The Rotator Cuff of the Hip: Why Trail Runners, Athletes, and Active People Need Strong Deep Hip Stabilisers

When people think of the "rotator cuff," they usually think of the shoulder. But did you know your hip has a similar group of deep stabilising muscles? These muscles play a vital role in controlling your hip during running, trail running, field sports, and other single-leg activities. And if they’re not doing their job properly, you may be laying the foundation for hip pain, groin strain, or even issues further down the leg or into the lower back.

What Is the Rotator Cuff of the Hip?

The "hip rotator cuff" refers to a group of small but powerful muscles that stabilise the ball-and-socket joint of the hip, keeping the femoral head (ball) centred in the acetabulum (cup) during movement — particularly during single-leg tasks like running, jumping, or changing direction.

This group includes:

• Piriformis

• Obturator internus and externus

• Gemellus superior and inferior

• Quadratus femoris

These muscles sit deep around the hip joint, close to the capsule, and act to fine-tune movement and resist unwanted shifts — similar to the rotator cuff in your shoulder.

More Than Just External Rotators

In addition to those six core muscles, there are three other key deep stabilisers that play a crucial role in hip control:

• Iliopsoas

A major hip flexor — but also a deep stabiliser. The iliopsoas connects the lumbar spine, pelvis, and femur, helping to:

1) Maintain anterior hip joint stability

2) Assist in femoral head positioning

3) Stabilise the lumbar spine during movement

It’s especially active during high knee drive, hill running, or dynamic change of direction. A weak or under-recruited iliopsoas often leads to compensation from superficial muscles like TFL (located laterally) or rectus femoris (one of your quads muscles), increasing risk of anterior hip pain or groin strain.

• Gluteus Minimus (anterior fibres)

This deep section of glute min blends with the hip capsule and helps with internal rotation and femoral head control, especially in the first part of stance during running.

• Deep Gluteus Medius

While most people train the outer glute med, the deep fibres provide crucial pelvic control and act like a local stabiliser — helping you maintain alignment in single-leg stance, trail running, and field sports.

Why These Muscles Matter for Runners, Trail Athletes & Field Sports

Running is effectively a series of single-leg hops. Every time your foot hits the ground, your hip stabilisers need to control not just rotation, but joint position, alignment, and force transfer from the trunk down through the leg.

If these deep muscles are weak or uncoordinated:

• The femoral head can shift slightly in the socket, leading to joint irritation

• Other tissues (like glutes, TFL, or quads) compensate and overload

• You may develop hip pain, gluteal tendinopathy, groin issues, or lower back strain

Trail runners are even more at risk, due to the uneven terrain, slopes, and constant need for dynamic control. Field sport athletes (AFL, rugby, netball, soccer) place enormous demand on these deep stabilisers with sprinting, cutting, and kicking.

What We Do at Up N Adam

At Up N Adam Performance Training & Physiotherapy, we focus on identifying and addressing weak links in your movement system. When it comes to deep hip control, we:

• Perform single-leg control and dynamic stability testing

• Assess hip flexor balance and iliopsoas function

• Use movement retraining, strength work, and manual therapy to restore function

• Build sport-specific programs for trail runners and field athletes

The Takeaway

Your deep hip stabilisers — including the external rotators, iliopsoas, gluteus minimus, iliocapsularis, and glute med — are the unsung heroes of efficient, pain-free movement. They keep your hips centred, your trunk supported, and your lower limbs aligned.

If you're experiencing hip niggles, groin pain, or just want to move better and stronger on the trails or field, book in for a full movement assessment. You may not need more glute bridges — you might just need to wake up your hip rotator cuff.

This is APA Sports Physiotherapist, Darren Glendenning, signing off for now!

You can book an appointment with Darren or Newcastle Knights Physiotherapists Katie or Hayd'n at www.upnadamptphysio.com

Bookings also available on our website for:

• Dietitian - Sweat testing, weight-loss or to optimise your training nutrition / fuelling

• VO2 Max testing - to discover more effective ways to train efficiently

• Strength & Conditioning Programs - contact us via the website or email us at upnadamptphysio@gmail.com

• Remedial Massage - to relieve accumulative muscle tension & keep you training well.