The gluteus medius muscles and gluteus minimus muscles are so
closely related that chiropractors care for gluteus medius
syndrome and gluteus minimus syndrome with similar techniques.
As mentioned in the About section, that's why they simply refer
to these syndromes as gluteus medius/minimus syndrome.
When you first seek care for this syndrome, your chiropractor
will probably perform spinal manipulative therapy, also known as
an adjustment, on your lumbar spine (in the low back) and
sacroiliac joint (a joint in your buttock that attaches your
ilium to your sacrum). Because the gluteus muscles are close to
the sacroiliac joint, they tend to limit its motion when they
become tight. This, in turn, can affect other joints in the
lumbar spine. When performing an adjustment, your chiropractor
will use a quick, strategic thrust with his or her hands or a
tool called an activator that will return motion to joints,
relax tight muscles in the lumbar spine, increase blood flow and
Trigger point therapy is another common form of care for
people with this syndrome. When performing this technique, your
chiropractor will target trigger points, which are groups of
muscle fibers that are in a state of contracture. In this state,
the muscle fibers feel like taut bands or nodules, usually
across the middle of a muscle, and can refer pain to other areas
of the body. With gluteus medius/minimus syndrome, trigger
points usually develop in the gluteus medius and gluteus minimus
muscles, but can also develop in other surrounding muscles.
To perform trigger point therapy, your chiropractor will
apply pressure to a trigger point for about 10 seconds. When he
or she releases the pressure, an influx of fresh blood will
enter the trigger point and wash away waste products that
contribute to muscle tightening. This can help decrease pain,
relieve tension, remove trigger points and increase blood flow
to tight muscles.
Your chiropractor may also manage this syndrome with
physiotherapeutic tools such as ultrasound and interferential
current. Ultrasound refers to any sound wave that has a
frequency above the range the human ear can perceive. To produce
these waves, chiropractors use a machine that channels
electricity through a crystal located at the end of an
applicator. The crystal vibrates in response to electricity, and
the machine allows users to alter the electrical current to
affect the waves' frequency. Depending on the frequency, this
can increase blood flow, decrease pain, reduce muscle spasm,
lessen nerve root irritation, break down scar tissue and speed
healing in the gluteus muscles.
Interferential current (IFC) works in a similar fashion, but
instead of sound waves it involves a mild electrical current.
IFC machines work by sending this painless current through the
skin into nerve fibers below, which causes the body to produce
endorphins, its natural painkillers. By aiming the current at
the buttocks, your chiropractor can cause endorphins to
interrupt the flow of pain signals from the affected tissues to
the brain. Like ultrasound, IFC also helps decrease
inflammation, which helps facilitate healing.
During your rehabilitation program, your chiropractor may
also want to address your posture if you have poor postural
habits that are affecting the gluteus muscles. Poor sleeping and
sitting positions can damage the lumbar spine. The lumbar spine
is attached to the pelvis, which is closely associated with
gluteus muscles. For this reason, postural problems that affect
the lumbar spine can cause dysfunction and postural stress in
the low back that can indirectly affect the gluteus muscles.
To improve your posture, make sure you sleep in a good
position, such as on your side with a pillow between your legs
or on your back with a pillow under your knees. You should also
make sure you practice good sitting posture, ensuring that your
feet are flat on the floor, that your low back is flat against
the back of a chair and that you don't slouch. These positions
will hold your spine in its natural curve, ensuring muscles in
the low back don't have to bear excess weight.
Practicing good posture is one of the best ways to prevent
gluteus medius/minimus syndrome from worsening, but to
rehabilitate weak muscles and build strong, flexible muscles
you'll need to exercise. An exercise program involving both
strengthening and stretching activities can help restore muscle
health and prevent future injuries. Strengthening and stretching
exercises that focus on your hip rotators and flexors, as well
as both the gluteus medius and gluteus minimus muscles, will
reinforce muscle balance in the hip region, stabilize
surrounding joints, prevent weakening of supporting structures
and help remove strain and tension from the affected muscles.
If none of these management techniques offer sufficient
relief, your chiropractor may need to examine your feet to
determine if abnormal walking patterns are causing dysfunction
that's leading to problems in your gluteus muscles. Every time
you take a step, your gluteus muscles contract, so if you're not
walking properly these muscles will have to work harder. If your
feet are contributing to your problem, your chiropractor may
prescribe orthotics, which are shoe inserts that offset
structural abnormalities to normalize foot motions.
Finally, don't rush back into activities that can exacerbate
your condition. Until your gluteus muscles are functioning
properly, your chiropractor may recommend that you refrain from
activities that involve running and switch to activities such as
swimming or biking until your symptoms subside. By giving your
muscles time to respond to chiropractic care and reintroducing
strenuous activity slowly, you can overcome this syndrome and
help prevent recurrences.