The buttocks have three major muscles: the gluteus maximus, gluteus minimus, and gluteus medius. As its name indicates, the gluteus maximus is the largest of these muscles, but the smaller gluteus medius and gluteus minimus are just as necessary for proper movement of the hip and leg. The importance of the gluteus medius is obvious to anyone who suffers a gluteus medius tear, as an injury to this muscle can prevent you from walking.
The gluteus medius and gluteus minimus attach to the outside of the hip and are known as abductors. Hip abductors are muscles that help move the leg away from the body’s midline. We use them to lift our legs to get out of bed or a car or step side to side. They are essential for moving the lower body, keeping the pelvis level while walking, and internally and externally rotating the hip.
The gluteus medius muscle is located underneath the gluteus maximus. It comes out of the top of the pelvis and attaches by a tendon to the outside of the femur. Gluteus medius tears often occur at the greater trochanter on the head of the femur.
Causes of Gluteus Medius Tears
Tearing the gluteus medius is most often caused by degradation in the muscle-tendon unit due to chronic issues. Those with conditions like tendinopathy (chronic inflammation of the gluteus medius tendon) may suffer a gluteus medius tear from changes to the muscle over time. Gluteus medius tears can also be caused by falls that pull your muscle out of its normal range of motion or sports injuries.
Although acute tears are rare, runners and athletes performing sudden bursts of activity in high-impact sports (like soccer or basketball) are more likely to tear their gluteus medius than those in low-impact sports like swimming or biking. If you have poor flexibility in your gluteus muscle, you may tear it due to trauma or overuse.
Gluteus medius tears can go partway through the muscle or cause the muscle-tendon unit to fully detach from the bone.
What does a gluteus medius tear feel like?
The symptoms of a gluteus medius tear vary depending on the exact location and severity of the tear. Common symptoms of a gluteus medius tear include:
- Pain and tenderness on the outside of the hip aggravated by running, climbing stairs, prolonged sitting, or laying on that side
- Swelling and inflammation in the hip
- Decreased range of motion in the hip
- Inability to put full weight on the affected leg
- Weakness in the hip causing a limp (called the Trendelenburg sign) wherein the pelvis drops toward the unaffected side while walking
Can a gluteus medius tear heal on its own?
If you are experiencing any of these symptoms, seeing an orthopedic hip specialist for a proper diagnosis is important. Your specialist will use a physical exam to feel the muscle and test its strength. They’ll ask you to walk and single-leg squat to check for a limp and full range of motion. They may also take an X-ray, MRI, or ultrasound to determine the extent of the injury and additional issues.
Your gluteus medius is under your hip bursa, which can become inflamed in a condition called hip bursitis. If you have a gluteus medius tear, you may also have bursitis and require additional treatment.
For those with bursitis, gluteus medius tears sometimes initially go unnoticed. They may also present as an issue with your lower back. Because of this, proper diagnosis by an orthopedic hip specialist is integral. Work with your orthopedic hip specialist to develop a treatment plan that addresses your full injury, goals, and lifestyle.
How do you treat a gluteus medius tear?
As with many soft-tissue injuries, the goal of treatment is restoring normal function. Most gluteus medius tears can be treated non-surgically. The RICE method and other actions can be useful tools for healing.
- Rest: Take a break from activities that put pressure and weight on the hip and avoid overstretching the hip.
- Ice: Apply a wrapped ice pack to the area several times daily for 20 minutes per session.
- Compress: Talk to your orthopedic hip specialist about using a hip brace to support the area and decrease swelling.
- Elevate: Use a pillow between your legs while side sleeping, with your healthy hip against the mattress.
- Support: Walk with the help of a cane or crutches to prevent putting your full weight on the healing muscle.
- Medicate: Take non-steroidal anti-inflammatory medications like aspirin, ibuprofen, and naproxen as directed.
- Ask: Talk to your orthopedic hip specialist about additional treatment options like injections, physical therapy, or surgery.
How long does a gluteus medius tear take to heal?
The time needed to heal from a gluteus medius tear depends on its severity, additional injuries, and if you need surgery. For a partial tear that can heal nonsurgically, your orthopedic hip specialist may recommend treatment for 4 to 6 weeks. If you need surgery, it often takes 3 months to 1 year to be fully released back to normal activities.
If you fully tear your gluteus medius muscle, you may need either endoscopic or open surgery. In minimally invasive endoscopic surgery, your orthopedic hip surgeon will make three or four small incisions and insert a camera to see the affected area. They will pull the tendon into the proper position and tie it over the bone.
Open surgery for a gluteus medius tear is somewhat rare, but it may be necessary in cases of chronic tears or those where the muscle is significantly out of place. In open surgery, your surgeon will make an incision on the outside of the hip a few centimeters wide and use sutures to attach the tendon to bone anchors in the greater trochanter.
If you’re experiencing hip pain and want to speak to an orthopedic hip specialist, please contact us or comment below.