Acupuncture for Gluteus Minimus Trigger Points
The gluteus minimus muscle is located on the back of the hip and is one of the three gluteal muscles. The other two are the gluteus maximus and the gluteus medius. The gluteus minimus is the deepest and smallest of the three glute muscles.
The gluteus minimus is primarily a hip abductor that shares the same actions as the anterior portion of the gluteus medius muscle and supports it to keep the hip and pelvis level while performing single-leg weight bearing exercises like walking or running. This function keeps the hip from dropping towards the opposite side.
Gluteus minimus trigger point pain can mimic sciatica pain. It is referred to as the “psuedo-sciatica” muscle by Travell & Simons. Glute minimus trigger points can cause sciatica-like pain down the back or side of the leg, as far down at the ankle, and rarely even to the top of the foot. The pain can be excruciating and deep, and difficult to pinpoint the origin of the pain to the gluteus minimus muscle.
As far back as 1941, research showed that 55 out of 70 patients that had “sciatica” pain actually had pain that was muscle (especially the gluteal muscles) or ligament related, rather than a spine or nerve issue.
Gluteus minimus pain can look like hip pain that can cause a limp, pain when lying on the affected side, or difficulty when standing up straight after sitting in a chair.
The gluteus minimus muscle can also be involved in cases of trochanteric bursitis because the muscle attaches to the anterior part of greater trochanter. The muscle’s bursa allows the gluteus minimus tendon to glide over the greater trochanter. Without this gliding, there can be a loss of range of motion as the muscle is not able to achieve a full stretch.
Gluteus minimus trigger point pain can mimic L5 and S1 radiculopathy, so assessing this muscle for trigger points is important in cases of radicular and sciatica pain.
Read more to learn about the gluteus minimus muscle, trigger points associated with it, and how acupuncture and dry needling can help relieve glute minimus pain naturally.
Origin and insertion of gluteus minimus
The gluteus minimus origin is at the outer gluteal surface of the hip (ilium) between the anterior and inferior gluteal lines. This area is close to the greater sciatic formamen, which is where the piriformis exits the pelvis.
The gluteus minimus insertion is on the anterior part of the greater trochanter - which is deep and anterior to the piriformis muscle attachment.
Based on the origin and insertion of the gluteus minimus muscle, we can see that it pulls the ilium (hip) and greater trochanter (leg) closer together, and primarily abducts the hip.
Actions of the gluteus minimus muscle
Abduct the hip
Medially rotate the hip
Flex the hip
When we think of moving this muscle we can think of abducting the hip, internal rotation of the hip, or flexion the hip.
Synergists and antagonists of the gluteus minimus muscle
Gluteus minimus synergists include the tensor fasciae latae and gluteus medius during abduction and medial rotation of the hip.
Gluteus minimus antagonists include the adductor muscle group which adduct the hip, and the gluteus maximus, piriformis, and lateral hip rotator group which laterally rotate the hip.
Gluteus minimus trigger points
Gluteus Minimus Trigger Points
Main complaints related to gluteus minimus trigger points include:
Buttock Pain
Sciatica
Lateral Leg Pain
Posterior Leg (Calf) Pain
Lateral Thigh & Hip Pain
Posterior Thigh Pain
Gluteus minimus trigger points refer pain into the buttock area and down the back or side of the leg. Since these trigger points span a wide area of the body - gluteus minimus pain can be hard to pinpoint and can be mistaken for many other trigger points. Travell and Simons refer to the gluteus minimus as the “pseudo-sciatica” muscle because these trigger points can mimic sciatica pain down the back or side of the leg. Gluteus minimus referred pain can be extremely persistent and severe. It is often a deep pain that can be hard to pinpoint the origin of it.
Gluteus minimus trigger points are divided into the anterior and posterior portion of the muscle. The anterior portion refers pain down the side of the leg, while the posterior portion refers pain down the back of the leg. It is important to check other muscles along the trajectory of the referral pain as it can be hard to differentiate gluteus minimus referral pain from other muscles with similar referral areas. The pain from gluteus minimus trigger point pain can be very distant from the site of the trigger point and this muscle should be assessed for a wide range of pain conditions because people in general sit so much.
