luteus maximus is the main extensor muscle of the hip. It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips.The gluteus maximus straighten the leg at the hip; when the leg is flexed at the hip, the gluteus maximus extends it to bring the leg into a straight line with the body.This study details about the anatomy, functions,clinical presentations , diseases associated,pain on the buttock region. please comment thank u

1. MEDICAL ASPECTS OF
BUTTOCKS
(gluteus maximus,gluteus medium,gluteus minimum)
PREPARED BY
MARTIN SHAJI
PHARM D
Anatomy , functions, clinical
presentations ,diseases ,training
associated with buttocks

2. INTRODUCTION
The buttocks are two rounded portions of the exterior anatomy
of most mammals, located on the posterior of the pelvic region. In
humans, the buttocks are located between the lower back and the
perineum. They are composed of a layer of exterior skin and
underlying subcutaneous fat superimposed on a left and right
gluteus maxims and gluteus medias muscles.

3. The two
gluteus
maximus
muscles are the
largest muscles
in the human
body.

4. ANATOMY
The buttocks are formed by the
masses of the gluteal muscles
or "glutes" (the gluteus
maximus muscle and the
gluteus medius muscle)
superimposed by a layer of fat.
The superior aspect of the
buttock ends at the iliac crest,
and the lower aspect is
outlined by the horizontal
gluteal crease.

5. The gluteus maximus has
two insertion points: ​1⁄3
superior portion of the
linea aspera of the femur,
and the superior portion
of the iliotibial tractus.
The masses of the gluteus
maximus muscle are
separated by an
intermediate intergluteal
cleft or "crack" in which
the anus is situated.

6. FUNCTIONS
They are responsible for achieving the
upright posture when the body is bent
at the waist; maintaining the body in
the upright posture by keeping the hip
joints extended; and propelling the
body forward via further leg (hip)
extension when walking or running. In
the seated position, the buttocks bear
the weight of the upper body and take
that weight off the feet.

7. The gluteus maximus straighten the
leg at the hip; when the leg is flexed
at the hip, the gluteus maximus
extends it to bring the leg into a
straight line with the body.
The gluteus maximus is a tensor of
the fascia lata, and by its connection
with the iliotibial band steadies the
femur on the articular surfaces of the
tibia during standing, when the
extensor muscles are relaxed.

8. Its most powerful action is to cause the body
to regain the erect position after stooping, by
drawing the pelvis backward, being assisted
in this action by the biceps femoris (long
head), semitendinosus, semimembranosus,
and adductor magnus.
Taking its fixed point from below, it acts
upon the pelvis, supporting it and the
trunk upon the head of the femur; this is
particularly obvious in standing on one
leg.

9. The lower part of the muscle also
acts as an adductor and external
rotator of the limb. The upper
fibers act as abductors of the hip
joints.

10. Training
The gluteus maximus is involved in a number of sports, from running to
weight-lifting. A number of exercises focus on the gluteus maximus as
well as other muscles of the upper leg.
Hip thrusts
Glute bridge

11. Quadruped hip extensions
Kettlebell swings
Squats and variations like
split squats, pistol squats and
wide-stance lunges
Deadlift (and variations)
Reverse hyperextension
Four-way hip extensions
Glute-ham raise

12. Functional assessment can be useful in assessing injuries to the gluteus
maximus and surrounding muscles. These tests include:
30 second chair to stand test
This test measures a participant's
ability to stand up from a seated
position as many times as possible
in a thirty-second period of time.
Testing the number of times a person can
stand up in a thirty-second period
helps assess strength, flexibility, pain,
and endurance, which can help determine
CLINICAL SIGNIFICANCE

13. Passive piriformis stretch.
The piriformis test measures
flexibility of the gluteus maximus.
This requires a trained professional
and is based on the angle of
external and internal rotation in
relation to normal range of motion
without injury or impingement.

14. WHAT DOES BUTTOCK PAIN INDICATE ?
When you have arthritis, buttoning a shirt or
fastening a clasp can be a pain in the butt. So is
folding laundry with achy joints, blow drying
your hair, or even signing paperwork. But then
there’s actual pain that can occur in your
buttocks — and it may actually be caused by
arthritis.
Buttock pain may indicate a problem in
either of the sacroiliac joints, the lumbar
spine (lower back), muscles of the pelvis or
any of those other layers,

15. Muscle strain
Your buttocks are made up of three
muscles: the gluteus maximus, the
gluteus medius, and the gluteus minimus.
You can strain one of these or other
overlapping muscles in the area, which
can cause pain, says Dr. Lajam. “The
hamstrings attach right at the bottom of
the pubic bone,” she says; “injury or tears
of the hamstrings can cause deep buttock
pain. Sprains or strains of the abductor
muscles [the side muscles of the hip] can
cause buttock pain.”

