Dissection of gluteus maximus and medius with respect to their suggested roles in pelvic and hip stability: implications for rehabilitation?

Abstract

Introduction Gluteal muscle dysfunction has been implicated in a variety of pelvic and lower limb injuries: rehabilitation programs are commonly devised to target this muscle group. This study examined the anatomy of gluteus maximus and gluteus medius with respect to their role in hip frontal plane stability. Methods One adult cadaver was dissected. The magnitude (thickness and surface area) and fibre orientation of each part of each muscle were calculated using a callipers, both muscles was calculated electronically, using the digital images. Results There were major differences in muscle size and fibre orientation, between and within the muscles. Gluteus maximus was strongly connected to the iliotibial band, while the insertion of gluteus medius enveloped the greater trochanter. The insertion and orientation of gluteus medius support its suggested primary role as a hip stabiliser and abductor. The more horizontal posterior fibres of gluteus medius may also be important in controlling femoral rotation. Discussion The results indicate that gluteus maximus may be important in the control of frontal plane stability of the hip on the pelvis through its greater size and its broad attachment to the ITB. There is evidence that these muscles may act together in the control of frontal plane stability. The synergistic activation of these muscles, rather than isolated activation of one particular muscle, should be an important consideration in the assessment and rehabilitation of hip frontal plane stability in an injured athlete.