MUSCLES OF THE HIP

ILIOPSOAS

Composed of two muscles - Iliacus & Psoas Major.

ILIACUS

Proximal Attachment: Superior two-thirds of iliac fossa (inner surface of the ilium)

Distal Attachment: Distal to the lesser trochanter of the femur.

Nerve: Femoral.

PSOAS MAJOR

Proximal Attachment: Anterior surfaces of transverse processes of all lumbar vertebrae (L1-L5) and the sides of bodies and corresponding intervertebral discs of the last thoracic and all lumbar vertebrae (T12-L5).

Distal Attachment: Lesser trochanter of femur.

Nerve: Lumbar plexus.

Combined Action: With the proximal attachment fixed, the Iliopsoas flexes the hip joint by flexing the femur on the trunk. It also may assist in external rotation of the hip joint.

The Psoas Major, acting bilaterally with the distal attachment fixed, may increase the lumbar lordosis. Acting unilaterally, it assists in lateral flexion of the trunk toward the same side.

The Iliacus acting bilaterally with the distal attachment fixed will increase the anterior tilt of the pelvis.

 

PSOAS MINOR

Proximal Attachment: Sides of bodies of twelfth thoracic and first lumbar vertebrae (T12-L1) and the intervertebral disc between them.

Distal Attachment: Iliopectineal eminence. {Ilium, near the superior ramus of the pubis.}

Action: Posterior tilt of the pelvis.

Nerve: Lumbar plexus.

Note: Does not cross the hip joint! This muscle is not present in approximately 40% of the population.

 

GLUTEUS MAXIMUS

Proximal Attachment: Posterior gluteal line of ilium and portion of bone superior and posterior to it {posterior 1/4 of the posterior crest of the ilium}, posterior surface of sacrum and coccyx.

Distal Attachment: Larger proximal portion and superficial fibers of the muscle into iliotibial tract of fasciae latae. Deeper fibers into gluteal tuberosity of femur (Posterior femur between the greater trochanter and the linea aspera).

Action: Extends and externally rotates the hip joint. The lower fibers may assist in adduction of the hip joint.

Through its attachment into the iliotibial band, the Gluteau Maximus helps to stabilize the knee in extension.

Nerve: Inferior gluteal.

 

GLUTEUS MEDIUS

Proximal Attachment: External surface of ilium between iliac crest, posterior gluteal line and anterior gluteal line {Lateral surface of the ilium below the iliac crest}.

Distal Attachment: Oblique ridge on the superior and lateral surface of greater trochanter of femur.

Action: Abducts the hip joint. The anterior fibers medially rotate and may assist in flexion of the hip joint. The posterior fibers laterally rotate and may assist in extension of the hip joint.

Nerve: Superior gluteal.

 

GLUTEUS MINIMUS

Proximal Attachment: External surface of ilium between anterior and inferior gluteal lines, and the margin of greater sciatic notch {Lateral surface of the ilium below the Gluteus Medius}.

Distal Attachment: Anterior border of greater trochanter of femur.

Action: Abducts, internally rotates, and may assist in flexion of the hip joint.

Nerve: Superior gluteal.

 

FASCIAE LATAE

Covers the gluteal region and lateral aspect of the thigh. NOT a muscle.

Very thin medially, but dense and well defined laterally. Portion of the fasciae latae on the lateral aspect of the leg is called the Iliotibial Band.

 Fasciae Latae (Iliotibial Band) cross the knee joint and attaches to the anterolateral tibial condyle.

 

TENSOR FASCIAE LATAE

Proximal Attachment: Anterior iliac crest and outer surface of anterior superior iliac spine (ASIS).

Distal Attachment: Into iliotibial band of fasciae latae.

Action: Flexes and abducts the hip joint, and tenses the fascia lata.

Through its attachment into the iliotibial band, the Tensor Fascia Latae helps to stabilize the knee in extension.

Nerve: Superior gluteal.

 

ADDUCTORS

(GROIN MUSCLES)

PECTINEUS

Proximal Attachment: Surface of superior ramus of pubis between iliopectineal eminence and pubic tubercle.

Distal Attachment: Pectineal line of femur (Between the inferior aspect of the lesser trochanter and the superior aspect of the linea aspera).

Nerve: Femoral.

 

ADDUCTOR BREVIS

Proximal Attachment: Outer surface of inferior ramus of pubis.

Distal Attachment: Distal two-thirds of pectineal line, and proximal half of medial lip of linea aspera.

Nerve: Obturator.

 

ADDUCTOR LONGUS

Proximal Attachment: Anterior surface of pubis, inferior to the crest {body of the pubis}.

Distal Attachment: Middle one-third of medial lip of linea aspera.

Nerve: Obturator.

 

ADDUCTOR MAGNUS

Proximal Attachment: Inferior pubic ramus and ischial tuberosity.

Distal Attachment: Middle of linea aspera, medial supracondylar line, and adductor tubercle of medial epicondyle of femur.

Nerve: Obturator and Sciatic.

 

GRACILIS

Proximal Attachment: Medial margin of inferior ramus of the pubis.

Distal Attachment: Anterior, medial surface of body of tibia, distal to condyle.

Nerve: Obturator.

 

Action for all Adductors: All adduct the hip joint.

In addition, the Pectineus, Adductor Brevis, and Adductor Longus flex the hip joint. The Adductor Magnus and Adductor Brevis also perform external or lateral rotation of the hip joint.

The Gracilis, in addition to adducting the hip joint, flexes and medially rotates the knee joint.

 

TWO JOINT MUSCLES at the HIP and KNEE

  1. Rectus Femoris
  2. Sartorius
  3. Bicep Femoris
  4. Semimembranosus
  5. Semitendinosus
  6. Gracilis

 

HIP LATERAL ROTATORS

1. Gluteus maximus

2. Gluteus medius (posterior fibers)

3. Iliopsoas

4. Sartorius (covered at the knee joint)

5. Six lateral rotators

a. Piriformis

b. Quadratus femoris

c. Obturator internus

d. Obturator externus

e. Gemullus superior

f. Gemullus inferior

6. Long Head of the Biceps Femoris

 

HIP MEDIAL ROTATORS

1. Gluteus minimus

2. Gluteus medius (anterior fibers)

3. Tensor fascia latae

4. Semimembranosus

5. Semitendinosus