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Gemellus inferior

Contents

Position

  • Deep

Origin

  • Tuberositas ischiadicum
    • Superior part

Insertion

  • Trochanter major femur
    • Medial surface

Main function

  • Hip
    • Lateral rotation

Secondary function

  • Hip
    • Abduction
  • Pelvis
    • Contralateral rotation

Nerve innervation

  • Segmental
    • L5-S1
  • Peripheral
    •  Plexus sacralis

Arterial supply

  • Ingerior gluteal artery
  • Obturator artery

Palpation

  • Patient position
    • Supine
  • The superior gemellus is deep and difficult to palpate
  • You can palpate the deep lateral rotator group, which the superior gemellus is a part of, but it's difficult to isolate the palpation to just the superior gemellus
  • Place your hand just lateral to the sacrum, halfway between the SIPS (spina iliaca posterior superior), and the apex fo the sacrum
  • Ask the patient to flex the knee to 90°
  • Give resistance to the patient in the direction of medial rotation, so that the patient is giving force towards lateral rotation
    • Feel for the contraction of the lateral rotators
  • NB! The deep lateral rotator group in the hip also consists of:
    • Quadratus femoris
    • Obturator internus
    • Obturator externus
    • Piriformis
    • Gemellus inferior
      • It can be difficult to seperate the individual muscles in the deep lateral rotator group but all of these muscles will be active during your resistance testing
      • Also the glutues maximus is activated during this movement. If you are giving too much force this will also be activated

Strength test

  • Patient position
    • Sitting with 90° flexion of the knee and the leg hanging freely over the floor
  • Place your one hand lateral on the patient's thigh on the side which is to be tested
  • Use the opposite hand to give resistance to the patient. Place the hand along the medial aspect of the calf, and pull the leg in a internal rotation mvovement of the hip, so that the patient is giving force towards external rotation
    • Please not that this tests also activates the quadratus femoris, obturator internus, obturator externus and gemellus superior which are all lateral rotators of the hip