I did my first lecture in Spanish last night- Well the introduction was in Spanish and the rest in English- not an easy task! I was talking to about 20 Chilean Drs, Surgeon and Physios! Terrifying stuff. I was talking to them about hip capsular pain and restriction, they were all sitting paying a great deal of attention and I was pleased when I got to the end, and they had understood my terrible Spanish and asked lots of questions!

One of the best questions came from the hip arthroscopy surgeon who was totally intrigued about the subject of what they should change about their post- op rehab!

He asked me what I thought about Glut Minimus and its action on the capsule. He had some great ideas- so I got thinking! Do we under estimate the action of the muscle the capsule?

Does Glut Min help to stabilise the head of Femur with Glut Med in the acetabulum during the gait cycle? The trick is understanding the action and mainly its’ attachment.

The Glut Min arises from the external iliac fossa, from there the fibres converge, crossing the hip antero-laterally to their insertion in the front of the greater trochanter. It inserts anterosuperiorly into the capsule of the hip and continues to its main insertion on the greater trochanter A study by Beck et al (2000) of its mechanics showed that gluteus minimus acts as a flexor, an abductor and an internal or external rotator, depending on the position of the femur and which part of the muscle is active. It follows that one of its functions is to stabilise the head of the femur in the acetabulum by tightening the capsule and applying pressure on the head.

They concluded that as well as stabilising the head of the femur in the acetabulum, especially in the extended hip, the other action is to tighten the joint capsule, which does not depend on the position of the hip, this can give more stability.

The attachment of the fibres of glut min onto the capsule has been preposed as working as a retracting mechanism from the capsule during hip motion. This occurs as other joints such as Shoulder and Knee, keeping the capsule out of the way during motion.  Perhaps it is possible that similar impingement of the hip capsule may occur with muscle ‘Dysfunction’ of dyssynchronous muscle activity- caused by perhaps muscle fatigue, and maybe the cause of the unexplained hip pain with capsular type symptoms.  Best get asking myself what to do about it!

References- Walters et al (2001)  Gluteus Minimus: Observations on its insertion. J Anat February; 198(Pt 2): 239–242.

Beck et al (2000) The anatomy and function of the Gluteus Minimus Muscle J Bone Joint Surgery 82-B:358-63.