Muscles and fascias of hip

The muscles of the hip or gluteal region can be divided into two groups; the superficial and the deep gluteal muscles.

Superficial gluteal muscles

1. Gluteus Maximusoriginates firm the gluteal surface of the ileum, sacrum, and coccyx and inserts at the iliotibial tract and the gluteal tuberosity of the femur. It is innervated by the inferior gluteal nerve. 2. Gluteus medius originates from the gluteal surface on the ileum and inserts onto the greater trochanter lateral surface. It is innervated by the superior gluteal nerve. 3. Gluteus minimus originates from the ileum surface and attaches to the greater trochanter. it is innervated by the superior gluteal nerve. 4. Tensor fascia lata originates from the ASIS (Anterior superior iliac spine) and attaches to the lateral condyle of the tibia with the iliotibial tract. It is innervated by the superior gluteal nerve.

Functions of superficial gluteal muscles

1. Gluteal Maximus extends the thigh and lateral rotations. 2. Gluteus medius used in abduction of lower limb and medial rotation. 3. Gluteus minimus used in abduction of lower limb and medial rotation.

Deep gluteal muscles

1. Piriformis originates on the anterior part of the sacrum and inserts onto the greater trochanter of the femur (it passes through the greater sciatic foramen). Innervated by the nerve to piriformis. 2. Obturator internus originates from the obturator foramen and inserts onto the greater trochanter of the femur (it passes through the lesser sciatic foramen). Innervated by nerve to obturator internus. 3. Gemelli superior originates from the ischial spine and attaches to the greater trochanter of the femur. Innervated by the nerve to piriformis. 4. Gemelli inferior originates from the ischial tuberosity and attaches to the greater trochanter of the femur. Innervated by the nerve to quadratus femoris. 5. Quadratus femoris originates from ischial tuberosity (lateral) and inserts onto the intertrochanteric crest (quadrate tuberosity). Innervated by the nerve to quadratus femoris.

Functions of deep gluteal muscles

All the deep gluteal muscles have the function of lateral rotation and abduction, except the quadratus femoris which only performs lateral rotation.

Fascias of the hip

Fascia is a connective tissue that separates and encloses the muscles beneath the skin. The fascias can also be divided into two groups; the superficial and deep fascia of the hip.

Superficial fascia

The superficial fascia is known as the cribriform fascia, it is the continuation of the lower back fascia that runs posteriorly.

Deep fascia

The deep fascia of the hip is found as a thin layer over the gluteus maximus muscles and thickens at the gluteus medius muscle forming an aponeurosis (it attaches to the iliac crest lateral surface). It is attached to the inguinal ligament anteriorly and posteriorly to the sacrum.

There are additional fascias, such as the iliopsoas fascia originating from the psoas fascia which covers the psoas major and then merges with the iliac fascia which covers the iliacus muscle. In addition, there is the iliotibial tract found on the lateral side of the thigh.