Rubric "Kinesiology". In this article, we will look at the anatomy, function and kinesiology of the gluteal region in particular: the gluteus maximus, medius, minimus, pelvic bones and ligaments, innervation of the buttocks. The lateral thigh muscles are external rotators and abductors of the hip joint. Subcutaneous fat of the buttocks, gluteal fascia. Biomechanical movements of the lower limb belt in space.
The gluteal region is located on the back of the body below the back and is limited: from above - by the iliac crests, from below - by the gluteal folds. It is divided in the middle by the sacrococcygeal median line, on the sides it is limited by lines that run from the anterior superior iliac spine to the tuberosity of the femur and then through an imaginary line to the gluteal fold.
Rice. 1. Muscles of the pelvis and thighs
Bones and ligaments of the pelvis
The pelvic bones are represented by the ilium, ischium and pubic bones in front and the sacrum and coccyx behind. They grow together after a person reaches puberty and become a single bone, forming the human pelvis, while each bone retains its individual name.
These bones form a ring in which parts of the digestive and genitourinary systems are located, and through which the main vessels and nerves pass, supplying and innervating the lower limbs, and the gluteal region. The ligamentous apparatus of the pelvis consists of dense ligaments that connect the bones of the pelvis, forming a single structure. 
There are eight muscles in the gluteal region. The most superficial of them -
Gluteus maximus muscle (lat. gluteus maximus) is the largest of the three gluteal muscles, has a diamond-shaped, flattened shape. It begins in the posterior sections of the outer surface of the ilium, along the lateral surface of the sacrum and coccyx, attaches to the gluteal tuberosity of the femur and the wide fascia of the thigh. Between the gluteal tuberosity and the muscle is the trochanteric bag of the gluteus maximus muscle. Its greatest thickness at the attachment to the sacrum is 6-7 cm, in the upper outer part its thickness decreases to 2.5-3 cm, and in the lower outer part it decreases to 1.5-2 cm in thickness.
The gluteus maximus muscle is the only one of all the gluteal muscles that does not attach to the tuberosity of the femur (trochanter), but attaches to the body of the femur. At the same time, its outer edge in the upper part at the place of attachment to the ilium is usually 3-6 cm outwards (4-5 cm on average) from the superior posterior iliac spine and continues down to the outer surface of the femoral tuberosity (trochanter).
Functions: It unbends and turns the thigh somewhat outward, straightens and fixes the torso.
Gluteus medius (lat. m. gluteus medius) located under the gluteus maximus. Participates in the abduction of the hip, with a fixed position of the hip, it takes the pelvis to the side. Straightens the torso bent forward, while standing, tilts the torso to its side. The anterior muscle bundles rotate the thigh inward, the posterior ones outward. It starts from the outer surface of the wing, the iliac crest and the broad fascia of the thigh, is attached to the greater trochanter of the femur. In the attachment area there is a trochanteric bag of the gluteus medius muscle.
Gluteus minimus (lat. m. gluteus minimus), the deepest of the three, is also involved in hip abduction and trunk extension. It starts from the outer surface of the iliac wing between the anterior and inferior gluteal lines, attaches to the anterior edge of the greater trochanter of the femur.
Buttock tissue layers
Under sufficiently thick skin is usually a pronounced layer of subcutaneous fatty tissue, which is separated from the gluteus maximus muscle by a plate of connective tissue - the superficial gluteal fascia. The muscles of the buttocks are located under the fascia, they are attached to the bones of the pelvis, which are tightly interconnected by ligaments, forming a single structure. 
Subcutaneous fat of the buttocks
In women, unlike men, most of the volume of the buttocks, as a rule, consists of fatty tissue located under the skin. Adipose tissue in this area is usually elastic, because all of it is permeated with thin strips of dense connective tissue that go from the skin to the muscles, are fused with each other along the edges, and when viewed from above form cells that are somewhat similar to a honeycomb. They provide stability to adipose tissue. In thin people, however, there may not be enough fat to fill these cells, making the subcutaneous layer relatively weak and prone to drooping (ptosis) of the buttocks.
