THE HIP JOINT

Muscles of the Hip

Gluteus Maximus O: lower posterior iliac crest and posterior surface of the sacrum I: gluteal tuberosity (upper, posterior aspect of the femur) & I.T. band Actions: Extension of the hip External rotation of the hip Lower fibers (below the center of motion) assist in adduction

Extension

Gluteus Maximus Produces hip extension beyond 15 degrees; not used extensively during walking Strongly used during running, hopping, skipping, and jumping Best isolated with the knee flexed to reduce hip extension from the hamstrings 40 degrees

Gluteus Medius O: outer surface of the ilium just below the crest I: greater trochanter Actions: Abduction of the hip Anterior fibers: Internal rotation, Posterior fibers: External rotation.

Gluteus Minimus O: outer surface of the ilium beneath the gluteus medius I: greater trochanter of the femur Actions Abduction of the hip Internal rotation

Gluteus Medius and Minimus During walking these muscles abduct (or hold up) the free leg, preventing it from sagging. Both are important in transferring weight from one leg to the other (e.g. running, hopping, skipping, etc.) Their effectiveness decreases with age.

Biceps Femoris Lateral side Origin: Insertion: Head of the fibula 1.) Long head - ischial tuberosity; 2.) Short head - lower half of the linea aspera Insertion: Head of the fibula Action: Extension of hip External rotation of the hip (and knee) (Flexion of knee)

Biceps Femoris One of the hamstring muscles (semitendinosus and semimembranosus) A two-joint muscle which is a powerful hip extensor unless the knees are flexed Isolated during leg curls with some external rotation of the hip and knee. This “lines up” the origin and insertion.

Semitendinosus Medial side; superficial Origin: Ischial tuberosity Insertion: Medial surface of proximal end of the tibia Action: Extension of the hip Internal rotation of the hip (and knee) Flexion of the knee

Semimembranosus Medial side, deeper than semitendonosus Origin: Ischial tuberosity Insertion: Medial surface of the tibia Action: Extension of the hip Internal rotation of the hip (and knee) Flexion of the knee

Semitendinosus & Semimembranosus Two-joint muscles Used in ordinary walking for hip extension Best exercised with knee flexion exercises (leg curls) with the hip and knee internally rotated Help to medially stabilize knee

Tensor Fasciae Latae O: iliac crest I: iliotibial (I.T.) band Actions: Flexion of the hip Internal rotation Abduction of the hip

Tensor Fasciae Latae Prevents external rotation at the hip is flexed Stretching Strengthening

Tensor Fascia Latae (Anterior View)

Iliopsoas Origins: I: lesser trochanter of the femur Actions: iliac fossa vertebral bodies of the last thorasic and lumbar vertebrae I: lesser trochanter of the femur Actions: Flexion of the hip External rotation

Iliopsoas Strong hip flexor muscle Raises legs off the floor from the supine position. Pulls anteriorly on the lower lumbar vertebrae May aggravate lower back problems Abdominal muscles can prevent lumbar strain Used during complete sit-ups and straight leg sit-ups. Stretching this muscle requires hyper-extension of the hip.

Pectineous O: pubic crest or ramus I: below the linea aspera Actions Flexion Adduction Internal rotation

Tensor Fasciae Latae Pectineus

Adductor Brevis Origin: Inferior ramus of pubis Insertion: Pectineal line (linea aspera) Actions: Adduction External rotation

Adductor Longus Below the adductor brevis O: front of the pubis just below its crest I: middle third of the linea aspera Actions: Adduction Flexion

Adductor Magnus Located posterior to the longus O: edge of the pubic crest and ischial tuberosity I: linea aspera Actions: Adduction External rotation

Gracilis O: pubic crest I: medial condyle of tibia Actions: Adduction at the hip Internal rotation [Flexion at the knee]

Adductor Muscles Adductor Brevis Adductor Longus Adductor Magnus Gracilis Not heavily used in ordinary movements Horse back riding, the breaststroke kick in swimming

Sartorius Origin: Anterior-superior spine of the ilium Insertion: Anterior medial condyle of the tibia (behind the medial condyle) Action: Flexion of hip External rotation of the hip [Flexion of the knee]

Sartorius Longest muscle in the body It is a two-joint muscle; hip flexion and knee flexion It is weak when both actions take place at the same time.

