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Gluteus medius

The fan-shaped buttock muscle that moves the thigh out to the side and holds the pelvis level in walking. Where it sits, how it weakens or shrinks, how it responds to training, and what it works with.

Region
Hip
Starts on
the gluteal fossa of the ilium, the gluteal aponeurosis, and the back lower edge of the iliac crest (Pelvis)2,6
Ends on
the greater trochanter, the bony bump at the top of the thigh bone, on its outer and upper-back facets (Gluteal tendons)2,6,7,8
Tendons
Gluteal tendons
Updated
September 30, 2026
Reviewed
September 30, 2026 · how entries are checked

Function

Where it sits and attaches

The gluteus medius lies beneath the gluteus maximus, the large muscle of the buttock, and over the gluteus minimus6. In 12 cadavers, the medius started from three sites2. One was the ilium, the wide upper part of the hip bone2. Another was the gluteal aponeurosis, a broad, flat sheet of tendon2. The third was the back lower edge of the iliac crest, the hip bone’s curved top rim2.

At its lower end, its tendon had an outer part and a back part2. Cadaver studies found the tendon attaching to the greater trochanter, the bony bump at the outer hip, at two sites7,8. These sit on the outer facet and the upper back facet, two of the bump’s four small flat areas7,8. The gluteal tendons page covers these attachments in detail.

Line drawing of the right hip bone and upper thigh bone seen from the side. A broad red area on the outer surface of the ilium marks where the gluteus medius starts, and a thin red outline narrows from it down to a slanted red strip on the outer face of the greater trochanter, where its tendon attaches.
Gluteus medius, outline and attachmentsFrederick Henry Gerrish, A Text-book of Anatomy (1902), Fig. 352. Public domain, via Wikimedia Commons. (source, Public domain)

By volume, the medius was the largest of the three hip abductors2:

Average volume in 12 cadavers (cm³)Gluteus medius27.6 Gluteus minimus14.1 Tensor fasciae latae (a small muscle at the upper outer thigh that pulls on the iliotibial band)1.8
Average volume in 12 cadavers (cm³). Bars start at zero; the table below gives each value with its source.
MuscleAverage volume in 12 cadavers (cm³)
Gluteus medius27.62
Gluteus minimus14.12
Tensor fasciae latae (a small muscle at the upper outer thigh that pulls on the iliotibial band)1.82

Its nerve and blood supply

The superior gluteal nerve serves three muscles: the medius, the minimus and the tensor fasciae latae9. It comes from the L4, L5 and S1 nerve roots, where nerves leave the spinal cord9. The medius and minimus also share one artery, the superior gluteal artery10.

In 20 muscles from 10 cadavers, the nerve left the pelvis through an opening called the greater sciatic foramen1. The pelvis is the ring of bone at the base of the spine. It passed above the piriformis, a small muscle deep in the buttock, then branched into the medius1.

Three parts, or four

Studies divide the muscle in different ways2,11. In 18 cadavers, the medius was made of three distinct parts, each with its own nerve branch11. In 15 healthy people, fine-wire electrodes (very thin wire sensors placed into a muscle) recorded its front, middle and back segments12. The segments’ share of a hardest effort differed in four of five test positions, which pointed to three segments working independently12.

Another dissection of 12 cadavers found three or four main nerve branches, each reaching a different region2. From its build and nerve supply, those authors judged it to have four compartments2. A systematic review, which searches for all the research on a question and sums it up, found little data on fibre direction and nerve branching13. So whether these muscles are divided into compartments was hard to judge13.

What it moves

The gluteus medius is the main abductor of the hip, moving the thigh away from the midline of the body1. Its front fibres also help with internal rotation, turning the thigh inward1. The hip abductors can also help steady the pelvis during walking13.

A study of fibre direction in 18 cadavers suggests the parts may split the work11. The front and middle parts seem to start the lift, which the tensor fasciae latae then completes11. The back part runs parallel to the femoral neck, the angled part of the thigh bone just below the ball of the hip11. It seems suited to holding the ball of the hip in its socket during walking11.

In walking and running

In computer simulations of eight people walking at four speeds, the medius was among the main muscles holding the body up and moving it forward14. Unlike the other main muscles, its share did not generally rise with walking speed14. In 15 healthy people walking, all three segments fired in two bursts during stance, while the foot is on the ground12. The front segment peaked later in both bursts12.

In ten active people without symptoms, every medius and minimus segment was more active in running than in walking15. All the gluteal segments peaked during stance in running15. The authors suggested that the medius segments’ greater stance activity may help steady the pelvis15.

Breakdown

When the muscle is weak

Weakness of the gluteus medius and minimus lets the pelvis drop toward the other side during walking3. This pattern is called Trendelenburg gait3. Damage to the superior gluteal nerve paralyses the medius and produces the same pattern9. The test for this gait was first reported by the German surgeon Friedrich Trendelenburg in 18953. It is used to reveal weakness or other problems in the hip abductors3.

Tendon tears and tendon pain

Tears of the medius or minimus tendons are the more severe end of gluteal tendon problems5. In 176 people having a hip replacement, 34 (20%) had tears from gradual wear in the hip abductors16.

Gluteal tendinopathy, local pain in a tendon that comes with activities that load it, mainly involves the medius and minimus17. It is now understood as a problem where these tendons attach, without inflammation17. In an MRI study of 185 people aged 50 or over, tendon changes and muscle wasting in the medius and minimus went together18. Both increased with age18.

Hip osteoarthritis

Osteoarthritis is a long-term joint disease in which the cartilage lining the joint wears away. A meta-analysis, which pools the results of several studies, covered 22 studies of hip osteoarthritis19. Hip abductor strength was lower in people with the disease than in controls, and lower than in their unaffected leg19.

