0.5 contact hours (30 min)
$19.99
Registration for the 2027 Annual EMG Symposium is now open!
Registration for the 2027 Annual EMG Symposium is now open!
Orthopedics · 9 min · September 27, 2026
From the course: Dry Needling the Gluteus Medius Tendon Junction: Landmark Accuracy in Cadavers · 0.5 contact hours
This episode examines a cadaver study on landmark-guided dry needling for greater trochanteric pain syndrome, comparing two palpation methods for reaching the gluteus medius osteotendinous junction. It also reviews the anatomical target, the study’s accuracy findings, and the practical limitations of using embalmed specimens and a single clinician.
Dinh B, Dunning J, Kearns GA, Thorp L, Charlebois C, Young I. A comparison of dry needle placement accuracy rates between two approaches targeting the gluteus medius osteotendinous junction in cadavers. Journal of Manual & Manipulative Therapy. Received 25 January 2025; accepted 29 May 2025. https://doi.org/10.1080/10669817.2025.2515581. Open access under a Creative Commons Attribution-NonCommercial-NoDerivatives license.
In a cadaver study published in the Journal of Manual & Manipulative Therapy, Dinh and colleagues compared two commonly taught landmark methods for dry needling the gluteus medius at its osteotendinous junction, where the tendon inserts on the greater trochanter. The method that measured the donor's own fingerbreadths from the apex of the greater trochanter reached the target in 9 of 10 hips. The method that estimated one-third of the distance along a line from the trochanter to the sacrococcygeal hiatus reached it in 1 of 10, and every one of its misses ended in the proximal vastus lateralis. The authors caution that the work was done in embalmed tissue by a single clinician, so the results cannot be generalized without further study.
Lateral hip pain was long attributed to trochanteric bursitis. The authors cite ultrasound work in which 79.8% of patients with lateral hip pain did not have bursitis, and they describe tendinopathy of the gluteus medius or minimus as the recognized primary source of symptoms in greater trochanteric pain syndrome. Within that picture, the osteotendinous junction of the gluteus medius is the most common site of insertional tendinopathy.
The target is small. The authors estimate the gluteus medius footprint on the greater trochanter at about 935 square millimeters, slightly less than the face of a US quarter. Dry needling is among the nonsurgical options they list for greater trochanteric pain syndrome, but they note that no standardized method existed for choosing an insertion point in the posterior lateral hip, and that no gold standard technique exists for reaching this junction without ultrasound guidance. Both techniques in this study are taught by postgraduate institutes, and neither had previously been checked against dissection.
Five embalmed donors, three male and two female, supplied 10 hips. Two further cadavers were used only for pilot work to develop a dissection method that would not move the needles, and their data were left out. With each donor prone, one investigator needled every hip twice, once with each technique, using a 100 mm by 0.5 mm needle directed anteriorly and inferolaterally toward the trochanter until it met bone or could advance no further.
| Technique 1: fingerbreadth method | Technique 2: line-and-thirds method | |
|---|---|---|
| Landmarks | Apex of the greater trochanter only | Greater trochanter and sacrococcygeal hiatus |
| Insertion point | Two fingerbreadths superior and three fingerbreadths posteromedial to the trochanter apex | One-third of the distance medially along a line from the trochanter toward the hiatus |
| How the distance was set | Digital calipers set to the donor's own finger widths | Visual estimate along the line |
Before dissection, each needle was held in place with a glue-filled guide tube. An anatomist with a doctorate in anatomical sciences, who had not placed the needles, dissected every hip and made a yes-or-no judgment on whether the needle tip sat at the gluteus medius osteotendinous junction.
Technique 1 reached the junction in 9 of 10 hips and Technique 2 in 1 of 10, a difference the authors report as larger than chance would explain. The misses followed a consistent pattern. All nine Technique 2 misses were in the proximal vastus lateralis, seven in its tendon and two in the muscle belly, which places them on a different tendon footprint inferior to the trochanter. The single Technique 1 miss stopped before the target because over-embalmed tissue produced what felt like a bony end feel; the tip lay over the junction without touching it. Average needle depth was close to 60 mm for both techniques.
The authors offer two explanations for the gap. Technique 1 depends on a single landmark that is relatively easy to palpate because little soft tissue covers it, and the caliper step-off can be repeated. Technique 2 requires palpating the sacrococcygeal hiatus through thicker tissue and then judging a fraction of a distance by eye, and the authors suggest this estimate, combined with differences in body shape, introduces variation.
The authors write that clinicians may consider selecting an insertion point superomedial to the greater trochanter to increase the chance of reaching the gluteus medius osteotendinous junction. They describe reaching a bony end feel as essential with the fingerbreadth technique, because the junction sits superficially over the periosteum. They also suggest that the line-and-thirds technique appears better suited to needling the osteotendinous junction of the vastus lateralis, given where its needles consistently finished. Dry needling remains within the scope only of clinicians permitted to perform it under their state practice act.
In this cadaver study, an insertion point two fingerbreadths superior and three fingerbreadths posteromedial to the apex of the greater trochanter, measured with the donor's own finger widths, reached the gluteus medius osteotendinous junction in 9 of 10 hips. The authors caution that the finding comes from embalmed tissue and a single clinician.
The authors describe gluteus medius or minimus tendinopathy, not bursitis, as the recognized primary source of lateral hip pain. They cite ultrasound work in which most patients with lateral hip pain did not have trochanteric bursitis.
No. Dinh and colleagues measured only whether the needle tip reached the target in cadavers. The study did not measure pain, function or any other patient outcome.
Dinh B, Dunning J, Kearns GA, Thorp L, Charlebois C, Young I. A comparison of dry needle placement accuracy rates between two approaches targeting the gluteus medius osteotendinous junction in cadavers. J Man Manip Ther. 2026;34(1):40-46. doi:10.1080/10669817.2025.2515581
Every episode belongs to one of our courses. To earn contact hours, take the course: read the written report, pass the post-test, and download your certificate when you finish.
This episode is part of the course below, worth 0.5 contact hours.