Associated gluteus minimus trigger points can include the gluteus medius, piriformis, and vastus lateralis muscles due to their anatomical proximity and similar referral patterns.
Signs and symptoms of gluteus minimus trigger points
Hip pain that can result in a limp while walking
Pain that can affect and interrupt sleep especially when lying down on the affected side
Difficulty getting up from a chair and standing straight after sitting for long periods of time
Pain that can be very strong, constant, and difficult to find a position or stretch to relieve it
What causes gluteus minimus trigger points?
Acute, sudden, or repetitive overload - can be caused by walking too much
SI joint pain or dysfunction
Prolonged immobility of hip (sitting too long)
Pelvic tilt (can be caused by other muscle issues and trigger points)
Unstable equilibrium or putting more weight on one leg when standing
Gluteus Minimus Trigger Point Locations
Gluteus minimus anterior trigger points - pain and tenderness in the anterior/lateral portion of the muscle. These trigger points can refer pain to the lower lateral buttock and down the side of the leg from the hip, lateral thigh and knee, and even as far down as the lateral ankle. Rarely, this referral pattern can extend past the ankle to the dorsum of the foot.
Gluteus minimus posterior trigger points - pain and tenderness in the posterior/medial/superior portion of the muscle. These trigger points refer pain to most of the buttock and down the leg through the posterior thigh and calf. Can also refer pain to the back of the knee.
Gluteus minimus anterior trigger points that can cause pain in the hip and down the side of the leg
Gluteus minimus posterior trigger points that can cause pain in the hip and down the back of the leg
How can acupuncture release gluteus minimus trigger points?
Trigger point acupuncture and dry needling can provide a gluteus minimus release by identifying the taut bands of muscle that create the pain referral pattern and eliciting a twitch response to relax the muscle to restore function, improve range of motion, and reduce pain. Glute mimimus trigger points are often deep and inaccessible without the use of an acupuncture needle.
Identifying trigger points and providing gluteus minimus muscle release with acupuncture and dry needling is one of the most effective ways to relieve pain in this muscle.
Other modalities like electroacupuncture, cupping, gua sha, and tui na can also help with pain in the hip and sciatica like symptoms.
Other muscles involved gluteus minimus pain symptoms:
Buttock Pain:
Gluteus Maximus
Iliocostalis Lumborum
Longissimus Thoracis
Semitendinosus
Semimembranosus
Piriformis
Gluteus Minimus
Rectus Abdominus
Soleus
Sciatica
Gluteus Minimus
Semitendinosus
Biceps Femoris
Piriformis
Gluteus Maximus
Lateral Leg Pain
Gastrocnemius
Gluteus Minimus
Peroneus Longus
Peroneus Brevis
Vastus Lateralis
Posterior Leg (Calf) Pain
Soleus
Gluteus Minimus
Gastrocnemius
Semitendinosus
Semimembranosus
Soleus
Flexor Digitorum Longus
Tibialis Posterior
Plantaris
Lateral Thigh & Hip Pain
Gluteus Minimus
Vastus Lateralis
Piriformis
Tensor Fasciae Latae
Vastus Intermedius
Gluteus Maximus
Vastus Lateralis
Rectus Femoris
Posterior Thigh Pain
Gluteus Minimus
Semitendinosus
Semimembranosus
Biceps Femoris
Piriformis
Obturator Internus
Over to you
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Sources:
Travell, J. G., Simons, D. G. (1993). Myofascial pain and dysfunction: The trigger point manual (Vol. 2). London: Lippincott Williams & Wilkins.
Biel, A., & Dorn, R. (2010). Trail guide to the body: A hands-on guide to locating muscles, bones and more. Boulder, CO: Books of Dicovery.
J.H. Kellgren, SCIATICA, The Lancet, Volume 237, Issue 6140, 1941, Pages 561-564.
Bewyer, Dennis & Bewyer Albrecht, Kathryn. (2003). Rationale for Treatment of Hip Abductor Pain Syndrome. The Iowa orthopaedic journal. 23. 57-60.