Superficial gluteal fascia
The superficial gluteal fascia is a plate of connective tissue that, like a film, covers the entire gluteal region. It is thickest in the region of the sacrum, where it joins the ligaments, and also in the region of the iliac crest, where it expands and fuses tightly with it. In its lower part, the superficial gluteal fascia also thickens, becoming more stable. At the same time, in the center of the buttocks, it is usually the thinnest, which is especially important when placing the implant subfascially (under the fascia) - you should try to place the implant so that its lower part is covered by the thicker part of the fascia, which is located below, at the place of its attachment to the tuberosity ischium.
Innervation of the buttocks
All muscles of the gluteal region are innervated by branches of the sacral plexus. The gluteal muscles of the superficial layer are innervated by the superior and inferior gluteal nerves. The inferior gluteal nerve emerges from the sacral plexus, medially from the sciatic nerve, and innervates the gluteus maximus muscle. The superior gluteal nerve innervates the gluteus medius and minimus. The muscles of the deep layer are mainly innervated by each - by its own branch. The sciatic nerve is the largest nerve in the human body and can be up to 2 cm in diameter in the gluteal region. It is responsible for the motor activity of the deep muscles of the buttocks and hamstrings, and at the same time provides skin sensitivity on the back of the thigh.
Lateral thigh muscles external rotators and abductors of the hip joint
Abductor muscles and muscles- External rotators of the hip joint are located behind and laterally to the hip joint in the buttocks. The three gluteal muscles (middle, small, and fibers large) are the main abductors of the hip joint, assisted by the tensor fascia lata. They originate above the joint, therefore, with a concentric contraction of these muscles, the hip joint is retracted from the midline of the body. Recall that the function of a muscle depends on the orientation of its fibers relative to the joint it acts on. The gluteus maximus and medius cover such a large area of the joint that one part of each muscle is able to perform the opposite movement of the other part. The main action of each of these muscles is determined by the action of all its parts. The main function of the gluteus maximus is to extend the hip joint, while the main function of the gluteus medius is to abduct the hip joint. Some fibers of the gluteus maximus muscle cross the hip joint from above its central axis, others - from below its functional axis. This means that the former are able to perform abduction, and the latter - adduction. The anterior part of the gluteus medius, contracting concentrically, causes an inward rotation, the fibers located behind cause an outward rotation. Deep under the gluteus maximus muscle are the six rotators of the hip joint. These are (when viewed from top to bottom): piriformis, superior gemellus, external and internal obturator, inferior twin muscles. The fibers in this group are oriented horizontally, which, combined with their placement behind the joint, makes them very effective hip rotators. When the hip joint is extended, the gluteus maximus also acts as a rotator. To stretch the rotators, the client should lie on his back, pull his bent knees and hips to the body and place them diagonally. This position involves adduction and outward rotation, which effectively stretches these muscles. In order to properly plan a training program, it is very important to understand the essence concentric and eccentric
muscle contractions. Remember how to determine the type of muscle contractions. If the direction of movement is opposite to gravity, the active muscle contracts concentrically, otherwise the muscle contracts eccentrically.
At the same time, when "eliminating" gravity during movements performed parallel to the floor, each muscle group contracts concentrically, producing the desired movement. When using rubber dampers, the same principles apply:
- concentric contractions occur when movement increases the resistance of the shock absorber,
- eccentric - when the movement leads to a decrease in its resistance.
On fig. (a) and (b) show hip abduction and adduction exercises, illustrating how body position can change the effects of gravity. On fig. (a) Raising the legs to the sides is shown. The initial action is the abduction of the hip joint with overcoming the force of gravity. Thus, the hip abductors act concentrically as agonists. During the downward leg movement phase, the hip joint is adducted. The movement of the joint is in the same direction as gravity, so the hip abductors contract eccentrically as agonists to control hip adduction.
Rice. (A)
On fig. (b) shows hip abduction/adduction from supine position, hips flexed, knees extended, legs elevated. The initial action is the abduction of the hip joints as the legs are more and more spread apart. Because movement is in the same direction as gravity, the hip adductors control movement through eccentric contractions. To bring the legs together in an upright position, the hip adductors must contract concentrically against gravity.
