Course Instructor (End)
Common Trigger Point Areas
10) Gluteus Maximus Muscle
- The Gluteus Maximus muscle originates at the posterior iliac crest, lateral sacrum, the coccyx and the Sacrotuberous ligament and inserts into the iliotibial band and the femur. It is innervated by L5, S1, and S2 spinal roots via the inferior gluteal nerve.
- This muscle helps maintain an upright posture as well as assisting in powerful extension of the thigh at the hip.
- The referred pain from Gluteus Maximus TP’s is usually concentrated in the buttock region.
11) Gluteus Medius Muscle
- The Gluteus Medius muscle originates along the anterior 2/3 of the iliac crest and inserts distally into the greater trochanter. It is innervated by the superior gluteal nerve from spinal roots L4, L5 and S1.
- The Gluteus Medius abducts the thigh and is responsible for stabilizing the pelvis during single limb weight bearing.
- Individuals with Gluteus Medius TP’s have pain when walking. The referred pain pattern is along the posterior crest of the ilium, the sacrum, the posterior lateral aspects of the buttocks and in the upper thigh.
12) Gluteus Minimus Muscle
- The Gluteus Minimus muscle its originate at the outer surface of the ilium between the anterior and inferior gluteal lines. It inserts at the greater trochanter. It is innervated by the superior gluteal nerve carrying fibers from L4, L5, and S1.
- The Gluteus Minimus assists the Gluteus Medius in stabilizing the pelvis during single limb weight bearing and assists in abduction of the thigh.
- Referred pain extends down the lateral and posterior aspects of the lower limb into the ankle. Vasoconstriction of this muscle is a common cause of sciatica.
13) Piriformis Muscle
- The Piriformis Muscle originates at the anterior surface of the sacrum and it passes through the greater sciatic foramen. It inserts into the greater trochanter. The piriformis is innervated by the first and second sacral nerves.
- It externally rotates the thigh when the hip is extended, abducts the thigh when the hip is flexed and restrains medial rotation of the thigh.
14) Iliopsoas Muscle
- The psoas portion originates from the twelfth thoracic and all the lumbar vertebral bodies as well as the corresponding discs and lumbar transverse processes. It runs inferiorly to join with the iliacus to become the iliopsoas. It exits the pelvis through the Lacuna Musculorum (along with the femoral nerve, and the lateral femoral cutaneous nerve) to insert at the lesser trochanter of the femur.
- The iliacus portion arises from the upper 2/3 of the inner surface of iliac fossa, which lines the lateral wall of the greater pelvis. It then joins the psoas at the lesser trochanter of the femur.
- The iliacus is innervated by spinal nerves L2, and L3. The psoas is innervated by L2, L3 and L4 spinal nerves.
- Iliopsoas T.P.’s refer pain to the lumbar spine, sacrum, groin and thigh. To stretch this muscle and alleviate T.P.’s have the patient perform a hip extension stretch (step forward with one foot, lean back and extend the opposite thigh at the hip. Hold this stretch for a count of 10 and then do the other side.)