Hip muscles, joints, and movement

Bones of the hip joint

Femoral head and acetabulum of the pelvis.

What type of joint is the hip joint?

Synovial ball-and-socket joint.

Main hip movements

Flexion, extension, abduction, adduction, medial/lateral rotation, circumduction.

Open-chain hip movement?

Foot is free; femur moves, e.g. straight-leg raise.

Closed-chain hip movement?

Foot is fixed/weight-bearing, e.g. squat or single-leg stance.

Main role of hip abductors in single-leg stance?

Stabilize pelvis and limit opposite-side pelvic drop.

What is muscle co-contraction?

Simultaneous activation of opposing muscles to improve stability and control.

What are the lumbar vertebrae?

Five vertebrae, L1–L5, between thoracic spine and sacrum.

Main lumbar spine movements?

Flexion, extension, lateral flexion, and limited rotation.

What is anterior pelvic tilt?

Front of pelvis (ASIS) tips down; lumbar lordosis often increases.

What is posterior pelvic tilt?

Front of pelvis (ASIS) tips up; lumbar lordosis often decreases.

What is femoral anteversion?

Femoral neck is oriented more anteriorly relative to the distal femur.

What is femoral retroversion?

Femoral neck has less anterior, or relatively more posterior, orientation.

What is pelvic anteversion often used to mean?

Anterior pelvic tilt; distinct from femoral version.

What is pelvic retroversion often used to mean?

Posterior pelvic tilt; distinct from femoral retroversion.

Femoral anteversion is often associated with what rotation pattern?

More available hip internal rotation and less external rotation.

origin of the Quadratus lumborum

12th rib and transverse processes of L1–L4.

insertion of the Quadratus lumborum

Iliac crest and iliolumbar ligament.

action of the Quadratus lumborum

• Lateral flexion of the trunk.

• Bilateral contraction extends the lumbar spine.

• Stabilizes the 12th rib during breathing.

• Can elevate the hip (hip hiking).

origin of the Erector Spinae group

Ribs, vertebral processes, and (for upper fibers) skull.

insertion of the Erector Spinae group

Broad common tendon from posterior iliac crest, sacrum, and lumbar spinous processes.

Action of the Erector Spinae group

• Bilateral contraction extends the spine.

• Unilateral contraction laterally flexes the spine.

• Helps maintain upright posture.

Origin of the Multifidus

Spinous processes 2–4 vertebral levels above their insertion

insertion of the Multifidus

Sacrum, posterior superior iliac spine, and transverse or articular processes of vertebrae.

action of the Multifidus

• Stabilizes the vertebral column.

• Assists with spinal extension.

• Assists with contralateral rotation.

Origin of the rectus abdominis

Xiphoid process and costal cartilages of ribs 5–7.

insertion of the rectus abdominis

Pubic crest and pubic symphysis.

action of the rectus abdominis

• Flexes the trunk.

• Posteriorly tilts the pelvis.

• Compresses abdominal contents.

What are the layers of the abdominus group from superficial to deep

External oblique, internal oblique, transversus abdominus

longissimus thoracis origin

Common erector spinae tendon (posterior sacrum, iliac crest, and lumbar spinous processes)

longissimus thoracis insertion

Transverse processes of T1–T12 and ribs 2–12

longissimus thoracis action

Bilateral: extends vertebral column. Unilateral: laterally flexes vertebral column to same side.

Iliocostalis lumborum origin

Iliac crest and he lateral portion of the common erector spinae tendon

Iliocostalis lumborum insertion

Inferior borders of the angles of the lower 6-7 ribs

Iliocostalis lumborum action

Bilateral: Extension of the spine

Unilateral: lateral flexion of the spine

origin of the External Oblique

External surfaces of ribs 5–12.

insertion of the External Oblique

Linea alba, pubic tubercle, and anterior half of iliac crest

action of the External Oblique

• Bilateral contraction flexes the trunk.

• Unilateral contraction rotates the trunk to the opposite side.

• Lateral flexion of the trunk.

• Compresses abdominal contents.

Femoral retroversion is often associated with what rotation pattern?

More available hip external rotation and less internal rotation.

origin of the internal oblique

Thoracolumbar fascia, iliac crest, and lateral half of inguinal ligament.

insertion of the internal oblique

Inferior borders of ribs 10–12, linea alba, and pubis via the inguinal ligament .

action of the internal oblique

• Bilateral contraction flexes the trunk.

• Unilateral contraction rotates the trunk to the same side.

• Lateral flexion of the trunk.