Rice. (b)
The buttocks, as they call the gluteus maximus muscle (musculus gluteus maximus), many of us rarely attach importance, and do not consider these muscles important, and remember them only when the bathing season comes, and it becomes necessary to wear swimming trunks and, moreover, attention is paid form, not function. The gluteal muscles have several functions besides being an attractive seat cushion, and if these muscles are weakened, then many problems arise. Well, if we sit all the time during the day (at work, at home, while eating or watching TV), then what kind of muscle strength can we talk about?
Nature has made this muscle big enough not only for the sake of beauty. The gluteus maximus ("MGM") is the largest and one of the strongest muscles in the human body. The gluteus maximus is the most superficial of the three gluteal muscles and forms most of the shape and appearance of the buttocks. The gluteus maximus muscle runs along the crest of the pelvic bone and inserts on the posterior side of the proximal femur and on the iliotibial ligament, providing a connection between the trunk and the lower extremities.
The large size of this muscle is one of the most characteristic features of the human muscular system. According to most researchers, humans evolved from ape-like ancestors about two million years ago on the vast savannah of Africa. It is believed that natural selection favored the survival of animals that could run. Over time, evolution solidified human anatomical features that allowed humans to run long distances, and the enlargement of the gluteus maximus may have played a crucial role in this process.
Functions of the gluteus maximus muscle.
The gluteus maximus muscle is very important in performing activities such as standing up, walking, running. The function of the muscle in these activities is to help straighten the leg, bring the torso upright, abduct and adduct the hip in line with our body, rotate the hip away from and towards the center of the body, and stabilize the pelvis. This muscle may also play a role in stabilizing the knee in extension.
During standing up, for example, the gluteus maximus plays an important role in hip extension and pelvic stabilization. During running, this muscle provides stability to the torso, and helps to extend the hip when accelerating and decelerate the leg when stopping motion.
Thus, weak gluteus maximus reduces the ability to perform many of our daily activities efficiently and safely. Muscle weakness can make it difficult to perform some movements that require the participation of these muscles, such as standing up, sitting, walking or running. Sometimes weakness of the gluteal muscles can be associated with pain in the back, knee and hip.
How to know if there is weakness of the gluteus maximus muscles?
Here, for example, is a simple and quick test that will determine the presence of weakness in the gluteal muscles.
Lie on your back with your knees bent at least 90 degrees. Squeeze your gluteal muscles. Slowly lift your thigh off the floor, and then straighten your right knee so that your thighs are parallel. Try not to change the level of the pelvis, and the hips do not rotate. If the pelvis tilts or rotates to one side when the leg is extended, then there is definitely glute weakness. But this test should not be performed by women until at least 6 weeks postpartum.
Physical therapy physicians can use additional manual and dynamic diagnostic methods to determine the weakness of the gluteal muscle:
- Manual diagnostic techniques include observing the correctness of the exercise, the presence of displacements during movements, or detecting the compensatory inclusion of other muscles in the execution of the movement.
- Dynamic methods include digital analysis of movement video, which allows the exercise therapist to examine the movement in detail. Such video analysis allows the exercise therapist to evaluate the work of the gluteal muscles in the kinetic chain, to observe the function of the pelvis and lower extremities dynamically, throughout the entire gait cycle.
What can be done to increase the strength of the gluteal muscle?
There are many exercises that can be performed that will not only improve the shape and tone of the gluteal muscles, but also improve their function.
Bridge on one leg
Lie on your back with your knees bent at least 90 degrees. Squeeze your gluteal muscles. Slowly lift your thigh off the surface and then straighten your right knee so that your thighs are parallel. Keep your pelvis level and do not rotate your hips. Hold for 10 seconds and then return to the starting position. Repeat this exercise with your left leg. Repeat the exercise 10 times. Note: This exercise should not be performed by women until at least 6 weeks postpartum.
Lying hip extension
Lie on your stomach, 1-2 pillows under your hips. Bend your knee 90 degrees. Squeeze your glutes and slowly lift your heel toward the ceiling. Don't let your back arch. Hold the leg in this position for 10 seconds and then return to the starting position. Repeat 10 times. Note: if there is back pain, then this exercise can only be performed under the supervision of an exercise therapy doctor.
Foot lift
Place your foot on the step. Tighten your gluteal muscles. Lean forward slightly on your hips and then take a step using your buttocks to lift your body. Keep your hips at the same level. Keep your knee in line with 2-3 toes. Repeat exercises 10 times on each leg.
