Gluteus Medius Trigger Points and Low Back Pain: Stretches and Exercises That Help

Written by Dr. Jeffrey Peng, MD — Board-Certified Sports Medicine Physician

Published: March 3, 2026 | Last Updated: March 3, 2026

One of the most common and overlooked causes of low back pain is not actually in the low back at all — it is in the gluteus medius muscle. In my practice, I frequently see patients who have been treated for lumbar spine problems for months or even years, only to discover that the true source of their pain is myofascial trigger points in the gluteal muscles. These trigger points, commonly known as muscle knots, can refer pain directly into the lower back and contribute to muscle imbalances, pelvic instability, and altered movement patterns that perpetuate chronic pain.

Research published in Pain Medicine found that active trigger points in the gluteus medius are among the most prevalent in patients with chronic nonspecific low back pain, and that the number of active trigger points is directly correlated with pain intensity (Iglesias-González et al., 2013). In this article, I will explain why the gluteus medius is so important, how trigger points develop in this muscle, and the specific stretches and exercises you can do at home to address this often-missed cause of low back pain.

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Why Does the Gluteus Medius Cause Low Back Pain?

The gluteus medius is a critical stabilizer muscle in the posterior hip. Its primary function is to stabilize the pelvis during activities like walking, running, and single-leg stance. When this muscle develops trigger points — hyperirritable spots within tight bands of muscle fibers — it can cause pain not only at the site of the trigger point but also in distant areas through a phenomenon called referred pain. For the gluteus medius, the referred pain pattern frequently manifests in the lower back, hip, and even down the leg.

A landmark study in the European Spine Journal examined 150 patients with chronic low back pain and found that gluteus medius weakness was significantly more prevalent in the low back pain group compared to healthy controls (Cooper et al., 2015). The study also found that gluteus medius weakness, gluteal muscle tenderness, and the Trendelenburg sign were all predictive of low back pain. This confirms what I see clinically: weakness and trigger points in the gluteus medius are a major, often undiagnosed contributor to chronic low back problems.

How Trigger Points Create a Cycle of Pain

When trigger points develop in the gluteus medius, they weaken the muscle and impair its ability to stabilize the pelvis. This pelvic instability forces the lower back muscles to compensate, working overtime to maintain proper posture and balance. Over time, these compensatory mechanisms lead to increased stress and strain on the lumbar spine and paraspinal muscles, resulting in fatigue, muscle strain, and worsening pain.

More recent research published in the Journal of Manipulative and Physiological Therapeutics confirmed this relationship, demonstrating that the presence of gluteus medius trigger points is directly associated with hip weakness in adults with chronic nonspecific low back pain (Carroll et al., 2023). Interestingly, muscles with latent trigger points — those that are present but not yet actively causing recognized pain — showed the greatest weakness, suggesting that even before you feel referred pain, the damage to muscle function has already begun.

Untreated trigger points can also be effectively addressed with clinical interventions. A randomized controlled trial found that both dry needling and ischemic compression of the gluteus medius improved pain and quality of life in patients with nonspecific low back pain, with dry needling showing more sustained benefits at one week follow-up (Álvarez et al., 2022). However, for most patients, the first line of treatment should focus on self-care strategies: stretching, self-massage, and targeted strengthening.

Two Stretches to Release the Gluteus Medius

Stretching is essential for releasing tension in the gluteus medius and reducing referred pain to the lower back. The following two stretches specifically target this muscle.

The 90/90 Glute Stretch

Begin by sitting on the floor with both knees bent to create 90-degree angles with each leg. Sit upright, then gently lean forward from the hips toward your front thigh. You should feel a deep stretch in the back of your hip where the gluteal muscles are located. Hold this position for 30 seconds, then repeat on the other side. Perform two repetitions on each side.

Pigeon Pose

Start on your hands and knees. Bring your right knee forward and bend it so that your right ankle is near your left hip. Keep your left leg extended straight behind you. Lean forward over your right leg and try to place your forearms on the floor. You should feel a stretch in the posterior hip. Hold for 30 seconds, then switch sides. Perform two repetitions on each side.

