Gluteal muscles

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Gluteus maximus

The gluteal muscles are the three muscles that make up the buttocks: the gluteus maximus muscle, gluteus medius muscle and gluteus minimus muscle.

The gluteal muscles

The gluteus maximus is the uppermost of the three muscles. It is the largest of the gluteal muscles and one of the strongest muscles in the human body. It inserts at the iliotibial band and the gluteal tuberosity of the femur. Its action is to extend and outwardly rotate hip, and extend the trunk.

Strength training exercises which are known to significantly strengthen the gluteus maximus include the squat^[1] and the deadlift. The leg press also uses the gluteus maximus.

Muscles of the gluteal and posterior femoral regions. Gluteus minimus and the origins and insertions of medius and maximus labeled

Problems associated with the gluteal muscles

Sitting for long periods can lead to the gluteal muscles atrophying through constant pressure and disuse. This may be associated with (although not necessarily the cause of) lower back pain, difficulty with some movements that naturally require the gluteal muscles, such as rising from the seated position, and climbing stairs. Some attribute severe menstrual cycles including mood swings and irritability to gluteal muscle atrophy, however, there are a vast array of known contributors to dysmenorrhoea, and currently clinical evidence of such a causative association is lacking.

The bulk of the gluteal muscle mass contributes only partially to shape of the buttocks. The other major contributing factor is that of the panniculus adiposus of the buttocks, which is very well developed in this area, and gives the buttock its characteristic rounded shape. Although the gluteal muscle bulk and tone can be improved with massage and exercise, it is the disposition of the overlying panniculus adiposus which may be responsible for the "sagging butt" phenomenon.

Treatment

Studies have shown that exercise and massage are effective at reversing and protecting against atrophy of these muscles. Poisoning by eating Lathyrus sativus Indian Pea or khesari dhal will lead to emaciation of Buttock muscles (Neurolathyrism).

Exercise and stretching

Any exercise that works and/or stretches the buttocks is suitable, for example lunges, climbing stairs, fencing, bicycling, squats, arabesque, aerobics, and various specific exercises for the bottom.

Powerlifting exercises which are known to significantly strengthen the gluteal muscles include the squat, deadlift, leg press, feet in squats (chin on chest & stick glutes out) and good mornings (bend over with a bar on the shoulders with a light amount of weight).

Massage

Gluteal exercises and stretching must be accompanied by therapeutic massage both in the relaxed muscle condition and during the neuron firing of muscle flexing and stretching. In order to properly restore the gluteal muscle group, the first step is to relax the entire neck, shoulders, arms and back region with massage. Once the patient's upper body is relaxed, effleurage (light but thorough stroking with fingers and palms) of the top, middle, bottom and side portions of the gluteal muscles (entire buttock and top thigh areas) is used to initiate the gluteal muscle group massage while the buttocks are in the relaxed condition with the patient lying face down with the hips slightly elevated, a pillow having been placed under the pelvis. The purpose of the effleurage is to fire the neurons near the surface of the muscle group. Attention should also be given to the gluteal fold, the crease where buttocks meet thighs, as this is a sensitive area where major muscles are joined.

At least 10 minutes of effleurage should be used before moving to a deeper muscle massage. Deeper massage should only be performed when the muscles loosen sufficiently. The top, middle and bottom areas of the buttocks as well as the tops and all sides of the thighs are massaged with increasing firmness in order to stimulate the neurons deeply embedded within the muscle group. Liberal amounts of massage lotion should be used as this area can require very deep massage as the muscles loosen and permit it.

Some massage schools reportedly teach the use of the double handed repetitive "chop" alternating with slapping of the maximus area. The chop fires the deeply embedded neurons while the slap fires the surface neurons. If this is done whilly the patient is alternately flexing and relaxing, the result is almost total neuron firing and should be followed up with additional effleurage to totally relax the muscle group. Obviously communication between therapist and patient is important at this stage.

Attention should be given to the gluteal fold with increasing pressure. This being a sensitive area, the therapist should communicate freely with the patient to determine the proper amount of pressure needed to relax these muscles. The therapist can simultaneously use both of his or her thumbs beginning in the middle where the thighs and buttocks meet, and slowing moving the thumbs outward and around the tops of the thighs to eventually use the fingers to massage the fold where thigh meets abdomen (another area where muscles are joined).

The two massage regimes (effleurage and deep muscle massage) are then repeated with the gluteal muscle group in the process of active neuron firing. That is, the areas should be massaged while the patient is actually performing the various exercises and stretches outlined above as well as others tailored by the therapist. It is reported that this results in exterior and interior neuron firing in such a way that the entire muscle group's shape, tension and overall health is restored rapidly. A weekly cycle of massage is required to achieve good results.

See also

Gluteal crease

External links

• 8b. The Muscles and Fasciæ of the Thigh Bartleby.com, Henry Gray, Anatomy of the Human Body, 1918.
• Glutes Stretch

References

McMinn, RMH (Ed) (1994) Last's Anatomy: Regional and applied (9th Ed). London: Churchill Livingstone. ISBN 0-443-04662-X