In addition, incline running gives a very good effect, which allows not only to strengthen the muscles of the buttocks, but also to improve the activity of the cardiovascular system.
The human gluteal muscle is a whole group of muscles. In their functionality, they are similar to the work of the deltoid muscles of the shoulder. Usually, by the buttocks, we mean the fleshy section just below the back, and with this article I will try to dispel your (and mine too) ignorance in this regard.
Gluteus maximus muscleThis, in fact, is what we call the buttocks. Where it is located, I think it is not necessary to explain. I think you will find ... This is the most powerful muscle in the human body. It is the gluteus maximus muscle that holds the torso in an upright position. We noticed that in monkeys this muscle is not visible. Because they don't walk on two legs like we do.
The structure of the gluteus maximus muscle
In structure, it is coarse-fibred, made of bundles lying parallel to each other and connected together into one large knot, but separated by fibrous partitions.
Begins in the posterior regions of the outer surface of the ilium
The fibers are directed obliquely downward and laterally; they form the lower and greater part of the muscle, together with the superficial fibers of the lower part, at the end of a dense sinewy plate, which goes around the greater trochanter of the femur and passes into the wide fascia of the thigh; the deeper fibers of the lower part of the muscle are located in the gluteal tuberosity between the vastus lateralis muscle of the thigh and the adductor muscle.
Function of the gluteus maximus muscle
It unbends and turns the thigh somewhat outward, straightens and fixes the torso.
The gluteus maximus is also a major muscle used by many athletes such as volleyball, hockey, basketball and football players.
When the gluteus maximus is stationary in the pelvis, it tightens the hip and ensures an upright position of the torso.
Taking a fixed position from below, it acts on the pelvis, supporting it and the torso above the femoral head; this is especially evident when standing on one leg.
She has a very strong effect on the body, keeping it upright after tilting, by pulling the pelvis back, she is helped by the biceps femoris, semitendinosus, and large.
Gluteus medius
The gluteus medius is the muscle of the outer group of muscles of the pelvis.
It is located under the gluteus maximus muscle. Approaches a triangle in shape. The muscle is thick, two layers of bundles are distinguished in it - superficial and deep. The muscle bundles are fan-shaped, starting with a wide part from the outer surface of the iliac wing, bounded in front by the anterior gluteal line, from above by the iliac crest, from below by the posterior gluteal line. Then all muscle bundles converge into a common powerful tendon, which is attached to the top and outer surface of the greater trochanter
Function of the gluteus medius
Participates in the abduction of the hip, with a fixed position of the hip, it takes the pelvis to the side. Straightens the torso bent forward, while standing, tilts the torso to its side. The anterior muscle bundles rotate the thigh inward, the posterior ones outward.
Gluteus minimus
the deepest of the three, also involved in hip abduction and trunk extension. It starts from the outer surface of the iliac wing between the anterior and inferior gluteal lines, attaches to the anterior edge of the greater trochanter of the femur.
The structure of the gluteus minimus
It resembles the gluteus medius in shape, but is much thinner in diameter. All along the avenue. It starts from the outer surface of the iliac wing, between the anterior and inferior gluteal lines. Then the muscle bundles converge and pass into the tendon, which is attached to the anterior edge of the greater trochanter of the femur.
The muscle tissue of the buttocks is a large array of quadrangular muscles located at the back of the pelvis. They determine the shape and shape of the buttocks (subject to the normal content of fat mass in them). On the one hand, they are fixed on the spine and pelvis, and on the other hand, on the upper part of the femur at the back. The muscles of the buttocks are of three types: large, medium and small. Developed muscle tissue is not only beautiful from an aesthetic point of view. Muscle tone determines the strength and health of the body as a whole. The muscles of the buttocks and thighs make up a large part of the human muscle volume.
Anatomy
The largest muscle is the gluteus maximus. It is located closest to the skin and is responsible for the appearance and aesthetics of the buttocks, since it depends on it how much this protrusion will protrude. In its structure, it has a diamond-shaped outline, wide and fleshy.
The abnormally large size of the muscle tissue of the buttocks is a characteristic feature of the structure of the muscles of people, and it is this feature that allows a person to keep the torso straight upright. Structurally, a large muscle consists of coarse fibers that are collected in bundles and are parallel to each other. These bundles are combined into one large one, but at the same time they are separated by partitions consisting of fibers.
