Deep Gluteal Muscles: External Rotators of the Hip - Anatomy, Function, and Clinical Significance

Inferior Gemellus

Origin: Ischial tuberosity; Insertion: Greater trochanter (with obturator internus); Action: External rotation; Clinical: Works as a unit with obturator internus

Short External Rotators of the Hip

6 muscles, deep to gluteus maximus, act like the 'rotator cuff of the hip', primary role: external rotation & stabilization of hip

Piriformis

Origin: Anterior sacrum (S2-S4); Insertion: Greater trochanter; Action: External rotation; abducts hip when flexed; Clinical: Can compress sciatic nerve (piriformis syndrome)

Obturator Internus

Origin: Inner surface of obturator membrane; Insertion: Greater trochanter (medial surface); Action: External rotation; stabilizes femoral head; Clinical: Key pelvic stabilizer

Superior Gemellus

Origin: Ischial spine; Insertion: Greater trochanter (with obturator internus); Action: External rotation; Clinical: Shares tendon with obturator internus

Obturator Externus

Origin: Outer obturator membrane & pubic/ischial rami; Insertion: Trochanteric fossa; Action: External rotation; hip stabilization; Clinical: Important in gait stability

Quadratus Femoris

Origin: Ischial tuberosity; Insertion: Intertrochanteric crest; Action: Powerful external rotation; adduction; Clinical: Strongest external rotator

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