More massage tips from Save Yourself website. To release trigger points in this area, there are several tools you can use:
- Small smooth massage balls (similar to tennis balls, but with variable densities to choose from depending upon your pain level)
- Large Spiky massage balls (larger balls are better for bigger muscle areas)
- Foam Rollers are a great way to roll out the IT Band (side of thigh), hips, glutes, and back
- Body Rolling Ball is a larger durable vinyl ball that is adjustable in inflation and feels good on the larger gluteus muscles and back muscles in addition to hamstrings
- TheraCane to apply pressure to release knots
Massage Therapy for Back Pain, Hip Pain, and Sciatica
Perfect Spot No. 6, an area of common trigger points in the gluteus medius and minimus muscles of the hip
Trigger points (TrPs), or muscle knots, are a common cause of stubborn and strange aches and pains, and yet they are under-diagnosed. The 13 Perfect Spots are trigger points that are common and yet fairly easy to massage yourself — the most satisfying and useful places to apply pressure to muscle. For tough cases, see the advanced treatment guide.
When you have back pain, buttock pain, hip pain, or leg pain, much or even all of your trouble may well be caused by trigger points in the obscure gluteus medius and minimus muscles, a pair of pizza-slice shaped muscles a little forward of your hip pocket. 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 a bit special: their contribution to pain in this area is particularly significant, and yet people who have buttock and leg pain rarely suspect that much of it might be radiating from muscle knots so high and far out on the side of the hip.
The leg pain that they produce can be so nasty that health professionals mistake it for sciatica,1 a compression of the large sciatic nerve that passes through the buttocks and into the leg. Don’t be fooled. Sciatica is often an incorrect diagnosis for pain in this area.
“One trigger point therapy treatment completely relieved a nasty stubborn hip pain that I’d had for five months!”
Jan Campbell, retired French language teacher, Palm Springs, recovered easily from several months of hip pain
What does Perfect Spot No. 6 feel like?
Even without nasty symptoms, pressure on these muscles can still feel important, as they usual harbour TrPs that aren’t obvious until they are poked (known as “latent” trigger points), but which are routinely responsible for stiffness, “heavy”-ness, vague discomfort, and aching throughout the hip and buttocks and descending into the leg. Their importance is often unsuspected because the key gluteus medius and minimus TrPs actually live way out on the side of the hip, but the discomfort they produce spreads inwards and downwards. Known as “referred pain,” this is the same phenomenon as the pain of a heart attack spreading into the shoulder and arm. In particular, it’s common for this referred pain to be strongest right under the butt cheek, which is why it is so often mistaken for sciatica.
Given their stealthy nature, massaging these muscles 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 deltoid of the butt: anatomy and function of the lateral gluteal muscles
The gluteus medius and minimus together are “the deltoid of the butt.” Just as the deltoid muscle lifts the arm out to the side, these lateral glutes lift the leg. They are small cousins of the more famous gluteus maximus, the big muscle that gives shape to the buttocks (and the home of very nearby Perfect Spot No. 12). Medius and minimus are very much a pair — almost one muscle in two parts — so I’m going to stop saying “medius and minimus” every time. They have a nearly identical shape, location, and function, both acting as lateral stabilizers, preventing the hips from swinging too far from side to side as you walk and balance. You can activate them easily just by standing on one leg and lifting the other out to the side several times. When you start to feel a burn on the sides of your hips, you are feeling your lateral glutes.
The deltoid of the butt
The gluteus minimus and medius muscles are shaped like slices of pizza. (The minimus is hidden here: it is the same shape as the medius, but smaller and lying directly under it.) Perfect Spot No. 6 is usually found halfway down the lateral edge, right on the side of the hip, in the meaty area between the ridge of the pelvis and the big bone on the side of the hip (greater trochanter). But rather than being “soft,” the edge of the gluteus medius is usually quite rigid — almost as hard as the bones above and below!
These muscles really have evolved for all-terrain activity. A life lived mostly on the flat and stable surfaces of a city offers little challenge to them, so they are weak and easily exhausted by weekend skiing trips, a walk on the soft sand of a beach, or really anything that requires more balancing than usual. The combination of chronic mild weakness with erratic stressful challenges may be the reason they tend to get polluted with TrPs. (But that’s just an educated guess. It’s generally impossible to know exactly why individual TrPs come and go.)
Both the medius and minimus are shaped just like a wide 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.
Where exactly is this perfect trigger point?
As with most of the spots, Perfect Spot No. 6 is not so much a single specific trigger point as a small area where you are likely to find a significant trigger point — if not several of them. This area is on the side of the hip behind it. Or, to use the pizza as a guide, it is roughly the forward half of the slice, and especially in the half near the tip of the slice. Start at the greater trochanter and explore up and back from there: all over the side of the hip, right where the seam of your pants would be.