Gluteus Minimus: Origin, Insertion, Nerve & "Pseudo-Sciatica"

The Gluteus Minimus is the smallest and deepest of the three gluteal muscles. Shaped like a fan, it lies directly beneath the Gluteus Medius. It acts as the primary internal rotator of the hip and works in concert with the Gluteus Medius to stabilize the pelvis.

[Image of Gluteus Minimus muscle anatomy]

Quick Anatomy Snapshot

Origin (Proximal)	External surface of the Ilium (between the Anterior and Inferior Gluteal Lines).
Insertion (Distal)	Anterior border of the Greater Trochanter of the Femur.
Nerve Supply	Superior Gluteal Nerve (L4, L5, S1) - *Shared with Glute Medius & TFL.*
Blood Supply	Superior Gluteal Artery.
Primary Actions	Hip Abduction: Moves thigh away from midline. Internal (Medial) Rotation: Primary internal rotator of the hip. Pelvic Stabilization: Prevents hip drop during walking.

Deep Dive: The "Rotator Cuff" of the Hip

Along with the Gluteus Medius and the small deep rotators, the Gluteus Minimus functions similarly to the rotator cuff in the shoulder.

1. Structural Support

It lies intimately against the hip joint capsule. Its fibers act to hold the head of the femur securely in the acetabulum (socket), providing dynamic stability during movement.

2. The Internal Rotator

While the Gluteus Medius has both internal (anterior fibers) and external (posterior fibers) rotation capabilities, the Gluteus Minimus is positioned more anteriorly on the trochanter, making it a dedicated and powerful Internal Rotator.

Physio Corner: Clinical Relevance

💪 Functional Fact: During the gait cycle, just as the heel strikes the ground, the Gluteus Minimus fires to stabilize the pelvis and internally rotate the femur slightly to "lock" the hip for weight bearing.

Palpation

Direct palpation is very difficult because it is completely covered by the Gluteus Medius and Tensor Fasciae Latae (TFL). Deep pressure applied about 2 inches posterior to the ASIS (Anterior Superior Iliac Spine) can reach the anterior fibers of the Minimus.

⚠️ Clinical Pathology: "Pseudo-Sciatica"
Trigger points in the Gluteus Minimus are famous for referring pain down the lateral and posterior aspect of the leg, all the way to the ankle. This pain pattern mimics Sciatica (disc herniation), but there is no actual nerve root compression. This is a common cause of misdiagnosis in leg pain.

Manual Muscle Testing (MMT)

We test abduction with internal rotation to bias the Minimus.

Testing Tip: By asking the patient to point their toes down (internal rotation) while lifting the leg, you mechanically disadvantage the Gluteus Maximus and posterior Medius, isolating the Minimus and TFL.

Step-by-Step Procedure (Oxford Scale)

Grade	Patient Action & Resistance
Grade 3, 4, 5 (Against Gravity)	Position: Side-lying. Bottom leg bent. Top leg straight. Setup: Patient Internally Rotates the hip (toes point toward floor). Action: Patient abducts the leg toward the ceiling while maintaining internal rotation. Resistance: Applied at the ankle, pushing down and slightly into external rotation. Grade 3: Full range against gravity. Grade 4/5: Holds against resistance.
Grade 2 (Gravity Eliminated)	Position: Supine. Leg straight and internally rotated. Action: Patient slides the leg out to the side (abduction). Result: Full range of motion.
Grade 0, 1 (Palpation)	Action: Palpate deeply between the ASIS and Greater Trochanter. Cue: "Turn your toes in and try to push your leg out." Grade 1: Deep tension felt (hard to distinguish from Medius). Grade 0: No activity.

Frequently Asked Questions

Does Gluteus Minimus extend the hip?

No. Because its fibers are located anterior to the hip joint axis, it assists in flexion, abduction, and internal rotation, but not extension.

What is the difference between Medius and Minimus?

Medius: Larger, superficial, inserts on lateral trochanter, acts on all planes (ant/post fibers).
Minimus: Smaller, deep, inserts on anterior trochanter, primary internal rotator.

Is it involved in GTPS?

Yes. Greater Trochanteric Pain Syndrome (GTPS) usually involves tendinopathy of the Gluteus Medius and/or Gluteus Minimus tendons where they attach to the trochanter.

Test Your Knowledge: Gluteus Minimus Quiz

1. Which nerve supplies the Gluteus Minimus?

2. What is the primary rotational action of the Gluteus Minimus?

3. Where does the Gluteus Minimus insert?

4. Which muscle lies directly superficial to the Gluteus Minimus?

5. "Pseudo-Sciatica" caused by Gluteus Minimus trigger points refers pain to:

6. Where does the Gluteus Minimus originate?

7. To bias the Gluteus Minimus during MMT, the hip should be:

8. Which muscle is a synergist to Gluteus Minimus for abduction and internal rotation?

9. The Gluteus Minimus helps prevent the pelvis from dropping on the:

10. True or False: Gluteus Minimus is the deepest of the gluteal muscles.

References

• Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2018). Clinically Oriented Anatomy. 8th ed. Philadelphia: Wolters Kluwer.
• Standring, S. (2016). Gray's Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. Elsevier.
• Travell, J. G., & Simons, D. G. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Williams & Wilkins.