Butt Stuff: Gluteus Medius and Piriformis

gluteus medius Butt Stuff: gluteus medius and piriformis

My pal Brooke Thomas, who has a guest post coming up, linked to an interesting post on Breaking Muscle yesterday written by Robert Camacho. the piece,  Your IT Band is Not the Enemy (But Maybe Your Foam Roller Is), was about foam rollers and the IT band in relation to gluteus medius.

I have never been a fan of foam rollers because I don’t think they are curative in any way. I have yet to meet someone who was able to stop using the foam roller once they started and for what it’s worth that doesn’t interest me much.  They work short term which is very cool when you do it, but soon after you are back to where you began.

The main thrust of Camacho’s post isn’t about the foam roller not working— it posits that if your issue in the outer hip is gluteus medius rather than the IT band and tensor fasciae latae then you might be making things worse.

Gluteus Medius and Minimus

Riffing on that, I will talk about the gluteus medius, a small muscle underlying the much larger gluteus maximus. Anatomy books assign different roles to gluteus medius and its close relation gluteus minimus. Some ascribe external rotation to gluteus medius and internal rotation to gluteus minimus while some say that the anterior portion of both internally rotate while the posterior portion of both externally rotate. Gluteus medius and minimus also abduct the leg in the same way as the tensor fasciae latae.

So there you have the long intro that gets me to the relationship of gluteus medius and the piriformis muscle, an external rotator that connects the leg to the sacrum. Piriformis— along with the psoas and gluteus maximus are the only muscles that connect the legs to the spine—tend to be extremely tight and troubling.

At the end of Camacho’s article he writes:

As with most movement disorders the true solution is mindfulness of your body position and mindfulness of your movements.

Any reader of the blog knows that this is right up my alley.

The piriformis is chronically tight in so many people due to turned out feet, a tucked under pelvis and thighs that sink forward of the hips.

Many problems with the deeper glutes, medius and minimus, stem from a tight piriformis. If the piriformis is too tight it inhibits the gluteal muscles ability to function correctly.

It always returns to posture. Here is a simple experiential exercise that might allow you to feel something of what I mean:

  • If you stand up and close your eyes with the feet together, fairly parallel, and the thigh bones well situated under the hips you should feel your body swaying slightly as the underlying gluteus medius and maximus do their thing searching for the balance between internal and external rotation.
  • Step your feet apart a bit and turn them out some, maybe even tucking the pelvis a bit and you might feel all of that internal search for balance shut down.

When we stand and walk poorly it is very hard for the body to work as designed. A tight and misaligned piriformis shortens the distance between the leg and the pelvis which also impacts the sacroiliac joint. When the piriformis is in this shortened state there is no room for the other muscles in the immediate area, specifically gluteus medius and minimus, to operate correctly.

Learning to change our posture to better align the piriformis can have incredible benefits including making everything happier in the surrounding area. This includes gluteus medius and minimus as well as the tensor fasciae latae and the IT band.