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Test: Palpation - Gluteus Maximus

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Background/Purpose

The gluteus maximus is the largest and most superficial of the three gluteal muscles and makes up a large portion of the shape and appearance of each side of the hips. Its thick fleshy mass, in a quadrilateral shape, forms the prominence of the buttocks.
Its large size is one of the most characteristic features of the muscular system in humans, connected as it is with the power of maintaining the trunk in the erect posture. Other primates have much flatter hips and can not sustain standing erectly.
The muscle is remarkably coarse in function and structure, being made up of muscle fascicles lying parallel with one another, and collected together into larger bundles separated by fibrous septa.
It arises from the posterior gluteal line of the inner upper ilium, a pelvic bone, and roughly the portion of the bone including the crest of the ilium (the hip bone), immediately above and behind it; and from the posterior surface of the lower part of the sacrum, the base of the spine, and the side of the coccyx, the tailbone; from the aponeurosis of the erector spinae (lumbodorsal fascia), the sacrotuberous ligament, and the fascia covering the gluteus medius (gluteal aponeurosis). The fibers are directed obliquely downward and lateralward; The gluteus maximus has two insertions:
those forming the upper and larger portion of the muscle, together with the superficial fibers of the lower portion, end in a thick tendinous lamina, which passes across the greater trochanter, and inserts into the iliotibial band of the fascia lata; the deeper fibers of the lower portion of the muscle are inserted into the gluteal tuberosity between the vastus lateralis and adductor magnus.

Procedure

Locate the iliac crest then move posterior along the crest to a small bony process called the posterior superior illac spine (PSIS). Place the palm of your hand with fingers pointing down and towards the midline of the body. The upper hand now covers the origin attachments and under the palm is the bulk of gluteus maximus. This can be confirmed by having the patient contract the muscle.
Gluteus maximus can be palpated whilst it acts during standing hip extension, a step-up, or whilst standing raise the medial borders of the foot. Tenderness or pain in the coccyx is also clinically important for dysfunction of the gluteus maximus.
Look for trigger points which primarily refer pain into the muscle.
Also assess for tenderness or tension around the gluteal nerves and their cutaneous branches.
Performed: Unilaterally

Dialog

Palpation of the Gluteus Maximus muscle with consideration of the coccyx and gluteal nerves

Criteria

No trigger points
No coccyx tenderness
Adequate muscle tone

Measurement

0.00

LOINC Code

Scale/Grading

selection range; grade - LOINC ID

Test Stats

Side Pass Fail
Left 0 0
Right 0 0
Avg. Measure. Left 0.0 0.0
Avg. Measure. - Right 0.0 0.0

Regions
Cervical	Thoracic	Lumbar	Pelvic
Hip/Thigh	Knee/Calf	Ankle	Foot
Shoulder/Arm	Elbow/Forearm	Wrist	Hand
Head	TMJ	Systemic