Studies of the muscle’s size disagree19,20:

StudyWhat it found
MRI study of people with osteoarthritis in one hipMedius volume was lower on the affected side than on the other side and than in controls, and the gap tracked disease severity20
Meta-analysisLow to very low quality evidence that the medius is smaller on the painful side when one hip is affected21
Systematic review and meta-analysisPooled data showed no difference in hip abductor size between patients and controls, or between legs; data were limited19
39 people with end-stage disease and 12 matched healthy controlsThe gluteus minimus was smaller, but the medius was not22

In 20 people with osteoarthritis in one hip and 20 matched controls, fine-wire recordings found no differences in medius activity during walking23.

Weaker hip abduction alongside other conditions

Reviews and studies have compared hip abduction strength in people with and without several other conditions24,25:

  • Low back pain. A review of 24 case-control studies found the medius tended to be weaker, with more trigger points (tender knots), in adults with the pain26. Results for its activity, timing, fatigue and size were unclear26.
  • Knee osteoarthritis. A meta-analysis of five studies found moderate-quality evidence of hip abduction strength 7% to 24% lower in people with symptoms24.
  • Pain around the kneecap. A review of five studies found lower hip abduction strength on the affected side in females with this pain25. A later review found lower hip strength in adults with the pain27.
  • Distance running. In a review of 11 studies in distance runners, weak hip abduction may be linked with iliotibial band syndrome28. The syndrome is named for the long band of tough tissue running down the outer thigh. That link was suggested by several studies done at one point in time28. Its role in four other running injuries was unclear28.
  • Falls. In 60 people over 65, the most hip abductor force they could make told apart those with and without past falls with good accuracy29.

For pain around the kneecap, the order of events is in question. A meta-analysis of 18 studies that followed 4,818 people forward found moderate evidence that weak hips did not raise the risk of later pain30. In teenagers, greater hip abduction strength was a risk factor30. The later review found no link between hip strength and developing the pain later27. It suggests the weakness may result from the pain rather than cause it27.

Recovery

Shrinking with disuse

Head-down-tilt bed rest is a research set-up in which people stay in bed with the head tilted slightly below the feet. In 24 healthy people, 59 days of it cut gluteus medius volume by 8.0%4. The fat level inside the muscle rose by 0.5% over the same period4.

Response to training

Two trials found little or no growth in the medius31,32. In untrained college-aged people, 9 weeks of hip thrusts or back squats gave the medius and minimus together little to no growth on MRI31. In a trial, 27 people with hip osteoarthritis were assigned by chance to 12 weeks of targeted gluteal exercise or a sham (dummy) program32. Medius volume did not change significantly, and hip strength improved similarly in both groups32.

A meta-analysis pooled randomised controlled trials in people with knee osteoarthritis33. These studies assign people to groups by chance, then compare the groups. Hip abductor strengthening lowered knee pain and raised function scores compared with control groups33.

Strength after hip replacement

A meta-analysis of 19 studies, covering 875 people, tracked hip abductor strength around hip replacement surgery34:

TimeChange in hip abductor strength
Before surgery, against controlsAbout 19% lower34
4 to 6 months afterRose by about 20%34
9 to 12 months afterRose by about 30%34

The review concluded that strength may improve slowly over 24 months, possibly without full recovery34. It rated the evidence as low to moderate in quality34.

Connections

The other hip abductors

The medius and gluteus minimus act as a pair to move the thigh out to the side, and both matter for normal walking35. The tensor fasciae latae works with the medius to bend the hip and move the thigh out to the side6. A 1989 study described the three as one abductor system, with the medius steadying the hip early in each step36.

Compared with other leg muscles

In a dissection of 27 muscles from 21 legs, the soleus, a wide, flat calf muscle, was the strongest by one measure of size37. It came ahead of the vastus lateralis, the outer thigh muscle, and the gluteus medius37. Judging by force capacity, the authors rank the soleus as likely the key muscle at the ankle37. They give the vastus lateralis that role at the knee, and the medius at the hip37.

Exercises that load it

Studies of the muscle’s electrical activity show how exercises use it. Activity is given as a share of maximum voluntary contraction, a person’s hardest effort with the muscle38:

ExerciseWhat studies found
Side-lying hip abductionBest of 12 exercises for medius activity in 21 active people39. About 40% in the middle segment on average across 8 studies of healthy people in one review38
Side plankWith hip abduction, the highest medius activity of 18 exercises in 24 healthy people, at 103%40
Single-leg Romanian deadliftIn 15 trained men, about 78% against 59% in the two-leg deadlift41
Farmer’s carryIn 16 trained men, about 26% in those with strong hip abductors. It was 42% to 47% where those muscles were weak next to the hamstrings or quadriceps42
Wall sitHolding a one-leg wall squat, 13% to 35% across the three segments in 15 pain-free people43
Bird dogIn the moving version done standing on one leg, a peak of about 45%44
Back squatOne review reports that stance width does not appear to change medius activity45

Related exercise pages: side-lying hip abduction, side plank, single-leg Romanian deadlift, farmer’s carry, wall sit, bird dog and back squat39,40,41,42,43,44,45.

Gluteus medius ends in

Gluteus medius lies beneath

Gluteus medius works with to move the thigh out to the side

Gluteus medius compared by force with

Gluteus medius starts on

Gluteus medius attaches to

Gluteus medius is loaded by

Sources

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  5. Spencer T, Nasser A, Brown NAT, Grimaldi A, Vicenzino B, Smith PN, Fearon A (2026). Low quality evidence supports surgery for gluteal tendon tears, no non-surgical evidence was identified: a systematic review.. BMC Musculoskeletal Disorders. doi:10.1186/s12891-026-09519-0 PMID 41634705
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Every source the library cites

Changes

  • First published.