Gluteal Muscle Pain

The gluteal muscles can have pain due to a variety of causes. Fortunately, there are many available ways to treat the pain.

Causes of Pain

The gluteal (buttocks) region of the body contains three muscles: gluteus maximus, gluteus medius, and gluteus minimus. The muscles run from the pelvis to the thigh bone, and they have several functions, including keeping the hip straight, stabilizing the pelvic region, and “assisting with outer movements of the hip”. These muscles are critical for the activities of jumping, squatting, running, and lunging. If there is too much tension or repetition, however, the muscles may tear, leading to gluteal strain. The tears are graded from 1 to 3, with the majority of strains being at grade 2. Grade 1 means that some fibers have torn, but they are still functional. Grade 2 has moderate loss of function. The most serious, Grade 3, means that “all muscle fibers are ruptured resulting in major loss of function”. Gluteal strains are typically caused by a “sudden contraction” of the muscles while they are in a stretched position. Lifting a heavy weight, performing an “explosive jump”, and running, as well as certain sports like basketball, soccer, rugby, football, and weight training can all lead to these strains. Older athletes, and those who have not warmed up properly, are at risk. Gluteal strains feel as if there is a “pulling sensation” or a sharp pain while performing activity, which (depending on how severe the strain is) may lead the patient to be unable to participate in the activity. The symptoms could increase while cooling down or after resting. Other symptoms include spasm, weakness, tenderness, bruising, and swelling.¹ Muscle tightness or weakness, excessive training, inadequate recovery, poor technique and posture, fatigue, joint stiffness, poor core stability, and muscle imbalances can all lead to strain.² Other causes of gluteal pain are bursitis, tendinitis, sciatica, iliotibial band syndrome, and piriformis syndrome.³ It is important to get a proper diagnosis.

Treatments

Most patients with minor strains can recover in a few weeks. A complete rupture may lead to surgery and months of rehabilitation. All patients need to rest and minimize the damaging activities. Ignoring symptoms of a strain is not a viable option, as a gluteal strain can become a chronic problem. Patients should first follow RICE (rest, ice, compression, and elevation) for 72 hours. Some may wish to use anti-inflammatory medications. Patients could need crutches as well.⁴ Ice massage is another option that patients can perform at home. This is done by rubbing ice over the affected area. After the acute injury, patients may wish to use moist heat while performing stretches and exercises. It is important not to apply heat while experiencing swelling. A change in athletic activities, such as swimming, may also help patients recover.⁵ There are many physiotherapy options available to patients, and they can seek this from their chiropractor. Chiropractic treatments often include ultrasound, soft tissue massage, orthotics, technique correction, advice on modifying activities, joint mobilization, and ice and heat treatments.⁶Chiropractors can also recommend appropriate exercises and stretches. Other treatment modalities that chiropractors provide are electrical muscle stimulation (EMS), Active Release Technique (ART), and even myofascial release and massage.⁷ Massage therapists can work with the patients’ trigger points to provide relief.⁸