Manual Muscle Test

KNEE MODULE – Full Clean Format

Medial Hamstrings

1. Neurological & Functional Insights

• - Primary knee flexors with strong medial stability role.
• - Support pelvic motion through posterior chain integration.
• - Important in deceleration and gait stance control.

2. Clinical Relevance

• - Weakness increases ACL strain risk.
• - Tightness contributes to posterior pelvic tilt.
• - Common site of strain in sprinting athletes.

3. Origin

• - Ischial tuberosity

4. Insertion

• - Pes anserinus (ST)
• - Posterior medial tibia (SM)

5. Innervation

• - Tibial nerve (L5–S2)

6. Actions – Open Kinetic Chain (OKC)

• - Knee flexion
• - Hip extension (assist)
• - Medial rotation (knee flexed)

7. Actions – Closed Kinetic Chain (CKC)

• - Posterior chain stabilization
• - Medial knee control

8. Associated Ligaments

• - Posterior medial capsule

9. Associated Organs

Fascial:

• - Posterior thigh fascia

Viscerosomatic:

• - L5–S2

TCM:

• - Bladder meridian

VM:

• - Posterior fascial chain tension

Lateral Hamstrings

1. Neurological & Functional Insights

• - Primary lateral stabilizer of knee flexion.
• - Controls tibial ER and deceleration mechanics.
• - Important in sprint propulsion.

2. Clinical Relevance

• - Tightness linked to lateral knee pain.
• - Weakness increases risk of hamstring strain.
• - Overactivity contributes to pelvic torsion.

3. Origin

• - Ischial tuberosity (long head)
• - Linea aspera (short head)

4. Insertion

• - Fibular head

5. Innervation

• - Tibial & common fibular nerves (L5–S2)

6. Actions – Open Kinetic Chain (OKC)

• - Knee flexion
• - External rotation (flexed knee)

7. Actions – Closed Kinetic Chain (CKC)

• - Lateral knee stabilization
• - Assists hip extension

8. Associated Ligaments

• - LCL connections

9. Associated Organs

Fascial:

• - Lateral thigh fascia

Viscerosomatic:

• - L5–S2

TCM:

• - Gallbladder meridian

VM:

• - Lateral chain tension

Hamstrings (Variation)

1. Neurological & Functional Insights

• - Targets specific fiber recruitment for imbalance detection.
• - Useful for identifying rotational bias patterns.
• - Reflects unique loading in sport-specific tasks.

2. Clinical Relevance

• - Variation exposes hidden asymmetries.
• - Important for assessing dynamic stability.
• - Helps refine return-to-sport decisions.

3. Origin

• - Ischial tuberosity

4. Insertion

• - Medial or lateral tibia (angle dependent)

5. Innervation

• - L5–S2

6. Actions – Open Kinetic Chain (OKC)

• - Flexion with rotational emphasis

7. Actions – Closed Kinetic Chain (CKC)

• - Rotational knee stabilization

8. Associated Ligaments

• - Posterior capsule

9. Associated Organs

Fascial:

• - Posterior chain fascia

Viscerosomatic:

• - L5–S2

TCM:

• - Bladder / Gallbladder

VM:

• - Posterior fascial modulation

Rectus Femoris

1. Neurological & Functional Insights

• - Biarticular extensor influencing both hip and knee mechanics.
• - Important for explosive power and kicking.
• - Controls femoral tracking via quadriceps synergy.

2. Clinical Relevance

• - Tightness contributes to anterior pelvic tilt.
• - Weakness reduces sprinting and jumping capacity.
• - Common site for strain in running sports.

3. Origin

• - AIIS
• - Superior acetabular rim

4. Insertion

• - Tibial tuberosity via patellar tendon

5. Innervation

• - Femoral nerve (L2–L4)

6. Actions – Open Kinetic Chain (OKC)

• - Knee extension
• - Hip flexion

7. Actions – Closed Kinetic Chain (CKC)

• - Anterior pelvic stabilization
• - Femoral tracking

8. Associated Ligaments

• - Patellar tendon
• - Quadriceps tendon

9. Associated Organs

Fascial:

• - Anterior thigh fascia

Viscerosomatic:

• - L2–L4

TCM:

• - Stomach meridian

VM:

• - Anterior chain tension

Rectus Femoris (Variation)

1. Neurological & Functional Insights

• - Emphasizes differential fiber recruitment.
• - Targets hip-flexion dominant activation.
• - Useful for assessing asymmetrical loading.

