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Obturator Internus Tendon

tendo musculi obturatoris interni

The obturator internus tendon takes a unique 90-degree turn around the lesser sciatic notch (which acts as a pulley), redirecting its force from a horizontal pelvic direction to a vertical trochanteric direction. The gemelli muscles arise adjacent to the notch and join the tendon to insert on the greater trochanter. The conjoint tendon of obturator internus and gemelli is identifiable at surgery as a distinct cord posterior to the hip joint.

Region: Pelvis & Hip

Biomechanics

Function & Actions

Hip external rotation force transmission; posterior hip capsule stabilisation

Clinical Relevance

Clinical Notes

Obturator internus tendinopathy produces deep posterior hip and buttock pain reproduced by resisted hip external rotation and deep palpation through the ipsilateral ischiorectal fossa. It is an increasingly recognised cause of deep gluteal pain syndrome alongside piriformis syndrome. MRI shows signal change at the lesser sciatic notch pulley level. Injection targeting the tendon at the notch provides diagnostic confirmation and relief.

Pathology

Common Injuries & Conditions

Obturator Internus Tendinopathy

Deep posterior hip pain from tendon overload at the lesser sciatic notch pulley managed with targeted injection and rehabilitation.