MUSCULATURE OF

HIP JOINT
BY:MISS.BHAGYASHREE PATTNAY
BPT: 3rd YEAR
BATCH:(2021-2022)
MUSCULATURE OF HIP JOINT
Main function of hip joint muscles are:
1. Weight bearing (HAT).
2. They provide stability to hip joint.
3. Each muscle works best at the mid range, when they are
slightly stretched position as they are two joint muscles .
4. Some of the hip joint muscles crosses two joint (both hip
and knee) so here the principal of both active and passive
insufficiency applied .
5. Alignment of hip joint muscles and the large range of
motion results in, change in muscle function according to
hip position .

Example:
-Adductor muscles help in hip flexion at neutral position, but act as hip extension when it is
already at flex position.

-Piriformis does medial rotation at 90 °of hip flexion, where as the lateral rotation at 0° or
neutral position.
FLEXORS MUSCLES

• They act on sagittal plane and frontal

axis .

• Range of motion:
-0° - 120°(with knee flexion)
-0 °- 90 °(with knee extension)
ILIOPSOAS- PSOAS MAJOR + ILIACUS

• Psoas Major
-Origin: vertebral bodies of T12 to L4 . Discs between T12 to L4. Transverse
process L1 to L5 vertebrae

- Insertion: Lesser trochanter of femur

-Action: Flexion of hip , lateral rotation of hip and lateral flexion of trunk
• Iliacus
• Origin: Iliac fossa ,
• Insertion: Lesser trochanter of femur
• Action: flexion of hip and anterior pelvic tilt
Function:
• Here the attachment of muscles helps in
Open Chain Function- anterior pelvic tilt ( Iliacus )
- lumbar spine flexion ( Psoas major)
Closed chain function- There occurs lumbar lordosis to keep the
head over the sacrum with the anterior pelvic tilt.
• Iliopsoas act past 90° of hip flexion.
• Whereas other hip flexors are actively insufficient.
 RECTUS FEMORIS
• Origin: straight head- AIIS, reflected head – Rim of accetabulum

• Insertion: Tibial Tuberosity of Tibia

• Action: Hip flexion and knee extension

• Function
-It is the only quadriceps muscle that crosses hip and knee.

- It flexes the hip joint and extend the knee joint .

- Hip flexion and knee extension will shorten the muscle and increase the active insufficiency.

- This muscle gives the best contribution to hip flexion when the knee is maintained in flexion.
 SARTORIUS
• Origin : ASIS

• Insertion: medial aspect of Tibia

• Action: -flexion, abduction and lateral rotation of hip

-Flexion and medial rotator of knee

Function:
-Although it is a two joint muscle but does not get affected by the position of knee.
- Most important function act is when the knee and hip need to be flexed simultaneously
e.g. climbing stairs
 TENSOR FASCIA LATA
• Origin : ASIS and Iliac crest
• Insertion : IT band (which is then attached to lateral tibial condyle )
• Action : Flexion , Abduction and medial rotation of hip joint
Function :
 It maintained tension in the IT band with
combination to Gluteus Maximus.
 Contributes in hip stability.

Special tests:
1) OBER’s TEST
-Tightness can limit adduction range
of motion when hip is extended.
-Perform to check flexibility of IT
band .
- Average passive hip adduction in
men - 9°,in female - 4°.
2) SNAPPING HIP SYNDROME
- Inflammation of trochanteric
bursae .
 SECONDARY HIP FLEXOR

• Pectineus, Adductor Magnus and Longus , Gracillis.

• They are predominantly adductors but can cause flexion.
• In open chain function
- primarily :The flexor muscles help in ambulation for
bringing the swinging limb .
-secondarily : The flexor muscles resist strong hip
extension.
ADDUCTOR MUSCLE

• They act on frontal plane and

sagittal axis
• range of motion = 20°-30°
Pectineus :
 origin – Superior pubic ramus
 insertion- Linea aspera of femur
Gracilis:
origin- inferior border of pubic symphysis
insertion- At Tibia on medial side
Adductor Magnus:
origin- inferior pubic ramus , pubic symphysis
insertion- Linea aspera of femur
Adductor Longus :
origin- superior pubic ramus , pubic symphysis
insertion- Linea aspera of femur
Adductor Brevis :
origin- inferior pubic ramus
insertion- Linea aspera of femur
Function
• All the muscles are located anteromedially .
• At normal hip in standing position -
-The posterior adductor magnus , adductor brevis , adductor longus and
pectineus muscles does medial rotation of hip joint.
• Gracilis and anterior adductor magnus muscles are responsible for lateral
rotation.
• These muscles work in synergist to abductor in bilateral stance by enhancing
side to side stability.
• Adductor longus often get strained in sports like hockey.

