Gemellus Superior, Gemellus Inferior, and Obturator Externus

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Gemellus Superior

The Gemellus Superior is a muscle of the gluteal region.

Anatomical Attachments:

• Origin: Attaches to the outer surface of the spine of the ischium.
• Insertion: Attaches to the medial surface of the greater trochanter of the femur, and combines with the tendons of the obturator internus.

Action: Rotates the thigh laterally.

Nerve Supply: L4, L5 and S1 nerves.

Vascular supply: Inferior gluteal artery.

Gemellus Inferior

The Gemellus Inferior is a muscle of the gluteal region.

Anatomical Attachments:

• Origin: Attaches to the posterior part of the tuberosity of the ischium.
• Insertion: Attaches to the medial surface of the greater trochanter, and merges with the obturator internus tendon.

Action: Rotates the thigh laterally.

Nerve Supply: Nerve to the Quadratus femoris.

Vascular supply: Inferior gluteal artery.

Obturator Externus

The Obturator Externus is a muscle of the gluteal region.

Anatomical Attachments:

• Origin: Attaches to the external border of the obturator foramen and the obturator membrane.
• Insertion: Attaches to the trochanteric fossa of the posterior femur.

Action: Laterally rotates and adducts the thigh.

Nerve Supply: Posterior branch of the obturator nerve (L3, L4).

Nerve Entrapment: The posterior branch of the Obturator nerve.

Vascular supply: Obturator and medial circumflex arteries.

Pain Referral for Gemellus Superior, Gemellus Inferior, and Obturator Externus

• Primary: According to Travell and Simons, it is difficult to distinguish trigger point referral of the lateral rotator group from that of the Piriformis and adductors. Therefore, should there be lancinating vaginal, rectal, scrotal, or posterior superior thigh pain, the lateral rotator group should be considered in addition to the Piriformis, Pelvic floor, and adductors.

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