Hip Abductors

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton, Kim Jackson and Sehriban Ozmen  

Introduction

Hip Abduction

Hip abduction is the movement of the leg away from the midline of the body. This action is used daily eg when we step to the side, get out of bed, get out of the car. We also use it in walking to stop unsupported leg from falling "into space".

The Hip abductor muscle group are located on the lateral thigh.

1. The primary hip abductor muscles include the gluteus medius, gluteus minimus, and tensor fasciae latae.
2. The secondary hip abductors include the piriformis, sartorius, and superior fibers of the gluteus maximus.

Many hip and knee problems arise due to weal hip abductors. Hip abduction strengthening exercises help to prevent and treat pain in the hips and knees.

Function

Trendelenburg Gait

The hip abductor muscles contribute to various actions, including pelvic stabilization during walking and running; abduction and rotation at the hip joint.

The hip abductor muscles stabilize the hip within the frontal plane during the single-limb support phase of walking.

High demand is placed on the hip abductors occurs with walking. eg The right abductor muscles must work when the right leg is in the single-limb support phase of gait, as the left limb is swinging forward. The right hip abductors must supply an adequate contraction force to keep the pelvis from dropping down to the L. Weakness of these muscles results in an unstable pelvis while walking or while attempting to stand on one leg.

The trendelenburg gait is caused by a unilateral weakness of the hip abductors, mostly the gluteal musculature.

Muscles

1. 

   Gluteal Muscles. The Maximus (yellow), medius (blue) and minimus (red).
   Gluteus medius is the prime mover of abduction at hip joint. It is located on the lateral aspect of the upper buttock, below the iliac crest. The superior muscle is broad with the muscle narrowing towards its insertional tendon giving it a fan-shape. The anterior portion of Gluteus medius abducts and assists in flexion and medial rotation of hip. The posterior portion of Gluteus medius abducts and assists in extension and lateral rotation of hip.
2. Gluteus minimus muscle is the smallest one of the three gluteal muscles, it lies deep to the gluteus medius muscle. The gluteus minimus is similiar to the gluteus medius in function, structure, nerve and blood supply. The gluteus minimus acts in synergy with the gluteus medius to abduct and internally rotate the thigh, and contributes to the stabilization of the hip and pelvis.
3. The tensor fasciae latae (TFL) is a muscle of the proximal anterolateral thigh that lies between the superficial and deep fibres of the iliotibial (IT) band. The TFL works in conjunction with the gluteus maximus, gluteus medius, and gluteus minimus in a wide variety of hip movements, including flexion, abduction, and internal rotation.The TFL is most important clinically for assisting in pelvis stability while standing and walking.

Tensor Fascia latae (and others)

The secondary hip abductors include the

1. Piriformis is a flat muscle and the most superficial muscle of the deep gluteal muscles. It assists in hip abduction when hip is flexed.
2. The Sartorius muscle is a thin, long, superficial muscle in the anterior compartment of the thigh. It runs over 2 joints (hip and knee joints) and is the longest muscle in the human body. At the hip it flexes, weakly abducts, and rotates the thigh laterally.
3. Superior fibers of the Gluteus Maximus, the largest and heaviest muscle in the body. It is the most superficial of all gluteal muscles that are located at the posterior aspect of the hip joint.

Physiotherapy Implications

Lateral Thigh Pain

Hip abductor weakness results in insufficient pelvic stabilised during locomotion. This altered biomechanics causes problems in the kinetic chain eg the hip drops in swing phase, the knee goes into valgus, the arch of the foot drops and up the kinetic chain the pelvis tilts anteriorly causing hyperlordosis of the lumbar spine.

See these relevant pages

• Trendelenburg Gait The trendelenburg gait is caused by a unilateral weakness of the hip abductors, mostly the gluteal musculature.
• Gluteal Tendinopathy (GT) Pelvic control in a single leg stance is controlled 70% by the abductor muscles. Weakness and/or muscle bulk changes impact the balance of the abductor mechanism and increase the compression of the gluteal tendons leading to GT and Greater Trochanteric Pain Syndrome
• Patellofemoral Pain Syndrome
• Relationship Between Hip Muscle Strength and Patellofemoral Pain SyndromeWeakness of the hip abductor muscles may increase medial femoral rotation and valgus knee moments. These deviations may alter the adduction/abduction moments at the hip or lead to an increased Q-angle, which may subsequently alter tracking of the patella, increase compressive forces on the patellofemoral joint, and ultimately lead to knee pain
• Hip osteoarthritis
• Knee Osteoarthritis Hip abductor strengthening improves function and reduces pain in people with medial knee OA.
• Total Hip replacement Physiotherapy directed hip abductor strength training improved gait speed and cadence in people who have been discharged from hospital after total hip replacement.
• Goniometry Hip Abduction