Rotator Cuff of the Hip

It was some time ago when I heard a reference to: Rotator Cuff of the Hip.

I think it was way back in 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:

After 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 when it came to rotator cuff of the hip that has come out the last few years.

A lot of it 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?

The rotator cuff of the hip is the hip abductor tendon which is made up of gluteus medius and gluteus minimus.

Gluteus medius has the function of:

  1. Abduction of the hip (femur) – anterior and posterior fibers.
  2. Transverse abduction of the hip (hip flexion at 90 degrees and hip abduction) – anterior and posterior fibers.
  3. Internal rotation – anterior fibers.
  4. External rotation of the hip during hip abduction – posterior fibers.

Gluteus minimus has the function of:

  1. Abduction of the hip (femur).
  2. Transverse abduction of the hip.
  3. External rotation of the hip during hip abduction.

Looking at the above function, you can see how they related, or can be compared to, the rotator cuff of the shoulder.

The muscle of the rotator cuff (supraspinatus, infraspinatus, subscapularis, teres minor) of the shoulder have a function of:

  1. Shoulder abduction of the humerus – supraspinatus.
  2. External rotation of the humerus – infraspinatus, teres minor.
  3. Internal rotation of the humerus – subscapularis.

I know when I had done my masters’ degree in rotator cuff exercises, looking at the research there is all kinds of argument on how much each muscle is involved with each movement.  It looks like we see this when it comes to the rotator cuff of the hip.

Looking at Al-Hayani 2009 dissection of the rotator cuff of the hip, these are the functions he suggests:

  1. Gluteus medisu had three distinct parts.
  2. Gluteus minimus had two distinct parts.
  3. All parts of the muscles had separate innervations from the superior gluteal nerve.
  4. Anterior and middle parts of gluteus medius, and anterior part gluteus minimus, have a vertical pull and initiate abduction, which is then completed by tensor fasciae latae.
  5. Posterior parts of 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:

  1. Gluteus medius anterior fibers – hip flexion, hip abduction and hip internal rotation.
  2. Gluteus medius posterior fibers – hip extension, hip external 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 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 is someone that has tenderness and weakness with hip abduction plus 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 a great 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 roll when it comes to stabilizing the hip and movement of the hip.  Just like with the rotator cuff in the shoulder and shoulder injuries.  When there is an injury in the hip, oftentimes what is affected is the rotator cuff of the hip.

If your client has a hip injury or if you have a hip injury, make sure to address the rotator cuff of the hip.

If you want to see the exercises that I use for the the Rotator Cuff of the Hip, you can check out my video presentation call Gluteus Medius Exercise Program.  You can CLICK HERE to get more information:

Gluteus-Medius-Exercise-Program

Where to get more information on 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

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