Muscle knots in the Gluteus Medius are typically located in the upper and outer portion of the buttocks. These muscle knots can refer pain to the lower back, outer hip, and sometimes down the side of the leg. You may feel like a deep, aching pain on the side of the hip, often mistaken for joint or bursitis pain. These muscle knots can cause discomfort when lying on your side or walking, particularly on uneven surfaces. They are typically characterized as tight, sore spots that restrict hip movement and make everyday activities feel stiff or strained.