updated 10/23/09
Massage Therapy for Back Pain, Hip Pain and Sciatica
Perfect Spot No. 6, in the gluteus medius and minimus muscles of the hip
by Paul Ingraham, Vancouver, Canada MORE
Credentials and qualifications
I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.
For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.
Credentials and qualifications
I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.
For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.
Trigger points (muscle knots) are the world’s most common cause of aches and pains. The Perfect Spots series of articles teaches you how to self massage the most satisfying and therapeutically significant places on the human body to apply pressure. Each Perfect Spot article focuses on a specific location. For a complete, advanced tutorial that walks you through every possible self-treatment option for muscle pain, see Save Yourself from Trigger Points & Myofascial Pain Syndrome!
When people complain of back, buttock and leg symptoms, even quite serious ones, their trouble is often caused by trigger points (muscle knots) in the little known gluteus medius and minimus muscles. The leg pain that they produce can be so dramatic that doctors, physiotherapists and other health professionals routinely mistake it for sciatica, a compression of the large sciatic nerve that passes through the buttocks and into the leg.1
Other muscles in the region are usually involved as well, such as the gluteus maximus, piriformis, and the lumbar paraspinal muscles. However, the gluteus medius and minimus are special: their contribution to pain in this area is particularly significant, and yet people who feel like they have buttock and leg pain rarely suspect that much of it is coming from muscle knots so far out on the side of the hip.
Even without nasty symptoms, pressure on these muscles can still feel important, as they usual harbour latent trigger points that aren’t obvious until they are poked, but which are often responsible for long term subtle stiffness in the area. Massaging them can really feel like a surprising and satisfying discovery of the true source of stiffness you did (or didn’t) know that you had — perfect characteristics for a Perfect Spot!
The gluteus medius and minimus are the smaller cousins of the more famous gluteus maximus, the big muscle that gives shape to the buttocks. Medius and minimus are very much a pair, almost one muscle in two parts. They have an almost identical shape, location, and function: both act as lateral stabilizers, preventing the hips from swinging too far from side to side as you walk and balance. You can activate them easily by standing on one leg and lifting the other out to the side several times; when you start to ache on the sides of your hips, you are feeling your gluteus medius and minimus.
These muscles really have evolved for all-terrain activity. A life lived mostly on the flat and stable surfaces of the city offers little challenge to them, and so they are almost always weak and easily exhausted by weekend skiing trips, a walk on the beach, or basically anything that requires more balancing than usual — and so they almost always contain trigger points.
Both the medius and minimus are shaped like a slice of pizza; the points converge downwards on the bony projection on the side of your hip, the greater trochanter at the top of the femur. Their “crust” follows the iliac crest, a bony ridge at the top of the pelvis that defines the waist. The medius completely covers the minimus, and the maximus covers most of the medius — but you can still easily reach these muscles simply by pressing into the soft tissue just below the waist at the side and back.
Like many of the spots, Perfect Spot No. 6 is not so much a single spot as a small area along the outer edge of pizza slice-like shape of the muscles. The area near the point is the best place to look for trigger points, but explore all along the lateral edge — on the side of the hip, right where the seam of your pants would be.
Trigger points in this area are easy enough to find, but not easy to massage on your own body. A KONG® dog toy is a surprisingly useful self-treatment tool that allows a variation on the more familiar tennis ball trick; its wedge shape allows you to roll the side of your hip onto it, the pressure increasing as you roll further. This is a difficult (and slightly absurd) process to describe, so all I can do is encourage you to take my word for it and experiment — your dog may get jealous, though!
The KONG® dog toy is an amazingly good self-massage tool!
All The Perfect Spots for Trigger Point Massage
Choose your
perfect spot!
Or, for general information and advanced tips about trigger point therapy, see Save Yourself from Trigger Points!
- Spot 1 — Massage Therapy for Tension Headaches
- Spot 2 — Massage Therapy for Low Back Pain
- Spot 3 — Massage Therapy for Shin Splints
- Spot 4 — Massage Therapy for Neck Pain (and Much More)
- Spot 5 — Massage Therapy for Tennis Elbow and Wrist Pain
- Spot 6 — Massage Therapy for Back Pain, Hip Pain and Sciatica
- Spot 7 — Massage Therapy for Bruxism, Jaw Clenching, and TMJ Syndrome
- Spot 8 — Massage Therapy for Your Quads
- Spot 9 — Massage Therapy for Your Pectorals
- Spot 10 — Massage Therapy for Tired Feet (and Plantar Fasciitis!)
- Spot 11 — Massage Therapy for Upper Back Pain
- Spot 12 — Massage Therapy for Low Back Pain (So Low That It’s Not In the Back)
- Spot 13 — Massage Therapy for Low Back Pain (Again)
and …
Is trigger point therapy too good to be true?
Trigger point therapy isn’t too good to be true: it’s just ordinary good. It can relieve some pain cheaply and safely in many cases. The existence of trigger points is not controversial. You can measure their electrical activity, take samples of their highly acidic tissue chemistry, and now a new MRI-like technology can now show them as well.
The Perfect Spots are based on a decade of my own clinical experience, and on the research and writing of Drs. Janet Travell and David Simons, pioneers of myofascial pain syndrome research. They produced “the Big Red Books” (a massive pair of texts).
Trigger points are clinically significant, but unfortunately obscure. As Dr. Simons wrote, “Muscle is an orphan organ. No medical speciality claims it.”
Notes
- Bewyer et al. Iowa Orthop J. 2003. Return to text.