2. Clinical Relevance

• - Supports identifying compensatory quadriceps patterns.
• - Relevant for post-ACL rehab.
• - Aids correction of pelvic control.

3. Origin

• - AIIS

4. Insertion

• - Tibial tuberosity

5. Innervation

• - Femoral nerve

6. Actions – Open Kinetic Chain (OKC)

• - Hip-flexion-biased engagement

7. Actions – Closed Kinetic Chain (CKC)

• - Pelvic control

8. Associated Ligaments

• - Quadriceps tendon

9. Associated Organs

Fascial:

• - Anterior thigh fascia

Viscerosomatic:

• - L2–L4

TCM:

• - Stomach

VM:

• - Anterior fascial chain

Vastus Medialis

1. Neurological & Functional Insights

• - Critical for medial stabilization of patella.
• - Works strongly in terminal knee extension.
• - Important for shock absorption.

2. Clinical Relevance

• - Weakness contributes to patellofemoral pain.
• - Tightness creates medial knee compression.
• - Important in deceleration control.

3. Origin

• - Medial linea aspera

4. Insertion

• - Medial patella → tibial tuberosity

5. Innervation

• - Femoral nerve (L2–L4)

6. Actions – Open Kinetic Chain (OKC)

• - Knee extension

7. Actions – Closed Kinetic Chain (CKC)

• - Patellar tracking stabilization

8. Associated Ligaments

• - Medial patellofemoral ligament (functional)

9. Associated Organs

Fascial:

• - Medial thigh fascia

Viscerosomatic:

• - L2–L4

TCM:

• - Spleen meridian

VM:

• - Medial chain

Vastus Lateralis

1. Neurological & Functional Insights

• - Primary lateral stabilizer of patella.
• - Produces significant knee extension torque.
• - Important for force production in running.

2. Clinical Relevance

• - Tightness can pull patella laterally.
• - Weakness reduces extension power.
• - Overactivity disrupts patellar tracking.

3. Origin

• - Greater trochanter
• - Lateral linea aspera

4. Insertion

• - Lateral patella → tibial tuberosity

5. Innervation

• - Femoral nerve

6. Actions – Open Kinetic Chain (OKC)

• - Knee extension

7. Actions – Closed Kinetic Chain (CKC)

• - Lateral patellar stabilization

8. Associated Ligaments

• - Lateral patellofemoral ligament (functional)

9. Associated Organs

Fascial:

• - Lateral thigh fascia

Viscerosomatic:

• - L2–L4

TCM:

• - Gallbladder

VM:

• - Lateral fascial chain

Vastus Intermedius

1. Neurological & Functional Insights

• - Deep extensor providing consistent extension force.
• - Stabilizes patella via central pull.
• - Works synergistically with RF.

2. Clinical Relevance

• - Weakness reduces terminal extension strength.
• - Inhibition common after knee surgery.
• - Key for stair climbing and loaded extension.

3. Origin

• - Anterior femur

4. Insertion

• - Patella → tibial tuberosity

5. Innervation

• - Femoral nerve

6. Actions – Open Kinetic Chain (OKC)

• - Knee extension

7. Actions – Closed Kinetic Chain (CKC)

• - Dynamic patellar stability

8. Associated Ligaments

• - Quadriceps tendon

9. Associated Organs

Fascial:

• - Anterior thigh deep fascia

Viscerosomatic:

• - L2–L4

TCM:

• - Stomach

VM:

• - Anterior deep fascial chain

MASTER REFERENCES – Knee Module

- Gray’s Anatomy.

- Netter FH. Atlas of Human Anatomy.

- Neumann DA. Kinesiology of the Musculoskeletal System.

- Kendall FP. Muscles: Testing and Function.

- Blumenfeld H. Neuroanatomy Through Clinical Cases.

- Barral JP. Visceral Manipulation.

- Deadman P. Manual of Acupuncture.

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