The gluteus maximus begins at the ilium (specifically, from the back of it) and is located directly above and behind the iliac crest. Further, it passes along the lower part of the sacrum away from the coccyx. The fibers are directed down and sideways, forming with the outer fibers a large part of the muscle in its lower part. Further, the muscle bypasses the thigh bones and turns into a wide shell. Deep-seated fibers in the lower part of the muscle are located between the lateral wide femoral and adductor muscles.
The gluteus maximus muscle is one of the main ones that is involved in sports such as hockey, basketball, football or volleyball. Her sprain can be very painful and long-lasting.
Middle muscle
On the outer surface of the ilium, the middle muscle of the buttocks originates (above from the anterior line of muscle tissue). The gluteal aponeurosis gives rise to it. Its parts converge into a tendon attached to the side of the hip joint.
small muscle
It originates between the lower and anterior gluteal lines in front of the ilium. Behind it passes from the ischial muscle and is attached to the hip joint.
Functions of the gluteal muscles
Being in a static state in the area, muscle fibers keep the thigh muscles in good shape and help the human body to stay upright. Fixing motionless below, the muscle supports the body above the head of the femur, which helps us stand on one leg. For example, when bending over, it helps the torso stay straight, pulling the pelvis back.
The gluteus maximus tenses the so-called wide fascia of the thigh (this is the connective sheath of the femur, passing from the pelvis to the knee joint along its outer part). This helps keep the hip from turning inward while running and stabilizes the knee joint. The gluteus maximus muscle has other functions:
- She is responsible for hip extension in the pelvic area.
- Unbends the body when it is fixed.
- Rotates the hips outward.
- Helps to move them in different directions.
- Helps to bring the hip into a central position.
- With its help, the body and legs are stabilized during physical exertion, such as running or walking.
Improving the muscles of the buttocks
To date, a sports lifestyle has become widespread, it has become fashionable to maintain one's physical shape and bring the whole body into tone. And if for the most part in this case we are talking about the aesthetic component and an increase in physical strength, then with regard to the gluteal muscles, the situation looks different - a lack of muscle mass in this area causes atrophy of the legs, a person cannot stand, walk or squat for a long time.
The functions of the gluteal muscles are very diverse. It is possible to change the appearance, shape and volume of muscles only through persistent and regular training (if we talk about natural changes, and not surgical intervention, for example).
The role of exercise
Different exercises for pumping up the gluteus maximus muscle have different goals: you can both increase their volume and correct the shape. Increasing the volume does not seem to be a particularly difficult task, it does not require any special methods and training programs, it is enough to regularly perform tasks to maintain muscles in good shape. If we are talking about visual adjustment, then it is necessary to work out each individual bundle of muscle fibers, for which whole complexes of various exercises are performed. The gluteus medius muscle is also involved in them.
The most effective exercises are squats, lunges and deadlifts. And if the first two types of exercises are feasible without special equipment, then the latter is feasible only in the gym.
Types of exercises
There are two general groups of exercises for the gluteal muscle:
- With or without weights.
- Basic or isolated.
When performing exercises, the main thing is not to forget about the technique of execution. If it is violated, instead of the gluteus maximus muscle, you risk increasing the quadriceps in volume. But even more serious consequences of incorrect exercise are a violation in the functioning of the joints, which can lead to injuries of the gluteus medius muscle.
Weights are dumbbells and barbells. The weight and type of weighting agent depends on the level of training of the trainee. When working with them, the technique should not be disturbed, while the work of the muscles should be felt.
The basis of any training aimed at adjusting the gluteus maximus should be basic exercises. The most effective of them: lunges, and deadlift.
Squats are one of the most effective and difficult exercises in terms of their technique. To master, you need a weighting agent of the smallest weight (for example, a neck without a load).
The deadlift can be performed with heavy weights and helps to improve the appearance of the gluteal region, as even the gluteus minimus will be involved.
When working on the muscles of the pelvic region, you can use not only weighting agents, but also various simulators and auxiliary items. Split squat is a lunge with the non-working leg fixed on the bench.
