Functional Anatomy of the Hip-Muscles and Fascia: Difference between revisions
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One theory assumes that the human body has two muscular systems: local and global. The local muscular system acts close to the joint axis, provides joint compression, and is responsible for this joint stability. The global system contains superficial muscles generating greater torque and greater moment arm.<ref name=":0">Retchford TH, Crossley KM, Grimaldi A, Kemp JL, Cowan SM. [http://ismni.org/jmni/pdf/51/01RETCHFORD.pdf Can local muscles augment stability in the hip? A narrative literature review]. J Musculoskelet Neuronal Interact. 2013 Mar 1;13(1):1-2.</ref>However it is the muscle architecture and the line of action that determines the muscles' primary role. Large forces produced by the muscles and small changes in their length create joint compression thus producing active stabilisation of the joint.<ref name=":0" /> | One theory assumes that the human body has two muscular systems: local and global. The local muscular system acts close to the joint axis, provides joint compression, and is responsible for this joint stability. The global system contains superficial muscles generating greater torque and greater moment arm.<ref name=":0">Retchford TH, Crossley KM, Grimaldi A, Kemp JL, Cowan SM. [http://ismni.org/jmni/pdf/51/01RETCHFORD.pdf Can local muscles augment stability in the hip? A narrative literature review]. J Musculoskelet Neuronal Interact. 2013 Mar 1;13(1):1-2.</ref>However it is the muscle architecture and the line of action that determines the muscles' primary role. Large forces produced by the muscles and small changes in their length create joint compression thus producing active stabilisation of the joint.<ref name=":0" /> | ||
Daily activities require the hip joint to withstand high forces which is possible due to the contribution of the individual muscles surrounding the joint. <ref>Correa TA, Crossley KM, Kim HJ, Pandy MG. Contributions of individual muscles to hip joint contact force in normal walking. Journal of biomechanics. 2010 May 28;43(8):1618-22.</ref>Active stability provided by the hip muscles can increase passive stability in the normal hip | Daily activities require the hip joint to withstand high forces which is possible due to the contribution of the individual muscles surrounding the joint. <ref>Correa TA, Crossley KM, Kim HJ, Pandy MG. Contributions of individual muscles to hip joint contact force in normal walking. Journal of biomechanics. 2010 May 28;43(8):1618-22.</ref>Active stability provided by the hip muscles can increase passive stability in the normal hip as well as the hip with structural abnormality. <ref name=":0" /> | ||
== Muscles == | == Muscles == | ||
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==== ''Deep External Rotators'' ==== | ==== ''Deep External Rotators'' ==== | ||
# [[Quadratus Femoris|Quadratus femoris]]: from ischial tuberosity to the intertrochanteric crest of the femur | |||
# [[Obturator Internus|Obturator internus]] and [[Obturator Externus|externus]] : from obturator membrane and ischiopubic rams to greater trochanter (internus) or intertrochanteric fossa of the femur | |||
# Gemelli ([[Gemellus Superior|superior]] and [[Gemellus Inferior|inferior]]): from ischial spine(superior) or ischial tuberosity (inferior) to greater trochanter and obturator internus tendon | |||
# [[Piriformis]]: from anterior surface of the sacrum and sacrotuberous ligament to greater trochanter | |||
The roles of these muscles are as follow: | |||
* Active stabilisers of the hip joint. The primary role includes femoral head stabilisation in the acetabulum | |||
* When deep external rotators are resected during hip arthroplasty with posterior surgical approach there is an increased rate of prosthetic dislocation and functional deficits. With capsular repairs, the dislocation rate is lower. | |||
* Resisted external rotation of the hip activates piriformis, but his line of force is not conducive to enhance joint compression. | |||
==== ''Superficial External Rotators'' ==== | ==== ''Superficial External Rotators'' ==== | ||
=== Internal Rotators === | === Internal Rotators === | ||
Gluteus minimus is an important stabiliser of the femoral head in the acetabulum.abductor, rotator and flexor of the hip. being able to modulate joint capsule stiffness; it may also help prevent anterior dislocation and superomedial migra- tion of the femoral head, as well as providing a proprioceptive role. | |||
=== Abductors === | === Abductors === | ||
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== Clinical relevance == | == Clinical relevance == | ||
== Resources == | == Resources == | ||
Revision as of 21:51, 23 February 2022
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Description[edit | edit source]
One theory assumes that the human body has two muscular systems: local and global. The local muscular system acts close to the joint axis, provides joint compression, and is responsible for this joint stability. The global system contains superficial muscles generating greater torque and greater moment arm.[1]However it is the muscle architecture and the line of action that determines the muscles' primary role. Large forces produced by the muscles and small changes in their length create joint compression thus producing active stabilisation of the joint.[1]
Daily activities require the hip joint to withstand high forces which is possible due to the contribution of the individual muscles surrounding the joint. [2]Active stability provided by the hip muscles can increase passive stability in the normal hip as well as the hip with structural abnormality. [1]
Muscles[edit | edit source]
External Rotators[edit | edit source]
Deep External Rotators[edit | edit source]
- Quadratus femoris: from ischial tuberosity to the intertrochanteric crest of the femur
- Obturator internus and externus : from obturator membrane and ischiopubic rams to greater trochanter (internus) or intertrochanteric fossa of the femur
- Gemelli (superior and inferior): from ischial spine(superior) or ischial tuberosity (inferior) to greater trochanter and obturator internus tendon
- Piriformis: from anterior surface of the sacrum and sacrotuberous ligament to greater trochanter
The roles of these muscles are as follow:
- Active stabilisers of the hip joint. The primary role includes femoral head stabilisation in the acetabulum
- When deep external rotators are resected during hip arthroplasty with posterior surgical approach there is an increased rate of prosthetic dislocation and functional deficits. With capsular repairs, the dislocation rate is lower.
- Resisted external rotation of the hip activates piriformis, but his line of force is not conducive to enhance joint compression.
Superficial External Rotators[edit | edit source]
Internal Rotators[edit | edit source]
Gluteus minimus is an important stabiliser of the femoral head in the acetabulum.abductor, rotator and flexor of the hip. being able to modulate joint capsule stiffness; it may also help prevent anterior dislocation and superomedial migra- tion of the femoral head, as well as providing a proprioceptive role.
Abductors[edit | edit source]
Adductors[edit | edit source]
Flexors[edit | edit source]
Extensors[edit | edit source]
Fascia[edit | edit source]
Clinical relevance[edit | edit source]
Resources[edit | edit source]
- ↑ 1.0 1.1 1.2 Retchford TH, Crossley KM, Grimaldi A, Kemp JL, Cowan SM. Can local muscles augment stability in the hip? A narrative literature review. J Musculoskelet Neuronal Interact. 2013 Mar 1;13(1):1-2.
- ↑ Correa TA, Crossley KM, Kim HJ, Pandy MG. Contributions of individual muscles to hip joint contact force in normal walking. Journal of biomechanics. 2010 May 28;43(8):1618-22.
