@kmartfit's TRT injection location advice, fact-checked

What did @kmartfit actually say?

The creator walked viewers through his personal intramuscular injection technique for testosterone, specifically targeting the gluteal muscle. He described dividing the buttock into four quadrants using one vertical and one horizontal line, then injecting into "the upper outer quadrant" of the glute. He also mentioned pinching the muscle before inserting the needle. That's the full claim, and it's worth looking at each piece carefully.

To his credit, he kept it practical and didn't pretend to be a doctor. But with 171,000 views, precision matters. People are going to replicate exactly what he describes, so the details count.

Does the science back this up?

Yes, mostly. The ventrogluteal and dorsogluteal injection sites are both well-documented in clinical literature, and the upper outer quadrant technique is a legitimate, widely taught method for avoiding the sciatic nerve. The dorsogluteal site, which is what @kmartfit appears to be describing, has been used for intramuscular injections for decades.

However, the evidence has shifted. A frequently cited study by Wynaden et al. (2006, Contemporary Nurse) and subsequent clinical reviews have pushed practitioners toward the ventrogluteal site as a preferred alternative, citing lower rates of sciatic nerve injury and less subcutaneous tissue interference. The ventrogluteal site, located on the lateral hip, is now recommended by many nursing and pharmacology guidelines over the dorsogluteal approach. The upper outer quadrant is not wrong, but it's not the current gold standard either.

What did they get wrong (or right)?

The quadrant-splitting technique he describes for identifying the dorsogluteal injection site is anatomically reasonable and reflects what most self-injection guides teach. Getting the upper outer quadrant right does meaningfully reduce sciatic nerve risk compared to injecting centrally or inferiorly into the gluteal region, so credit where it's due.

The pinching technique is where things get a bit muddled. Pinching is typically recommended for subcutaneous injections, not intramuscular ones. For IM injections, clinical guidelines from organizations like the CDC and the World Health Organization recommend spreading the skin taut using a Z-track method or simply holding the skin flat, not pinching. Pinching can inadvertently pull subcutaneous fat upward, increasing the risk that the needle deposits medication into fat rather than muscle tissue. This is not a minor issue. Subcutaneous testosterone absorption differs from intramuscular absorption, and unpredictable delivery can affect hormone levels. Geber and colleagues (2019, Journal of Clinical Endocrinology and Metabolism) noted inconsistent testosterone levels as a concern in suboptimal IM administration technique.

What should you actually know?

If you're on a physician-supervised TRT program, your prescribing provider or pharmacist should walk you through injection technique before you ever pick up a syringe. TikTok tutorials, including this one, are not a substitute for that. The dorsogluteal site @kmartfit describes carries a real, documented risk of sciatic nerve injury if the injection drifts toward the lower inner quadrant, which is exactly why site identification matters and why some clinicians now prefer the ventrogluteal site.

A few things worth knowing:

• The ventrogluteal site has a thicker muscle mass and fewer major nerves and blood vessels nearby compared to the dorsogluteal site, per WHO immunization guidelines and multiple injection safety reviews.
• Needle length matters significantly. Body composition affects whether a standard needle reaches the muscle at all. A 1-inch needle in someone with significant gluteal fat tissue may not achieve IM delivery.
• Z-track technique, where you pull the skin laterally before injecting and release after withdrawing the needle, reduces medication leakage and is recommended by the American Nurses Association for IM gluteal injections.
• Rotating injection sites reduces localized tissue damage over time, a point the video skips entirely.

Is this video safe to follow?

Partially. The upper outer quadrant guidance is directionally correct and reduces the most serious risk, which is sciatic nerve injury. But the pinching instruction is a real technique error with real downstream consequences for drug absorption. Anyone using this video as their primary injection tutorial is getting incomplete and partially inaccurate information. A telehealth provider overseeing your TRT should give you a proper injection guide, and most regulated platforms do exactly that.