Muscles of the hip

In human anatomy, the muscles of the hip joint are those muscles that cause movement in the hip. Most modern anatomists define 17 of these muscles, although some additional muscles may sometimes be considered. Muscles of hip joint are divided in to 6 groups on the basis of its function. Those are: Hip Flexor, Hip Extensor, Hip Abductor, Hip Adductor, Hip internal Rotator, Hip External Rotator

Hip joint is most stable and multi-axial joint in the body .Muscular factor is one of them which give more stability to the hip joint.According to different movements of hip, different muscles are listed below, which act on hip join.

1. EXTENSOR MUSCLES
Prime movers
1. Gluteus Maximus
2. Semitendinous
3. Semimembraneous
4.Biceps Femoris( Long Head)
5.Adductor magnus
( Hamstring part)

2. FLEXOR MUSCLES
Prime movers
1.Psoas Major
2.Iiacus
3.Rectus Femoris
4.Sartorious
Accessory muscles
• Tensor fasciae latae
• Sartorious
• Rectus femoris
• Pectineus

3. ABDUCTOR MUSCLES
Prime movers
1.Gluteus medius
2.Gluteus minimus
3.Tensor fasciae latae

Accessory muscles
• Gluteus maximus
• Piriformis
• Sartorious

4. ADDUCTOR MUSCLES
Prime movers
1.Adductor magnus
2.Adductor longus
3.Adductor brevis
4.Gracilus

Accessory muscles
• Gracilis
• Pectineus
• Obturator internus
• Gemelli 2
• Obturator externus
• Quadricep femoris

5. Medial Rotator Muscles
1.Gluteus medius
2.Gluteus minimus
3.Tensor fasciae lata
6. Lateral Rotator Muscles
(Prime movers)
1.Obturator externus
2.Obturator internus
3.Periformis
3.2 Gemelli
4.Quadricep femoris
5.Quadratus femoris
Accessory muscles
• Iliopsoas
• Gluteus maximus

1. Hip Flexors.
The iliacus and psoas major comprise the iliopsoas group. The iliopsoas is a large muscle that runs from the transverse processes of the T-12 to L-5 vertebrae, joins with the iliacus via its tendon, and connects to the lesser trochanter of the femur. The iliacus originates on the iliac fossa of the ilium. Together these muscles are commonly referred to as the “iliopsoas”.Because of their common action and nerve supply.Function: flexion at hip joint.

Prime Movers.

Psoas major .

Origin: Transverse process of all lumber vertebra, Intervertebral discs b/w the lumbar vertebrae,Lateral sideof the bodies of lumbar vertebrae.
Insertion: Tip of the lesser trochenter of femur
Nerve: Lumber plexus
Iliacus.
Origin: Iliac fossa, inner lip of iliac crest, base of sacrum.
Insertion: Base of lesser trochenter
Nerve: Lumber plexus

Hip Flexor Accessory
Rectus femoris:
Origin: Straight head from AIIS ( Anterior inferior iliac spine ) and reflected head from above acetabulum.
Insertion: upper border of patella
Nerve: Femoral nerve.
Function: Flexor of hip and extensor of knee joint.
Sartorius:
Origin: ASIS ( Anterior superior iliac spine )
Insertion:Upper part of medial shaft of tibia
Nerve: Femoral nerve.
Function: 1) Weak flexor, abductor and lateral rotator of hip.
2) weak flexor and medial rotator of knee.

2. Hip Extensors.
Gluteus maximus and Hamstring muscles are the main extensors of hip joint. Gluteus maximus is one of the largest and thickest muscle in the body, it placed entirely behind the hip joint and is shaped like a parallelogram.
1) Gluteus Maximus:
Functions.
1. It is an extensor of hip joint but it is used only when the joint has to extend with power e.g aginst gravity. It is mainly used in rising from sitting position, climbing a hill, or going upstairs. It is used in running but not in walking on level surface.
2. The anterior fibers of gluteus maximus help in abduction at hip joint.
3. It is a lateral rotator of extended thing and loses this power when thing is flexed.
2) Hamstring muscles:
Functions.
1. They extend the hip and flex the knee.
2. Bicep is the lateral rotator of flexed knee.
3. Semimembranosus, semitendeninosus, Gracillis, Sartorius and Popliteus are the medial rotator of flexed knee.

1) Gluteusmaximus:
Origin: Behind Posterior gluteal line of ilium, Sacrum, Sacrotuberosus Ligament,Deep fascia,Thoraco Lumbar verterea.
Insertion: 3/4 Iliotibial band of fascia lata over GT ( femur), 1/4 Gluteal tubersity.
Nerve : Inferior gluteal.

2) Hamstring muscles:
Semitendinosus:
Origin: Medial surface of upper part of Ischial tubersity above the transverse ridge.
Insertion: Upper medial surface of shaft of tibia
Nerve: Sciatic nerve
Semimembranosus:
Origin: Lateral surface of upper part of Ischial tubersity above the transverse ridge.
Insertion: Medial condyl of tibia.
Nerve: Sciatic nerve
Bicep femoris:
Origin: Long head from ischial tubersity & short head from lower end of linera aspera.
Insertion: Head of the fibula.
Nerve: Sciatic nerve.
Adductor magnus (hamstring part):
Origin: Lower part of ischial tubersity below the transverse ridge.
Insertion: Medial femoral condyl (adductor tubercle) .
Nerve: Sciatic nerve.

