[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/) › Gluteus medius tendon [Muscular system](https://durgical.com/en/anatomy/system/muscular-system/) · [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/) # Gluteus medius tendon The gluteus medius tendon attaches to the bony point of the outer hip (greater trochanter); it is a common source of side-hip pain. Official name: Tendon of gluteus medius [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=lower_limb&select=gluteus_medius_tendon&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The tendon of the gluteus medius, attaching to the greater trochanter on the outer hip. This is where gluteal tendinopathy and tears happen. ## What it does Carries the pull of the gluteus medius to the [femur](https://durgical.com/en/anatomy/femur/) to keep the [pelvis](https://durgical.com/en/anatomy/region/pelvis/) level. ## Key points - Gluteal tendinopathy, rather than pure bursitis, is the commonest cause of pain over the greater trochanter; the trochanteric bursae are often involved secondarily - The [superior gluteal nerve](https://durgical.com/en/anatomy/superior-gluteal-nerve/) runs between the [gluteus medius](https://durgical.com/en/anatomy/gluteus-medius-muscle/) and minimus about 5 cm above the tip of the trochanter (texts differ); splitting the medius higher in a lateral hip approach endangers it - A full-thickness tear leaves a 'bald' facet on ultrasound or MRI, with the tendon pulled back from the trochanter ## Key facts **Attaches** Lateral and superoposterior facets of the greater trochanter **Function** Abducts the hip and keeps the pelvis level in single-leg stance; its tendinopathy or tear (the 'rotator cuff of the hip') is a main cause of greater trochanteric pain syndrome **Tight in** Hip adduction (crossing the legs) ## Relations **Superficial** [IT band](https://durgical.com/en/anatomy/iliotibial-tract/), [gluteus maximus](https://durgical.com/en/anatomy/gluteus-maximus-muscle/) and [tensor fasciae latae](https://durgical.com/en/anatomy/tensor-fasciae-latae/), with the [trochanteric bursae](https://durgical.com/en/anatomy/trochanteric-bursa-of-gluteus-maximus-muscle/) between **Deep** [Gluteus minimus tendon](https://durgical.com/en/anatomy/tendon-of-gluteus-minimus/), with a small bursa between them **In front** Tensor fasciae latae and the [gluteus minimus](https://durgical.com/en/anatomy/gluteus-minimus-muscle/) insertion on the anterior facet **Behind** [Piriformis tendon](https://durgical.com/en/anatomy/tendon-of-piriformis/) ## How to find it Lying on the side, the tip and outer surface of the greater trochanter are felt; tenderness just above and behind the tip, with pain on resisted abduction, points to the tendon. ## Examination - Trendelenburg test: standing on the affected leg, the opposite side of the pelvis drops if the abductors are weak - Single-leg stance for 30 seconds: lateral hip pain within that time suggests gluteal tendinopathy - Resisted external derotation test: lateral hip pain when the bent, outwardly rotated hip is brought back to neutral against resistance suggests gluteal tendinopathy ## On imaging Ultrasound shows a thickened, hypoechoic tendon, calcification, tears and bursal fluid; MRI shows tendon signal change, tears, fatty change of the muscle and oedema over the trochanter. ## Common problems - Gluteal tendinopathy: wear and pain of its tendon at the outer hip, common in women over 40 and in runners. It is the main cause of greater trochanteric pain syndrome. - Tendon tears, sometimes called a 'rotator cuff tear of the hip'. - Weakness causes a limp where the pelvis drops on the other side (Trendelenburg gait). ## How it is diagnosed Physical exam: tenderness over the outer hip, pain when standing on one leg, and strength testing. Ultrasound or MRI shows tendon damage or tears. ## Treatment - Physical therapy with progressive loading exercises; avoiding crossing the legs and lying on the sore side. - Injections or shock wave therapy for pain that does not settle. - Surgical repair of the tendon (open or endoscopic) for significant tears. ## Clinical notes - Tears can be repaired endoscopically or through an open approach; chronic tears with fatty muscle may need a muscle transfer - After hip replacement through a lateral approach, failed healing of the abductors is a cause of limp and lateral hip pain ## Development Its insertion, the greater trochanter, ossifies from a separate centre that appears around the fourth year and fuses with the shaft in adolescence; until then a violent abductor pull can, rarely, avulse the trochanteric apophysis. ## Related conditions - [Greater Trochanteric Pain Syndrome](https://durgical.com/en/conditions/greater-trochanteric-pain-syndrome/) ## Test yourself Think of the answer, then tap the question to see it. ## Where does the gluteus medius tendon insert? On the lateral and superoposterior facets of the greater trochanter. ## What is the commonest cause of pain over the greater trochanter? Gluteal tendinopathy, rather than pure bursitis; the trochanteric bursae are often involved secondarily. ## What does a positive Trendelenburg test show? Weak hip abductors: standing on the affected leg, the opposite side of the pelvis drops. ## Which nerve is endangered if the gluteus medius is split too high in a lateral hip approach? The superior gluteal nerve, running between the gluteus medius and minimus about 5 cm above the trochanter tip. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/tendon-of-gluteus-medius/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** musculus gluteus medius TA2 2599 **Official Spanish (DeCS)** Tendón del glúteo medio DeCS D013710 **English (TA2)** Tendon of gluteus medius **Also called** musculus glutaeus medius ## Related - [Trochanteric bursae](https://durgical.com/en/anatomy/trochanteric-bursa-of-gluteus-maximus-muscle/) - [Gluteus medius](https://durgical.com/en/anatomy/gluteus-medius-muscle/) - [Femur](https://durgical.com/en/anatomy/femur/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=14088); [Anatomy, Bony Pelvis and Lower Limb, Gluteus Medius Muscle](https://www.ncbi.nlm.nih.gov/books/NBK557509/); [8.5 Development of the Appendicular Skeleton](https://openstax.org/books/anatomy-and-physiology-2e/pages/8-5-development-of-the-appendicular-skeleton) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/tendon-of-gluteus-medius/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/tendon-of-gluteus-medius/