The gemellus superior arises from the ischial spine and blends with the obturator internus tendon to insert on the greater trochanter. Together with the gemellus inferior it flanks the obturator internus, reinforcing its external rotation action. The trio (gemelli + obturator internus) is sometimes called the triceps coxae. The ischial spine origin of the gemellus superior is the posterior reference point for pudendal nerve block injection.
| Origin | Ischial spine |
|---|---|
| Insertion | Medial surface of the greater trochanter (with the obturator internus tendon) |
| Nerve Supply | Branch of the nerve to obturator internus (L5, S1) |
| Blood Supply | Superior gluteal artery |
| Actions | Hip external rotation; Minor hip abduction assistance |
|---|
Deep gluteal space pathology involving the gemellus superior and obturator internus tendons collectively produces the deep gluteal syndrome pattern. The ischial spine — gemellus superior origin — is the landmark for pudendal nerve block (injecting local anaesthetic at this level anaesthetises the pudendal nerve as it rounds the ischial spine).
Not independently palpable due to its deep position within the deep gluteal space.
Gemellus superior and obturator internus complex pathology in the deep gluteal space managed with ultrasound-guided injection and targeted physiotherapy.
