THE HIP JOINT

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THE HIP JOINT
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Muscles of the Hip
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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
  adduction

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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
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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.

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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

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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.

Stretching
Strengthening
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Biceps Femoris

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

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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

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Semitendinosus

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

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Semimembranosus

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

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Semitendinosus Semimembranosus

• A two-joint muscle
• Used in ordinary walking for hip extension
• Best exercised with knee flexion (leg curls)
• Help to medially stabilize knee

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Tensor Fasciae Latae

• O iliac crest
• I iliotibial (I.T.) band
• Actions
• Flexion of the hip
• Internal rotation
• Abduction of the hip

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Tensor Fasciae Latae

• Prevents external rotation at the hip is flexed

Stretching
Strengthening
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Tensor Fascia Latae (Anterior View)
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Iliopsoas

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

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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
• Also used during complete sit-ups and straight
  leg sit-ups.
• Stretching this muscle requires hyper-extension
  of the hip.

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Pectineous

• O pubic crest or ramus
• I between the lesser trochanter and the linea
  aspera
• Actions
• Flexion
• Adduction
• Internal rotation

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Tensor Fasciae Latae
Pectineus
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Adductor Brevis

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

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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

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Adductor Magnus

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

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Gracilis

• O pubic crest
• I medial condyle of tibia
• Actions
• Adduction at the hip
• Internal rotation
• Flexion at the knee

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Adductor Muscles

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

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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

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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.

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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

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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

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Hip Rotator Muscles

• ANTERIOR
• Obturator Externus

Anterior
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Hip Rotator Muscles

• POSTERIOR
• Piriformis
• Gemellus superior
• Obturator internus Gemellus inferior
• Quadratus femoris

Posterior
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Hip Rotator Muscles
Posterior
Posterior
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Hip Rotator Muscles
Posterior
Anterior
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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.

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• Review

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The Femur
3.
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.
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Anterior
1.

• 1
• 2
• 3
• 4
• 5
• 6

iliac crest anterior spine greater
trochanter lesser trochanter ischial
tuberosity pubis crest
2.
3.
4.
5.
6.
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Name the sections of the pelvis
1.
Ilium
2.
Pubis
3.
Ischium
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Posterior
1.

• 1
• 2
• 3
• 4
• 5

iliac crest greater trochanter ischial
tuberosity lesser trochanter linea aspera
2.
3.
4.
5.
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Name the muscle

• 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
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Name the muscle

• Actions
• adduction of the thigh at the hip
• aids in flexion

Adductor Brevis
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Name the muscle

• Actions
• abduction of the thigh
• medial rotation
• flexion

Gluteus Minimus
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Name the muscle

• Actions
• adduction of the thigh
• assists in flexion of the thigh at the hip

Adductor Longus
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Name the muscle

• Actions
• abduction of the thigh
• anterior fibers flexion and medial rotation,
• posterior fibers extension and lateral rotation.

Gluetus Medius
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Name the muscle

• Actions
• adduction at the hip
• medial rotation
• flexion at the knee

Gracilis
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Name the muscle
Iliopsoas

• Actions
• flexion of the thigh at the hip
• slight adduction
• flexion of the spine

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Name the muscle

• Actions
• flexion of the hip
• adduction

Pectineus
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Name the muscle

• Actions
• flexion of the thigh at the hip
• medial rotation
• abduction of the thigh, medial rotation (weak)

Tensor Fasciae Latae
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Name the muscle

• Actions
• adduction of the thigh at the hip
• flexion (anterior fibers)
• extension (posterior fibers)

Adductor Magnus
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• What is the most anterior hip rotator muscle?
• Obturator Externus

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Name the action at her hip
Abduction
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Name the action at his hip
Flexion
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Name the action at her hip
Extension, Abduction External Rotation
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Name the action at her (?) hip
External Rotation
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Name the actions at his hip
Flexion
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Name the actions at his hip
Extension and External Rotation and Abduction
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Name the actions at his hip
Flexion and Adduction
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Fill in the blanks

• Piriformis
• Gemellus superior
• Obturator internus
• Gemellus inferior
• Quadratus femoris

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Name the muscle

• Deep muscle
• Action
• Extension of the hip
• Flexion of the knee
• Internal rotation of the hip (and knee)

Semimembranosus
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Name the muscle

• Superficial muscle
• Action
• Extension of the hip
• Flexion of the knee
• Internal rotation of the hip (and knee)

Semitendonosis
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Name the muscle
Sartorius

• Action
• Flexion of hip
• External rotation of the hip
• Flexion of the knee

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Name the muscle

• Actions
• Flexion of the hip
• Extension of the knee

Rectus Femoris
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Name the muscle

• Action
• Extension of hip
• Flexion of knee
• Lateral rotation of the hip (and knee)

Biceps Femoris
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Name the muscle
Gluteus Medius
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Name the muscles
Pectineus
Adductor Brevis
Adductor Longus
Adductor Magnus
Gracilis
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Name the landmarks
Iliac crest
Anterior spine
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Name the landmarks

1. Acetabulum
2. Sciatic notch
3. Ischial tuberosity

1
2
3
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Name the muscles

1. Tensor fasciae latae
2. Sartorius

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