Self-Massage Techniques for Trigger Point Release

Self-myofascial release using simple tools can help break up trigger points and improve blood flow to the gluteus medius. A systematic review of 49 studies found that foam rolling can reduce muscle stiffness, increase range of motion, decrease delayed-onset muscle soreness, and improve the pressure pain threshold (Hendricks et al., 2020). The optimal duration appears to be 90 to 120 seconds of rolling per area.

Foam Rolling

Position the foam roller under your glutes while lying on your side. Roll back and forth slowly, pausing on any tender spots for 20 to 30 seconds. The goal is to release muscle tension, improve blood flow, and reduce pain in the gluteal region.

Tennis Ball or Massage Ball Release

Place a tennis ball or massage ball under your glutes while sitting on the floor. Lean into the ball and move your body to locate tender spots. Hold pressure on each tender area for 20 to 30 seconds before moving to the next spot. This technique allows for more precise, targeted pressure compared to foam rolling.

Two Strengthening Exercises for the Gluteus Medius

A strong gluteus medius is essential for maintaining pelvic stability and reducing compensatory strain on the lower back. Trigger points frequently develop in muscles that are weak or deconditioned, so strengthening is critically important for addressing the root cause rather than simply managing symptoms.

Clamshell Exercise

Lie on your side with both hips and knees bent. Keep your feet together and raise the top knee as high as possible without allowing your hips or pelvis to rotate. Pause briefly at the top where you feel maximum engagement in your glutes, then slowly lower the knee back down. To increase the difficulty, place a resistance band around your thighs just above the knees. Perform 2 sets of 15 repetitions on each side.

Side-Lying Leg Raise

Lie on your side with your legs straight. Raise the upper leg while maintaining a straight line with your body, aiming for approximately 45 degrees of hip abduction. Hold briefly at the top, then gently lower it back down. This exercise targets hip abduction, which is excellent for enhancing hip stability and balance. Perform 2 sets of 15 repetitions on each side.

When to Seek Professional Treatment

If your low back pain persists despite consistent stretching and strengthening, or if you suspect you have significant trigger points that are not responding to self-massage, it may be time to consult with a sports medicine physician. Clinical treatments such as dry needling, trigger point injections, and guided physical therapy programs can provide more targeted relief. In my practice, I often combine these interventions with a home exercise program to achieve the best long-term outcomes.

If you are in the San Francisco Bay Area and would like to schedule a consultation, you can request an appointment here.

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References

Iglesias-González JJ, Muñoz-García MT, Rodrigues-de-Souza DP, Alburquerque-Sendín F, Fernández-de-Las-Peñas C. Myofascial trigger points, pain, disability, and sleep quality in patients with chronic nonspecific low back pain. Pain Medicine. 2013;14(12):1964-1970. DOI

Cooper NA, Scavo KM, Strickland KJ, et al. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. European Spine Journal. 2016;25(4):1258-1265. DOI

Carroll M, Ellis R, Kohut S, Garrett N, Fernández-de-Las-Peñas C. Associations between gluteus medius trigger points with hip passive range of movement and muscle strength in adults with chronic nonspecific low back pain. Journal of Manipulative and Physiological Therapeutics. 2023;45(9):641-651. DOI

Álvarez SD, Velázquez Saornil J, Sánchez Milá Z, et al. Effectiveness of dry needling and ischemic trigger point compression in the gluteus medius in patients with non-specific low back pain. International Journal of Environmental Research and Public Health. 2022;19(19):12468. DOI

Hendricks S, Hill H, den Hollander S, Lombard W, Parker R. Effects of foam rolling on performance and recovery: a systematic review of the literature to guide practitioners on the use of foam rolling. Journal of Bodywork and Movement Therapies. 2020;24(2):151-174. DOI

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Disclaimer: This content is for educational purposes only and does not substitute for the medical advice of a physician. Always seek the advice of your physician or qualified health provider with any questions you may have regarding a medical condition.