I heard a reference to Rotator Cuff of the Hip some time ago. It was way back as an undergrad at Simon Fraser University. I was reading an article on the topic and found it very interesting.
I was at a course, and it was brought up again.
Mike Robertson talking about the Rotator Cuff of the Hip:
Hearing about it, it got me thinking.
I went looking for the old article but could not find it.
There was a lot of other information regarding the rotator cuff that has come out in the last few years.
Many had to deal with rheumatologists and orthopedic surgeons coming across a tear when doing a hip replacement.
What is the Rotator Cuff of the Hip?
It is the hip abductor tendon, made up of gluteus medius and gluteus minimus.
Gluteus medius has the function of:
- Abduction of the hip (femur) – anterior and posterior fibers.
- Transverse abduction of the hip (hip flexion at 90 degrees and hip abduction) – anterior and posterior fibers.
- Internal rotation – anterior fibers.
- External rotation of the hip during hip abduction – posterior fibers.
Gluteus minimus has the function of:
- Abduction of the hip (femur).
- Transverse abduction of the hip.
- External rotation of the hip during hip abduction.
Looking at the above function, you can see how they relate or can be compared to the shoulder rotator cuff.
Muscle of the Rotator Cuff of the Shoulder Functions :
- Shoulder abduction of the humerus – supraspinatus.
- External rotation of the humerus – infraspinatus, teres minor.
- Internal rotation of the humerus – subscapularis.
I know when I had done my master’s degree in rotator cuff exercises, looking at the research, there were all kinds of arguments on how much each muscle is involved with each movement. It seems like we see this when it comes to the rotator cuff of the hip.
Looking at Al-Hayani’s 2009 dissection, these are the functions he suggests:
- Gluteus medisu had three distinct parts.
- Gluteus minimus had two distinct parts.
- All parts of the muscles had separate innervations from the superior gluteal nerve.
- The anterior and middle parts of the gluteus medius, and the anterior part, gluteus minimus, have a vertical pull and initiate abduction, which is then completed by tensor fasciae latae.
- Posterior parts of the gluteus medius and minimus stabilize the femoral head into the acetabulum during different stages of locomotion.
Then I look at course notes from Robertson 2010, and the functions are:
- Gluteus medius anterior fibers include hip flexion, hip abduction, and internal rotation.
- Gluteus medius posterior fibers – hip extension, external hip rotation, hip abduction.
I think we can argue about the specific function of each muscle, but it is clear that the rotator cuff of the hip is made up of the tendon that makes up the gluteus medius and minimus.
Rotator Cuff Tear of the Hip
Even if you look into the research, you will find quite a bit of information on rotator cuff tears of the hip. A typical client with a torn rotator cuff of the hip has tenderness and weakness with hip abduction plus the failure of conservative means. Then they get an MRI done, and a partial tear of the gluteus medius tendon at the attachment to the greater trochanter is found.
Here is an excellent image from Bunker 1997 that shows the rotator cuff tear of the hip:
Take-Home Message about Rotator Cuff of the Hip
Gluteus medius and minimus play a role in stabilizing the hip and movement of the hip. The rotator cuff of the hip is damaged when there is an injury there, just as with the rotator cuff of the shoulder and shoulder injuries.
If your client has a hip injury or if you have a hip injury, make sure to address the rotator cuff of the hip.
Al-Hayani A. (2009). The functional anatomy of hip abductors. Folia Morphol (Warsz). 2009 May;68(2):98-103.
Bunker TD, Esler CN, Leach WJ. (1997). Rotator-cuff tear of the hip. J Bone Joint Surg Br. 1997 Jul;79(4):618-20.
Kagan A 2nd. (1999). Rotator cuff tears of the hip. Clin Orthop Relat Res. 1999 Nov;(368):135-40.
Robertson, M (2010). Bulletproofing Your Client’s Knees and Lower Back. Course Notes, 2010 December.
Rick Kaselj, MS