• Adductor muscles give 22.5% of total muscle mass.

 EXTENSOR MUSCLE
• They act on sagittal plane and frontal axis.
• Range of motion is 0 °– 45 °.
Gluteus Maximus:
-Origin: posterior Gluteal line of Ilium, crosses SI joint & attaches the IT band.
-Insertion: Gluteal tuberosity of femur.
-Action: Hip extension, lateral rotation and abduction .

Function : .
- It is a large quadrangular muscle.
- It is the one joint muscle .
-Muscle contributes 12.8% of muscle mass.
- The moment arm of this muscle at hip extension is considerably longer than other extensor
muscles, and it is maximal in the neutral position of hip joint.
- It allows to exert peak extensor moment at 70° hip flexion .
- This muscle also causes lateral rotation of femur, when there is increase in hip flexion
( as the moment arm decreases) .
 HAMSTRING
1.Biceps Femoris :
• origin-a) long head- Ischial Tuberosity

b) short head-lateral Lip of Linea

aspera

• Insertion- Head of Fibula

2. Semitendinosus:

• origin- inferomedial impression of Ischial

Tuberosity

• insertion- below medial condyle of tibia

3. Semimembranosus:

• origin- Inferolateral impression of Ischial

tuberosity

• insertion- medial condyle of tibia

Action- Hip extension and knee flexion

Function:
• This muscle increases its moment arm for hip extension as the hip flexes to
35° .
• When the knee is flexed to 90° or more, and the hip is extended then the
hamstring muscle is not able to contribute much because of active insufficient .
• Extension forces of the hip increase by 30% when knee is extended

SECONDARY MUSCLES

• Posterior fiber of Gluteus Medius and Gluteus minimus

assist these muscles to perform a action or movement of hip
extension .
ABDUCTOR MUSCLES

THEY ACT ON FRONTAL PLANE AND SAGITTAL AXIS

RANGE OF MOTION 0° -40°.
 GLUTEUS MEDIUS
Origin: between anterior and posterior Gluteal line of Ilium
Insertion: lateral aspect of greater trochanter
Action: abduction of hip and extension of hip

Function:
-It is analogous to Deltoid
-It has : i)anterior fiber – helps in active hip flexion
ii) middle fiber –it also helps in hip flexion
iii) posterior fiber –helps in hip extension and lateral rotation
-In hip flexion all portions medially rotate of Gluteus Medius.
-All the portion of muscles help in abduction .
 GLUTEUS MINIMUS

Origin: between anterior and inferior guteal

line of Ilium
Insertion : superior border of greater
trochanter
Action: abduction and extension of hip joint
Function:
-It is an abductor + Extensor of hip joint.
-With flexion it does the medial rotation.
-Throughout the attachment it provide stability
to the head of femur .

*Both the muscles helps in abductor of femur and

stabilizer of pelvis in unilateral stance against the
gravity .
LATERAL ROTATOR MUSCLE

THEY ACT ON TRANSVERSE PLANE AND VERTICAL AXIS .

RANGE OF MOTION 0°-45°

 MUSCLEs…….
1.Obturator Internus
-origin: Posterior border of obturator Foramen muscle
-insertion : medial surface of greater trochanter of femur
2.Obturator externus
-origin: Anterior border of obturator foramen
-Insertion: Trochanteric fossa of femur
3. Gemellus superior
-origin: Ischial Tuberosity
-insertion: medial surface of greater trochanter of femur
4.Gemellus inferior
-origin: Ischial tuberosity
-insertion: medial surface of greater trochanter of femur
5.Quaderatus femoris
-origin: Ischial tuberosity
-insertion: Intertrochanteric crest of femur
6.Piriformis (at 0°)
-origin: interior surface of sacrum (S2,S4)
-insertion: greater trochanter of femur
Action
• Lateral rotation of hip joint
Function
• At both weight bearing and not weight bearing position .
• It act as an ideal hip joint stabilizer.
• Function of some lateral rotator muscle can decrease with hip
flexion due to compressive line of action or force at hip joint .
 MEIDAL ROTATORS
• They act on transverse plane and vertical axis
• Range of motion 0°-40°

Function
• The Gluteus Medius and Gluteus minimus ,piriformis (at 90°) , Tensor fascia Lata
muscles help in medial rotation.
• There are no muscle with a primary function of producing medial rotation of hip joint.

