacting mobility and overall function of the hip joint.

How are gluteus medius / minimus tears diagnosed?

Diagnosing tears in the gluteus medius and minimus muscles involves first a comprehensive history of the symptoms and a physical examination. Dr. Shane J. Nho will want to know when the pain and/or hip dysfunction started, whether there was an injury at the onset of the pain, the severity and characterization of the pain, how it limits your daily activities and athletic pursuits, and what treatment options, if any, you have pursued prior to the visit. Next, during the physical examination, Dr. Nho will perform specific tests to assess the hip strength, range of motion, and to identify areas of tenderness or pain.

Next, x-rays of the hip will be evaluated to identify potential sources of the hip pain, including fractures, femoroacetabular impingement syndrome, and osteoarthritis. X-rays evaluate the bony structures of the hip, but they are unable to evaluate the soft tissue surrounding the hip, including the muscles, tendons, and ligaments. In case when Dr. Nho suspects that the patient may have a gluteus medius and/or minimus tendon tear, he will obtain additional imaging studies, most often an MRI (Magnetic Resonance Imaging) to better assess the gluteus medius and minimus muscles and tendons, alongside the surrounding soft tissue structures, including the hip labrum and cartilage.

In some cases, Dr. Nho will perform diagnostic injections into the greater trochanteric bursa (side of the hip) and/or into the hip joint to better identify the source of pain.