Gluteus maximus tendon !
The gluteus maximus tendon joins the large buttock muscle to the back of the femur and to the iliotibial band.
Official name: Tendon of gluteus maximus
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What it is
The tendon end of the gluteus maximus. Most of it blends into the IT band; the deeper part attaches to the back of the femur (gluteal tuberosity).
What it does
Carries the muscle's pull to extend the hip and to tighten the IT band.
Key facts
- Attaches
- Upper and superficial lower fibres into the iliotibial tract (about three quarters); deep lower fibres to the gluteal tuberosity of the femur
- Function
- Carries hip extension and lateral rotation; tenses the iliotibial tract to steady the extended knee; the trochanteric bursa lies between it and the greater trochanter
- Tight in
- Hip flexion with adduction
Relations
- Superficial
- Fat and skin of the buttock and upper outer thigh
- Deep
- Greater trochanter with the trochanteric bursae, the vastus lateralis origin, the short external rotators and the sciatic nerve
- Below
- Vastus lateralis in front and adductor magnus behind, between which the deep fibres reach the gluteal tuberosity
- Lateral
- IT band, into which most of its fibres continue
How to find it
Tightening the buttock while standing brings out the muscle; its lower fibres converge on the outer back of the upper thigh, just below the greater trochanter, where the insertion lies.
Examination
- Side-lying snapping test: repeated hip flexion and extension shows a visible or palpable snap over the trochanter in external snapping hip
- Prone hip extension with the knee bent, against resistance, tests gluteus maximus strength
On imaging
Dynamic ultrasound shows the band catching over the trochanter in external snapping; MRI shows the uncommon tears at the gluteal tuberosity and fluid in the trochanteric bursae.
Common problems
- Strains from sprinting or jumping (less common than hamstring strains).
- Weakness from inactivity or after injury, linked to back, hip and knee pain.
- Buttock pain from a bruise or an irritated bursa under the muscle.
How it is diagnosed
Physical exam and strength testing; ultrasound or MRI if a tear is suspected.
Treatment
- Rest, ice, then progressive strengthening (bridges, squats, step-ups) with a physical therapist.
- Treating the underlying cause of buttock pain, such as a back or hip problem.
Clinical notes
- Painful external snapping that does not settle can be treated surgically by lengthening or releasing the IT band or the gluteus maximus insertion
- Injury to the inferior gluteal nerve weakens hip extension: climbing stairs and rising from a chair become hard, and the trunk is thrown backward at heel strike (gluteus maximus lurch)
- Calcific tendinitis at its femoral insertion can erode the femoral cortex and be mistaken for a tumour on imaging
Anatomical variants
- How much of the muscle goes to the IT band and how much to the gluteal tuberosity varies between people
- A prominent gluteal tuberosity forms a third trochanter in some people
Test yourself
Think of the answer, then tap the question to see it.
Where do the fibres of the gluteus maximus tendon insert?
About three quarters into the iliotibial tract; the deep lower fibres into the gluteal tuberosity of the femur.
What causes external snapping hip?
A thickened band at the back of the IT band or the front edge of the gluteus maximus flicking over the greater trochanter as the hip moves.
Which major nerve lies deep to the gluteus maximus?
The sciatic nerve, emerging below the piriformis and running down over the short external rotators.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- musculus gluteus maximus TA2 2598
- Official Spanish (DeCS)
- Tendón del glúteo mayor DeCS D013710
- English (TA2)
- Tendon of gluteus maximus
- Also called
- musculus glutaeus maximus
Related
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Bony Pelvis and Lower Limb, Gluteus Maximus Muscle.
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Representative model, for educational purposes only.
