| Origin |
|
|---|---|
| Insertion |
|
| Action |
|
| Nerve | Branches of the sacral plexus (nerve to piriformis, nerve to obturator internus, nerve to quadratus femoris); obturator externus is supplied by the obturator nerve from the lumbar plexus (L3–S2) |
| Members | Piriformis, Gemelli, Obturator internus, Obturator externus, Quadratus femoris |
Palpation
- Client prone with a bolster under the ankles; stand beside the hip.
- Find the greater trochanter, the side of the sacrum and the ischial tuberosity. The group fills the space behind the hip between these points, under gluteus maximus.
- Sink in slowly with flat fingers or a soft fist. You cannot feel the muscles one by one; feel for general deep firmness in bands running across the buttock towards the trochanter.
- Bend the client's knee to 90° and ask them to press the foot inwards against your hand (hip lateral rotation); the deep tissue firms under your fingers.
The deep hip rotators are sometimes called the “deep six”. From top to bottom they are Piriformis, the superior gemellus, Obturator internus, the inferior gemellus, Quadratus femoris and, deepest and furthest forward, Obturator externus. The two gemelli have their own note, Gemelli. You can see all six act when you cross your legs to rest one ankle on the other knee: the thigh turns out and the knee points to the side.
They work a little like the rotator cuff of the shoulder: small, deep muscles that turn the joint and hold the ball in the socket. They lie under Gluteus maximus, so in a massage you reach them through it, with slow Compression between the Sacrum, Ischial tuberosity and Greater trochanter. Only piriformis is usually singled out in a Cert IV relaxation routine; working the smaller members one by one is remedial-level work.
Their opposite numbers are the medial rotators at the front of the hip: Gluteus minimus, the front fibres of Gluteus medius and Tensor fasciae latae. The nerve roots above span the whole group: the sacral plexus branches come from L4–S2, and the obturator nerve branch to obturator externus from L3–L4.