• In CP patient:
-crouch gait is present with medial rotation.

-due to adductor spasticity

-due to increase hip flexion which causes other

muscles to medially rotate
BILATERAL STANCE
In sagittal plane
analysis
• Plane will be sagittal plane and axis will be
frontal axis.
• LOG passes posteriorly to the hip joint, which
produce gravitational extension moment .
• Here muscle movement are inactive, stability is
provided by anterior capsuloligamentous str.
• Hence they balance the gravitational extension
movement.
• Thus is bilateral stance we have equilibrium.
IN FRONTAL PLANE ANALYSIS
• Plane will be frontal plane and axis
will be sagittal axis.
• Weight transmitted to hip joint is
“ HAT” ( Head, arm and trunk) .
• Weight is transmitted through
sacroiliac joint to the hip .
• HAT=2/3rd of the body weight
• As to each hip HAT will be equally
distributed at bilateral stance.
• Hence, weight in one hip =1/2
HAT
FORCE TRANSMISSION AND JOINT
COMPRESSION

• Force transmission ( B.W acting on hip joint)

• Joint compression= compression due to B.W +
compression due to muscle force
FORCE TRANSMISSION
• Weight is directed downward

• Moment arm of both the weight – Wr=MAr

- Wl =MAl

since it is equally distributed Mar=Mal

i.e., Wr=Wl

• Torque= Force * momentum

i.e., Wr*Mar=Wl*Mal

• So the net torque is zero as it cancelling out at both side, and as

MA is acting opposite to each other there is no muscle or other
compression acting at hip joint .

• So in bilateral stance the joint compression = ½ HAT

• Example
Let,
Person body weight= 875N
weight of HAT = 2/3rd of total weight of body
=(2/3)*875
=550N
So, at right hip joint = ½ HAT
=275N
Same at left side = 275N.
 UNILATERAL STANCE
• Here one leg is elevated and the weight is
transmitted to the other limb.
• Total body weight compression
= weight of (HAT) + the elevated leg
BODY WEIGHT COMPRESSION
• Let the left side leg is elevated
• Weight acting on right leg
= weight of HAT + weight of left leg
= 2/3 of body weight + 1/6th of body
weight
• Total weight= (2/3 + 1/6)of body weight
= 5/6 of body weight
i.e, 5/6 N
• Example

person weight = 120kg

HAT weight = 2/3rd of total body weight
=(2/3)*120Kg
=800N = 80kg
weight of lower limb =(1/3)*120kg
=40 kg
only left leg =(1/6)*120kg
=20kg
total body weight transmitted= (5/6)*120kg
=1000N=100kg
COMPRESSION DUE TO
MUSCULAR FORCE
• Here the abductor muscles act to prevent the fall
and to maintain the stability at unilateral stance
to maintain equilibrium
• At unilateral stance only one side torque is acting
Gravitational torque
=body weight*moment arm
= 5/6 *0.1Nm
If we consider the previous example then ,
5/6th of weight =100N*0.1m
= 10Nm
• This 10Nm (abductor torque) torque is
responsible for the imbalance which should be
balanced.
• So, the abductor muscles has to generate a force
equal to gravitational torque to balance or
maintain the stability and equilibrium
• Abductor muscles are originating from pelvic to
the Greater Trochanter of Femur. So, moment arm
is very less than pelvic moment arm,
i.e. , let consider 5cm or 0.05m
i)Force of abductor torque
› Abductor torque =force*moment arm

›10Nm =F*0.05m

›F=10Nm/0.05m=200N

So, the abductor muscle produce 200N force to balance the

stability or maintain the equilibrium.

ii)Total body compression

› TBC= compression due to body weight + compression of muscle
force
=100n+200N
=300N