The Anatomy of the Glutes and their role in lower back pain

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Lower back pain is a common causing discomfort to around 80% of individuals within their lifetime. Pain in the lower back is usually a symptom of injury or stress to the muscles, ligaments, joints, tendons or discs. The Glutes can be a key factor in lower back pain, they alongside many others play key roles in supporting the pelvis by stabilizing and moving the hip joint internally and externally.

The Anatomy

The Gluteal’s are made up of three layers:

Gluteus Minimus: the smallest of the three is located just under the gluteus medius.

FUNCTION: abduct, flex and internally rotate the hip

Gluteus Medius: located just partway under the gluteus maximus, it connects the ilium to the upper femur.

FUNCTION: externally rotate the hip when it is extended behind you, and internally rotate the hip when it is flexed in front.

Gluteus Maximus: the largest and most superficial of the three. It attaches to the ilium, hip, Sacrum, coccyx and ITB.

FUNCTION: Extending and externally rotating the hip joint

Clinical Relevance

Let’s look a little more closely at the stability roles.

  • As a powerful extensor of the hip, it is only majorly activated during climbing, running or when using the squat motion.
  • They are used alongside hamstrings to extend the trunk and maintain an upright posture.
  • It is not greatly used during normal walking, however by sitting when sitting at a desk for majority of the day your glutes can become tight and inactive. They work through contracting to offload the ischial tuberosity’s when supporting the bodies weight during sitting
  • Due to the superior fibres of the gluteus maximus attaching onto the iliotibial tract they play a roles in extending and supporting the knee
  • The attachments onto the sacrum alongside the fascia and ligaments play a role in stabilising the sacroiliac joints.


  • The upper fibres of the Glute Max connect onto a thick fascia (thoracolumbar) of the lower back – this is key in energy transfer of the gait.
  • Lower fibres connect onto the tensor fascia lata and iliotibial band – key in extend, abduction and laterally rotating the hip.

When working on the glutes a muscle, alongside many others called the piriformis can be affected. The piriformis lies deep underneath the Gluteus maximus and externally rotates the hip. The sciatic nerve is located inferiorly to this muscle, so if the lateral rotators of the hip become tight this can exert pressure of the sciatic nerve.


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