For a more detailed, point adjustment of the muscles of the buttocks, the so-called isolated exercises are used. They are performed after the basic ones. These include: lifting the pelvis, bench press, abducting the legs to the side.
The choice of the number of weekly workouts and their duration depends on the individual preferences of the person, his characteristics and regimen. You can train once a week, working out a specific muscle in detail (in our case, the gluteus maximus or small muscle), you can divide the workout into three stages, doing certain sets of exercises for different problem areas. The most important thing when choosing the intensity of training is not to overdo it, because this can lead to stretching of muscle tissue and prolonged pain in the buttocks.
In any case, even if you overtrained the muscle in the previous workout, by the beginning of the next, all discomfort should pass. Aiming at working out the large and small muscles of the pelvis, you should not forget about proper nutrition, because the lack of it will lead to excessive accumulation of fat in the problem area and make training, even regular and long, useless.
The main task of training is to improve the body as a whole and maintain a healthy physical form. The race for the aesthetic component of training is far from an end in itself. We examined the anatomy of the gluteal muscles.
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proximal attachment. Posterior end of iliac crest; lateral surface of the sacrum; coccyx.
Distal attachment. Gluteal tuberosity of the femur; ilio-tibial tract of the wide fascia of the thigh.
Function. Hip extension during strenuous activities such as running, jumping, climbing stairs, and rising from a seated position; helps to maintain an upright position; promotes lateral rotation of the hip.
Upper fibers: hip abduction. Lower fibers: hip adduction.
Palpation. To localize the gluteus maximus muscle, the following structures must be identified:
. The superior posterior iliac spine is a bony prominence that lies deeper than the characteristic cavities located above the buttocks. It is located on the same horizontal line with the second sacral vertebra, which, in turn, begins about 2 cm below the upper border of the sacrum.
. Iliac crest.
. Sacrum.
. Coccyx.
. The greater trochanter of the femur is a bony protrusion on the lateral surface of the thigh, located approximately a palm length below the iliac crest; lies on the same horizontal line with the pubic crest.
The ischial tubercle is a bony protrusion that is easily palpated in a sitting position and bears most of the weight in a seated person; located in the middle of the buttocks, approximately at the level of the gluteal fold.
To localize the gluteus maximus muscle, approximately estimate its boundaries as follows: upper border - draw an imaginary line from the superior posterior iliac spine to a point just above the greater trochanter; lower border - draw an imaginary line from the coccyx to the ischial tuberosity. On palpation of the gluteus maximus muscle, follow the direction of the fibers obliquely and laterally, moving from the lateral border of the sacrum to the greater trochanter of the femur.
Pain pattern. Medial parasacral trigger points cause pain on the sides of the intergluteal gap, incl. in the sacroiliac joint. Distal trigger points located above the ischial tuberosity cause pain in the buttocks and increased sensitivity in the depths of them. Pain can occur with prolonged sitting and intensify when walking with the torso tilted forward.
Causal or supporting factors.
Excessive load or shock, for example, when falling. Prolonged walking with the torso tilted forward.
satellite trigger points. Back of the gluteus medius and minimus, hamstrings, iliopsoas, and rectus femoris.
Affected organ system. Excretory function of the digestive system; colon.
Associated zones, meridians and points.
Dorsal and lateral zones. The foot meridian of the bladder is tai-yang, the foot meridian of the gallbladder is shao-yang. BL 26-30, 35, 36, 53, 54; GB 30.
Stretching exercise. Lying on your back, pull your knee to the shoulder of the same name, grasp the back of the thigh and pull in the direction of the shoulder, stretching the gluteus maximus muscle. Fix the pose until the count of 10-15. Stop stretching. Pull your knee towards the opposite shoulder. Lock the pose for a count of 10-15 and lower your leg.
Strengthening exercise. Bend your knee on the affected side. By contracting the gluteus maximus muscle, tighten the thigh. Repeat 10-12 times.
The degree of muscle tension is determined by the initial position of the patient. Grade 1 (patient in the most relaxed state): the patient performs exercises while standing, holding onto a wall or back of a chair to maintain balance. Grade 2: The patient lies on their side, tensing the gluteus maximus of the upper leg. Grade 3: the patient is in a knee-elbow position; the muscle works against gravity, developing maximum strength.
D. Finando, C. Finando