The Anatomy of the Gluteus Maximus

The gluteus maximus muscle is the largest gluteal muscle located in the buttocks. Not only does it help move the thigh, it gives shape to the buttocks itself. The other two muscles that make up what’s most commonly referred to as the glutes are the gluteus medius and the gluteus minimus. The gluteus medius runs underneath the gluteus maximus and the gluteus minimus is located in front (or underneath) the gluteus medius. Together, the glutes help support your hips.

Anatomy

Structure

Within the gluteus maximus, fibers from the muscle enter into different parts of the body. This includes the femur (also known as the thighbone) and the iliotibial tract or band, which is made up of connective tissue that runs up the thigh. The area of the gluteus maximus known as the gluteal crease (also called the gluteal sulcus) is known as the horizontal crease right under the buttocks. This is caused by curve in fascia (connective tissue) and is actually not part of the gluteus maximus muscle itself. The superior gluteal artery transports blood from the heart to the glutes.

The gluteus maximus muscle is innervated by the inferior gluteal nerve, which is a branch of the sacral plexus. The sacral plexus nerves help with motor and sensory function in the thighs, lower legs, feet, and pelvis. The sciatic nerve runs under the gluteus maximus, from the lower back down to the leg, and is often the culprit for nerve pain in that area. The pudendal nerve, which is the main nerve of the perineum, runs under the gluteus maximus muscle.

Location

The gluteus maximus muscle lies over top of the gluteus medius and gluteus minimus, which is why it’s responsible for making up the buttocks and defining their shape. The gluteus maximus is commonly called a superficial muscle, which is what muscles that help provide shape are sometimes referred to.

The origin of the gluteus maximus is on the sacrum (a bony shield-like structure at the bottom of the lumbar vertebrae), the ilium (the upper, large part of the hip bone), the thoracolumbar fascia (tissue that connects the muscles in the lower part of the body like the buttocks and hips), and the sacrotuberous ligaments (which are attached to the posterior superior iliac spine). The gluteus maximus slopes at a 45-degree angle from the pelvis to the buttocks, then inserts at the gluteal tuberosity of femur and the iliotibial tract.

Anatomical Variations

In rare cases there may be a duplicate muscle the originates from the gluteus maximus muscle, or what’s more common is that the fibers of the gluteus maximus muscle may be inserted into different parts of the body and femur than they typically do. This can cause a condition called greater trochanteric pain syndrome (GTPS). GTPS can also be caused by inflammation of the glute med and minimum tendons, as well as inflammation of the bursa. Someone with GTPS will have tenderness or a pulsing feeling on the outer side of the hip and thigh when lying on the side as well as other symptoms.

Function

The gluteus maximus extends and externally rotates the hip joint, in addition to stabilizing and moving the hip joint both away and toward the body. The gluteus maximus is most vigorously engaged when effort or force is produced, in activities like running, climbing, or hiking. Regular walking, in an average person, does not typically target strength training in the gluteus maximus, though the gluteus maximus does help promote balance when walking (as well as other activities) by helping keep the pelvis balanced and assisting in keeping your posture upright.

Associated Conditions

The most common condition associated with the gluteus maximus is muscle strain, which can result from stretching and working the muscle so much that it becomes overstretched or tears. This can happen from over-exercising or not warming up or cooling down properly after exercising. Alternatively, not exercising and not utilizing your gluteus maximus can cause it to weaken which can lead to lower back pain, hip pain, as well as stability and posture issues.

Rehabilitation

If you are having pain in the lower extremities and think your gluteus maximus may be the cause, it’s important to make an appointment with a physical therapist. The therapist will evaluate the strength of your gluteus maximus muscles to diagnose any strain or weakness. From there, the therapist will develop a plan to help your gluteus maximus muscle heal. In the case of strain, this will include stretches once the strain is rested and improves.

It’s also recommended that if you’ve strained your gluteus maximus you take a few days up to a week off to rest the muscle, or at the very least stop doing the activity that caused you to strain the muscle to being with. You can also treat a mild strained gluteus maximus muscle with ice and over-the-counter medication like ibuprofen.

For weak gluteus maximus your physical therapist will help you strengthen the muscle with a tailored program of exercises that will help not only the gluteus maximus muscles get stronger, but the surrounding muscles in the glutes as well.

If you’re unsure where to start to deal with your gluteus maximus pain or don’t know how to find a physical therapist, start with an appointment to your general practitioner, who can help diagnose your lower extremity pain and point you in the right direction for finding a physical therapist if needed.