16. Bursitis
This painful condition occurs when the small, fluid-filled sacs — called
the bursae — that cushion the bones, tendons, and muscles near your
joints become inflamed. The most common causes are repetitive
motions or positions that put pressure on the bursae around a joint.
Bursitis most often affects the shoulder, elbow, and hip. “Bursitis of
the hip can lead to buttock pain,”
You also have bursae in your buttocks called ischial bursa, which can
become inflamed and cause ischial or ischiogluteal bursitis. This can
result from sitting for a long time on a hard surface, direct trauma, or
injury to the hamstring muscle or tendon from activities like running or

18. Sacroiliitis
This is inflammation of the SI
joints, which can cause pain in
your buttocks, and well as your
lower back, hips, or groin. Some
forms of inflammatory arthritis,
such as ankylosing spondylitis
and psoriatic arthritis, as well as
osteoarthritis, can cause
sacroiliitis, so might an injury,
pregnancy, and infection. Learn
more about sacroiliitis.

19. Sciatica
Pain that radiates from your lower back to your
buttock and down the back of your leg is the
hallmark symptom of sciatica. It most commonly
occurs when a herniated disk, bone spur on the
spine, or narrowing of the spine (spinal stenosis)
compresses part of the nerve. Injuries or overuse of
the piriformis muscle, which is located in the
buttocks near the top of the hip joint, can contribute
to sciatica too. This causes inflammation, pain, and
often some numbness in the affected leg. The pain
can range from mild ache to a sharp, burning, or
excruciating pain. Usually only one side of your body
is affected.

20. Injury/bruising
Your buttocks may develop a
painful bruise (or black-and-
blue mark) if you get hurt, such
as falling off your bike or kicked
by your kiddo during an overly
aggressive wrestling match. You
may notice swelling,
discoloration, and tenderness
to the touch.

21. How Arthritis Can Cause Buttock Pain
Osteoarthritis of the hip
The hip is a ball-and-socket joint. The “ball” is the
top of your thigh bone, and it sits in a “socket” that’s
formed by part of your pelvic bone. Slippery tissue
called cartilage covers the bone surface and helps
cushion the joint. Osteoarthritis (OA) occurs when
the protective cartilage gradually wears down, which
over time leads to pain and stiffness. The most
common symptom of hip osteoarthritis is pain
around the hip joint. As hip OA disease progresses,
low-grade inflammation can set. That results in
increased sensitivity of the surrounding nerves,
which can cause pain in and around the low back
and buttocks

22. Osteoarthritis of the
spine
The bones in your spine (vertebra) are
separated by spongy discs, which act as
shock absorbers. With age, these discs can
wear or shrink, which narrows the space
between the spinal joints, or “facet” joints.
Disc changes can lead to more strain on the
joints, which can cause the cartilage to
wear down and the facet joints in the
vertebrae to rub against one another,
leading to the pain and stiffness of OA. “It
is not uncommon for these joints to refer
pain into the buttocks, especially with
prolonged standing or even walking,”

23. Ankylosing spondylitis (AS)
Ankylosing spondylitis is a form of arthritis
that causes inflammation in the joints in
your spine. Most commonly, it affects the
vertebra in your lower back and the SI
joints. Over time, inflammation can cause
some of the vertebrae to fuse, which
makes your spine less flexible and leads to
chronic pain and discomfort. Early
symptoms of AS are frequent pain and
stiffness in the lower back and buttocks,
which comes on gradually over the course
of a few weeks or months. Some people
even use the phrase “alternating buttock
pain” to describe their AS symptoms.

24. Rheumatoid arthritis
With rheumatoid and other forms of
inflammatory arthritis, the immune
system mistakenly attacks a protective
lining in your joint called the synovium,
and destroys cartilage. Though RA tends
to affect smaller joints first (such as
those in your hands and feet), symptoms
can spread to both your hips as the
disease progresses. Inflammatory
arthritis in your hip will feel painful and
stiff. You may also experience a dull or
aching pain in the buttocks that’s worse
in the morning, and gradually improves
with activity.

25. MEDICAL PROCEDURES ASSOCIATED WITH BUTTOCKS
Buttock augmentation
Gluteoplasty denotes the plastic surgery and the liposuction procedures for the
correction of the congenital, traumatic, and acquired defects and deformities of
the buttocks and the anatomy of the gluteal region; and for the aesthetic
enhancement (by augmentation or by reduction) of the contour of the
buttocks.

26. Hydrogel and silicone buttock injections
You may have heard about hydrogel buttock
shots as a cheaper method of augmentation.
This method gives temporary results and
doesn’t require a traditional surgical procedure.
It’s also dangerous.
Like hydrogel injections, silicone injections
don’t involve surgery and they also don’t
directly change the shape of your buttocks.
While there’s some conversation about silicone
injections being used in place of butt implants,
this method is not recommended. In fact,
silicone injections for the buttocks can be quite
dangerous.

27. A buttock lift is a cosmetic surgical
procedure to improve the appearance of
the buttocks. It may be done as part of a
tummy tuck (belt lipectomy) or lower
body lift to contour the buttocks, groin,
thighs and abdomen.
A buttock lift alone won't add any
volume to the buttocks. But sometimes,
a buttock lift is combined with an
augmentation procedure to alter the
shape or size of the buttocks with
implants or fat grafts.
Buttock lift

28. https://www.slideshare.net/martinshaji