Rectus Femoris Two joint muscle; most superficial Origin: anterior-inferior iliac spine of the ilium Insertion: top of the patella and patellar ligament to the tibial tuberosity Actions: Flexion of the hip [Extension of the knee]

Rectus Femoris A two-joint muscle: hip flexion and knee extension Powerful knee extension when the hip is extended but weaker when the hip is flexed. The gluteus maximus and the hamstring muscles will extend the hip making the rectus femoris stronger during knee extension

Hip Rotator Muscles ANTERIOR Obturator Externus Anterior

Hip Rotator Muscles POSTERIOR Piriformis Gemellus superior Obturator internus Gemellus inferior Quadratus femoris Posterior

Hip Rotator Muscles Posterior Posterior

Hip Rotator Muscles Posterior Anterior

Six Hip Rotator Muscles Common action is External Rotation Powerful external rotation of the hip is required to throw a baseball, swing a bat or golf club. The sciatic nerve passes just inferior to the piriformis therefore a tight piriformis muscle my contribute to compression on the sciatic nerve.

Review

Name the action at her hip Abduction

Name the action at his right hip Flexion

Name the actions at her hip Extension, Abduction & External Rotation

Name the two action at his right hip Extension and External Rotation

Name the action at his hip Flexion

Name the actions at his hip Flexion and External Rotation and Abduction

Name the actions at his hip Flexion and Adduction

The Femur 1 = 2 = 3 = 4 = 5 = 6 = 7 = Head Neck Greater trochanter 3. The Femur 1. 2. 1 = 2 = 3 = 4 = 5 = 6 = 7 = Head Neck Greater trochanter Lesser trochanter Linea Aspera Medial condyle Lateral condyle 4. 5. 6. 7.

Anterior 1 = 2 = 3 = 4 = 5 = 6 = iliac crest anterior spine 1. 1 = 2 = 3 = 4 = 5 = 6 = iliac crest anterior spine greater trochanter lesser trochanter ischial tuberosity pubis crest 2. 3. 4. 5. 6.

Name the sections of the pelvis 1. Ilium 2. Pubis 3. Ischium

Posterior 1. 1 = 2 = 3 = 4 = 5 = iliac crest greater trochanter ischial tuberosity lesser trochanter linea aspera 2. 3. 4. 5.

Name the muscle Gluteus Maximus Actions: extension of the thigh at the hip lateral rotation of the thigh lower fibers (below the center of motion) assist adduction upper fibers (above the center of motion) assist in abduction Gluteus Maximus

Name the muscle Actions adduction of the thigh at the hip aids in flexion Adductor Brevis

Name the muscle Actions Gluteus Minimus abduction of the thigh medial rotation flexion Gluteus Minimus

Name the muscle Actions: Adductor Longus adduction of the thigh assists in flexion of the thigh at the hip Adductor Longus

Name the muscle Actions: abduction of the thigh anterior fibers: flexion and medial rotation, posterior fibers: extension and lateral rotation. Gluetus Medius

Name the muscle Actions: adduction at the hip medial rotation [flexion at the knee] Gracilis

Name the muscle Iliopsoas Actions: flexion of the thigh at the hip slight adduction flexion of the spine

Name the muscle Actions flexion of the hip adduction Pectineus

Name the muscle Actions: flexion of the thigh at the hip medial rotation abduction of the thigh, medial rotation (weak) Tensor Fasciae Latae

Name the muscle Actions: adduction of the thigh at the hip flexion (anterior fibers) extension (posterior fibers) Adductor Magnus

What is the most anterior hip rotator muscle? Obturator Externus

What is the common action of these muscles? Piriformis Gemellus superior Obturator internus Gemellus inferior Quadratus femoris External Rotation

Name the muscle Deep muscle Action: Extension of the hip Flexion of the knee Internal rotation of the hip (and knee) Semimembranosus

Name the muscle Superficial muscle Action: Extension of the hip Flexion of the knee Internal rotation of the hip (and knee) Semitendonosis

Name the muscle Action: Sartorius Flexion of hip External rotation of the hip [Flexion of the knee] Sartorius

Name the muscle Actions: Rectus Femoris Flexion of the hip [Extension of the knee] Rectus Femoris

Name the muscle Action: Extension of hip Flexion of knee Lateral rotation of the hip (and knee) Biceps Femoris

Name the muscle Gluteus Medius

Name the muscles Pectineus Adductor Brevis Adductor Longus Adductor Magnus Gracilis

Name the landmarks Iliac crest Anterior spine

Name the landmarks Acetabulum Sciatic notch Ischial tuberosity 1 2 3

Name the muscles Tensor fasciae latae Sartorius 2 1

Iliac Crest 1. Name the muscle Gluteus Maximus Iliotibial band 2. Name the landmark Iliac Crest 1. Name the muscle Gluteus Maximus 3. Name the structure Iliotibial band