• Compresses abdominal contents.

origin of the Transversus Abdominis

Internal surfaces of costal cartilages 7–12, thoracolumbar fascia, iliac crest, and lateral third of inguinal ligament.

insertion of the Transversus Abdominis

Linea alba, pubic crest, and pecten pubis via the conjoint tendon, inguinal ligament.

action of the Transversus Abdominis

• Compresses abdominal contents.

• Stabilizes the trunk and lumbar spine.

• Increases intra-abdominal pressure.

Origin of iliopsoas?

Psoas major: T12–L5 vertebrae; iliacus: iliac fossa.

Insertion of iliopsoas?

Lesser trochanter of femur.

Action of iliopsoas?

Powerful hip flexion; assists external rotation.

Origin of gluteus maximus?

Posterior ilium, dorsal sacrum/coccyx, and sacrotuberous ligament.

Insertion of gluteus maximus?

Iliotibial tract and gluteal tuberosity of femur.

Action of gluteus maximus?

Hip extension and lateral rotation.

Origin of gluteus medius?

External ilium between anterior and posterior gluteal lines.

Insertion of gluteus medius?

Lateral surface of greater trochanter.

Action of gluteus medius?

Hip abduction; stabilizes pelvis; fibers assist rotation differently.

Origin of gluteus minimus?

External ilium between anterior and inferior gluteal lines.

Insertion of gluteus minimus?

Anterior surface of greater trochanter.

Action of gluteus minimus?

Hip abduction, medial rotation, and pelvic stabilization.

Origin of tensor fasciae latae (TFL)?

ASIS and anterior iliac crest.

Insertion of TFL?

Iliotibial tract to Gerdy's tubercle on lateral tibia.

Action of TFL?

Hip flexion, abduction, medial rotation; tensions IT band.

Origin of rectus femoris?

AIIS and area superior to acetabulum.

Insertion of rectus femoris?

Patella via quadriceps tendon; tibial tuberosity via patellar ligament.

Action of rectus femoris?

Hip flexion and knee extension.

Origin of sartorius?

Anterior superior iliac spine (ASIS).

Insertion of sartorius?

Pes anserinus on medial proximal tibia.

Action of sartorius?

Hip flexion, abduction, lateral rotation; knee flexion.

Origin of pectineus?

Pecten pubis and superior pubic ramus.

Insertion of pectineus?

Pectineal line of femur.

Action of pectineus?

Hip adduction and flexion.

Origin of adductor longus?

Body of pubis, inferior to pubic crest.

Insertion of adductor longus?

Middle third of linea aspera.

Action of adductor longus?

Hip adduction; assists flexion.

Origin of adductor brevis?

Body and inferior ramus of pubis.

Insertion of adductor brevis?

Pectineal line and proximal linea aspera.

Action of adductor brevis?

Hip adduction; assists flexion.

Origin of adductor magnus?

Pubic/inferior pubic ramus and ischial ramus; hamstring part from ischial tuberosity.

Insertion of adductor magnus?

Linea aspera and adductor tubercle of femur.

Action of adductor magnus?

Hip adduction; adductor part assists flexion, hamstring part extension.

Origin of gracilis?

Body and inferior ramus of pubis.

Insertion of gracilis?

Pes anserinus on medial proximal tibia.

Action of gracilis?

Hip adduction; assists knee flexion and medial tibial rotation.

Origin of piriformis?

Anterior surface of sacrum.

Insertion of piriformis?

Superior border of greater trochanter.

Action of piriformis?

Lateral rotation of extended hip; abducts flexed hip.

Origin of obturator internus?

Pelvic surface of obturator membrane and surrounding bone.

Insertion of obturator internus?

Medial surface of greater trochanter.

Action of obturator internus?

Lateral rotation of extended hip; abducts flexed hip; stabilizes femoral head.

Origin of obturator externus?

External obturator membrane and margins of obturator foramen.

Insertion of obturator externus?

Trochanteric fossa of femur.

Action of obturator externus?

Hip lateral rotation and joint stabilization.

Origin of quadratus femoris?

Lateral border of ischial tuberosity.

Insertion of quadratus femoris?

Quadrate tubercle on intertrochanteric crest.

Action of quadratus femoris?

Hip lateral rotation and adduction.

Origin of Gemelli Superior

Ischial spine

insertion of Gemelli Superior

Medial surface of the greater trochanter of the femur, through the tendon of the obturator internus

action of Gemelli Superior

Lateral rotation of the thigh; stabilizes the hip joint

origin of Gemelli inferior

Ischial tuberosity

insertion of Gemelli inferior

Medial surface of the greater trochanter of the femur, through the tendon of the obturator internus

action of Gemelli inferior

Lateral rotation of the thigh; stabilizes the hip joint

Insertion of semitendinosus?

Pes anserinus on medial proximal tibia.