Functional Anatomy of the Hip-Muscles and Fascia
Original Editor - Ewa Jaraczewska
Top Contributors - Ewa Jaraczewska, Jess Bell, Kim Jackson and Lucinda hampton
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]
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 with extension activates piriformis, but his line of force is not conducive to enhance joint compression.
Internal Rotators[edit | edit source]
Tensor Fascia Latae: from anterior superior iliac spine to iliotibial track.
- Located between the deep and superficial layers of the ITB
- Works in different movement planes: assist with hip abduction in the frontal plane, performs hip flexion in saggital plane, completes internal rotation in transverse plane together with anterior gluteus medium and gluteus minimus [3]
Abductors[edit | edit source]
Gluteus minimus: from the outer surface of the ilium, between the anterior and posterior gluteal lines to the greater trochanter.
Its function include:
- Stabilisation of the hip and pelvis through modulation of the joint capsule
- Stabilisation of the femoral head in the acetabulum
- Rotation and flexion of the hip
- Prevention of anterior dislocation and migration of the femoral head in superior and medial direction
- Proprioceptive role
Gluteus medius: from the outer surface of the ilium, between the iliac crest, and the anterior and posterior gluteal lines to the greater trochanter. The muscle has three segments; anterior, posterior, middle or superficial, each with a specific orientation of the muscle fibres.
- Primary abductor of the hip
- Stabiliser of the pelvis and hip,
- Preventing the pelvis from adduction in single leg stance.
- Important stabiliser of the pelvis on the hip by contracting prior to and after foot contact regardless of the walking speed.[1]
Piriformis: externally (laterally) rotates the femur during the hip extension and abducts the femur during hip flexion.[4] The piriformis muscle acts as an auxiliary muscle and shows coactivation during pelvic floor muscles contracture.[5]
Adductors[edit | edit source]
Adductor longus, brevis, magnus
Gracilis
Pectineus
Flexors[edit | edit source]
Iliopsoas
Rectus femoris
Tensor Fascia Latae
Sartorius
Extensors[edit | edit source]
Gluteus maximus
Biceps Femoris
Semimembranosus
Semitendinosus
Fascia[edit | edit source]
Clinical relevance[edit | edit source]
Resources[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 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.
- ↑ Besomi Molina M. Towards the investigation of the tensor fascia lata muscle and iliotibial band function in runners: the relevance of the why and the how. The University of Queensland, Australia. A thesis submitted for the degree of Doctor of Philosophy at The University of Queensland in 2020.
- ↑ Chang C, Jeno SH, Varacallo M. Anatomy, bony pelvis and lower limb, piriformis muscle. StatPearls [Internet]. 2020 Nov 12.
- ↑ Wang Z, Zhu Y, Han D, Huang Q, Maruyama H, Onoda K. Effect of hip external rotator muscle contraction on pelvic floor muscle function and the piriformis. International Urogynecology Journal. 2021 Nov 29:1-7.