3. Abductor Muscles (prime movers):
Gluteusmedius:
Origin: Gluteal surface b/w middle and posterior gluteal line.
Insertion: Lateral surface of GT of femur.
Nerve :Superior gluteal nerve (L4,5,S1).
Gluteus minimus
Origin: Outer surface of ilium b/w anterior and inferior gluteal line.
Insertion: Anterior surface of GTof femur.
Nerve: Superior gluteal nerve (L4,5,S1).
Tensor fascia lata:
Origin: Anterior part of outer lip of iliac crest.
Insertion: Lateral condyl of tibia.
Nerve:Superior gluteal nerve (L4,5, S1).

Abductor Accessory.
Gluleus maximus:
Piriformis:
Origin: S2,S3,S4 segment of sacrum(anterior).
Insertion: Apex of GT of femur.
Nerve: Sacral Plexus (S1,S2).

Gluteus medius and minimus:-
Functions:
Gluteus medius and minimus both act in combination as abductor of hip joint. During walking the two limbs alternately support body weight when stand on right lower limb the pelvis on left side tilt downward due to action of gravity. The right gluteus medius and minimus become active in this situation pull upon pelvis prevent the tilt as unsupported limb and vice versa.
When glutei of one side get paralyzed than during walking pelvis tilt to opposite side in order to prevent this tilting the patient learn to sway his trunk toward paralyzed side in order to lift the pelvis, to reduce the forces and to get some comfort this kind of gait are called “Trendelenberg gait”.

4. Adductor Muscles (prime movers):
The adductor brevis, adductor longus, adductor magnus, pectineus, and gracilis make up the adductor group. The adductors all originate on the pubis and insert on the medial, posterior surface of the femur, with the exception of the gracilis which inserts just below the medial condyle of the tibia.
Aductor magnus:
Origin:Outer margin of inferior surface of Ischial tubersity, Inferior ramus of ischium.
Insertion: Whole length of linea aspera & up to medial supra condyal of femur.
Nerve: Obturator nerve ( L3,4).
Adductor longus:
Origin: Anterior surface of pubic at angle b/w Pubic crest and superior ramus.
Insertion: Middle portion of medial lip of linea aspera.
Nerve: Obturator nerve (L3,4).
Adductor brevis:
Origin: Outer surface of inferior ramus of pubis.
Insertion: Upper part of linea aspera.
Nerve: Obturator nerve (L3,4).
Gracilus:
Origin: Anterior surface of inferior ramus of pubis.
Insertion: Medial surface of shaft of tibia.
Nerve: Obturator nerve.
Function:-
Adduction of thigh at hip joint.

5. Hip External Rotators.
Obturator externus:
Origin: Medial side of bony margin of obturator foramen.
Insertion: Trochenteric fossa of femur.
Nerve: Obturator nerve (L3,4).
Obturator internus:
Origin: Internal surface of obturator formen.
Insertion: Medial border of GT of femur.
Nerve: Obturator nerve (L5 S1,2).
Periformis:
Origin: S2,S3,S4 segment of sacrum(anterior).
Insertion: Apex of GT of femur
Nerve: Sacral Plexus (S1,S2)
Gemellus superior:
Origin: Outer surface of Ischial spine.
Insertion: Medial border of GT of femur.
Nerve: Obturator nerve (L5,S1,S).
Gemellus Inferior:
Origin: Posterior surface of body of ischium just above ischial tubersity.
Insertion: Medial border of GT of femur.
Nerve: Quadratus femoris (L4,L5 ,S1).
Quadratus femoris:
Origin: Lateral surface of body of ischium.
Insertion: Quadrate tubercle of inter trochenteric crest.
Nerve: Quadratus femoris.
Function:
All six are lateral rotator of the hip

6. Hip Internal Rotators.
Gluteus medius.
Gluteus minimus.
Tensor fasciae lata.


Flexion of the hip occurs when the angle between the torso and thigh is decreased. When this angle is increased beyond normal standing posture, the movement is called hip extension. Hip rotation occurs when the femur moves along its longitudinal axis. When the anterior surface of the femur turns outward, this is lateral rotation of the hip. The movement of the anterior surface of the femur inward is medial rotation of the hip. Medial rotation of the hip is carried out by gluteus medius and gluteus minimus. Hip abduction occurs when the femur moves outward to the side, as in taking the thighs apart. Hip adduction occurs when the femur moves back to the midline.
Many of the hip muscles are responsible for more than one type of movement in the hip, as different areas of the muscle act on tendons in different ways.
The psoas is the primary hip flexor, assisted by the iliacus. The pectineus, the adductors longus, brevis, and magnus, as well as the tensor fasciae latae are also involved in flexion.
The gluteus maximus is the main hip extensor, but the inferior portion of the adductor magnus also plays a role.
The adductor group is responsible for hip adduction. Abduction primarily occurs via the gluteus medius as well as the gluteus minimus.
Medial rotation is performed by the glutaei medius and minimus, as well as the tensor fasciae latae and assisted by the adductors brevis and longus and the superior portion of the adductor magnus.
Each muscle of the lateral rotator group causes lateral rotation of the thigh. These muscles are aided by the gluteus maximus and the inferior portion of the adductor magnus.

References:

  1. Primary Anatomy, 8th edition by: john V. Basmajian
  2. Muscle Testing, 4th edition by: luicille Daniels
  3. Atlas of anatomy by: Frank H. Nitter
  4. lecture by Anatomy teacher Dr.Jahanzeb PIPOS
  5. http://www.eorthopod.com/public/patient_education/6610/hip_anatomy.html
  6. http:/chestofbooks.com/health/body/massage/Handbook-Of-Anatomy-For-Students-Of-Massage/Muscles-Acting-On-The-Hip-Joint-Joint.html

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