Manual Muscle Test

HIP MODULE – Full Clean Format

Iliacus

1. Neurological & Functional Insights

• - Works with psoas to form iliopsoas—the primary hip flexor.
• - Stabilizes the anterior hip during gait swing phase.
• - Supports lumbar spine through fascial continuity.

2. Clinical Relevance

• - Weakness reduces hip flexion power.
• - Tightness contributes to anterior pelvic tilt.
• - Important in running and kicking mechanics.

3. Origin

• - Iliac fossa

4. Insertion

• - Lesser trochanter

5. Innervation

• - Femoral nerve (L2–L3)

6. Actions – Open Kinetic Chain (OKC)

• - Hip flexion

7. Actions – Closed Kinetic Chain (CKC)

• - Anterior pelvic stabilization

8. Associated Ligaments

• - Iliofemoral ligament (indirect influence)

9. Associated Organs

Fascial:

• - Iliac fascia

Viscerosomatic:

• - L2–L3

TCM:

• - Stomach meridian region

VM:

• - Anterior pelvic fascial tension

Iliacus (Variation)

1. Neurological & Functional Insights

• - Reflects recruitment bias toward upper iliacus fibers.
• - Useful for assessing pelvic asymmetry.
• - Activates differently depending on hip angle.

2. Clinical Relevance

• - Variation relevant in hip impingement biomechanics.
• - Helps identify flexion-motor imbalance.
• - Useful for rehab specificity.

3. Origin

• - Iliac fossa (upper fibers)

4. Insertion

• - Lesser trochanter

5. Innervation

• - Femoral nerve (L2–L3)

6. Actions – Open Kinetic Chain (OKC)

• - Hip flexion (angle-specific)

7. Actions – Closed Kinetic Chain (CKC)

• - Segmental pelvic control

8. Associated Ligaments

• - Iliolumbar fascia

9. Associated Organs

Fascial:

• - Iliac fascia

Viscerosomatic:

• - L2–L3

TCM:

• - Stomach region

VM:

• - Upper pelvic fascial load

Psoas Major

1. Neurological & Functional Insights

• - Primary hip flexor with major influence on lumbar lordosis.
• - Connects spine, pelvis, and lower limb as a global stabilizer.
• - Works in respiration through diaphragmatic relationship.

2. Clinical Relevance

• - Tightness linked with LBP and pelvic dysfunction.
• - Weakness reduces swing-phase clearance.
• - Crucial for acceleration movements.

3. Origin

• - T12–L5 vertebral bodies and transverse processes

4. Insertion

• - Lesser trochanter

5. Innervation

• - Lumbar plexus (L1–L3)

6. Actions – Open Kinetic Chain (OKC)

• - Hip flexion
• - External rotation

7. Actions – Closed Kinetic Chain (CKC)

• - Lumbar stabilization
• - Pelvic control

8. Associated Ligaments

• - Anterior longitudinal ligament

9. Associated Organs

Fascial:

• - Psoas fascia
• - Diaphragmatic fascia

Viscerosomatic:

• - L1–L3

TCM:

• - Kidney meridian region

VM:

• - Visceral tension via diaphragmatic–psoas chain

Tensor Fasciae Latae (TFL)

1. Neurological & Functional Insights

• - Key stabilizer of pelvis and knee via IT band.
• - Assists internal rotation and abduction.
• - Highly involved in single-leg stance mechanics.

2. Clinical Relevance

• - Overactive in glute med weakness.
• - Tightness contributes to IT band syndrome.
• - Important for dynamic knee stability.

3. Origin

• - ASIS

4. Insertion

• - IT band → lateral tibia

5. Innervation

• - Superior gluteal nerve (L4–S1)

6. Actions – Open Kinetic Chain (OKC)

• - Hip abduction
• - Internal rotation
• - Flexion

7. Actions – Closed Kinetic Chain (CKC)

• - Pelvic stabilization in stance

8. Associated Ligaments

• - IT tract connections

9. Associated Organs

Fascial:

• - Lateral thigh fascia

Viscerosomatic:

• - L4–S1

TCM:

• - Gallbladder meridian

VM:

• - Lateral fascial tension affecting TFL mechanics

Tensor Fasciae Latae (Variation)

1. Neurological & Functional Insights

• - Emphasizes upper fiber recruitment and IR bias.
• - Useful for evaluating hip flexion–abduction synergy.
• - Variation helps detect pattern dominance.

2. Clinical Relevance

• - Important in early-phase gait mechanics.
• - Overactivity increases valgus loading.
• - Helps refine hip stabilization strategies.

3. Origin

• - ASIS (upper fibers)

4. Insertion

• - IT band

5. Innervation

• - Superior gluteal nerve

6. Actions – Open Kinetic Chain (OKC)

• - Abduction
• - IR (emphasized)

7. Actions – Closed Kinetic Chain (CKC)

• - Dynamic pelvic control

8. Associated Ligaments

• - IT band

9. Associated Organs

Fascial:

• - Lateral fascia

Viscerosomatic:

• - L4–S1

TCM:

• - Gallbladder

VM:

• - Upper lateral chain tension

Gluteus Maximus

1. Neurological & Functional Insights

• - Primary hip extensor generating powerful propulsion.
• - Stabilizes trunk and pelvis via thoracolumbar fascia.
• - Critical in gait, lifting, sprinting.

2. Clinical Relevance

• - Weakness leads to lumbar compensation.
• - Underactivity common in sedentary populations.
• - Key for athletic explosiveness.

3. Origin

• - Ilium
• - Sacrum
• - Coccyx

4. Insertion

• - IT band
• - Gluteal tuberosity

5. Innervation

• - Inferior gluteal nerve (L5–S2)

6. Actions – Open Kinetic Chain (OKC)

• - Extension
• - ER

7. Actions – Closed Kinetic Chain (CKC)

• - Pelvic and trunk stabilization

8. Associated Ligaments

• - Sacroiliac ligaments

9. Associated Organs

Fascial:

• - Thoracolumbar fascia

Viscerosomatic:

• - L5–S2

TCM:

• - Bladder meridian

VM:

• - Posterior pelvic fascial influence

Gluteus Maximus (Distal Fibers)

1. Neurological & Functional Insights

• - Lower fibers contribute more to hip external rotation.
• - Assist hip extension at deeper hip angles.
• - Play a stabilizing role for femoral alignment.

2. Clinical Relevance

• - Important for controlling knee valgus.
• - Weakness increases IR dominance.
• - Essential in deep squat mechanics.

3. Origin

• - Lower ilium
• - Posterior sacrum

4. Insertion

• - Gluteal tuberosity

5. Innervation

• - Inferior gluteal nerve

6. Actions – Open Kinetic Chain (OKC)

• - Extension
• - ER (emphasized)

7. Actions – Closed Kinetic Chain (CKC)

• - Femoral alignment control

8. Associated Ligaments

• - Sacrotuberous ligament

9. Associated Organs

Fascial:

• - Posterior chain fascia

Viscerosomatic:

• - L5–S2

TCM:

• - Bladder

VM:

• - Posterior hip fascial load

Gluteus Medius

1. Neurological & Functional Insights

• - Primary hip abductor and frontal-plane stabilizer.
• - Controls pelvic drop in gait.
• - Essential for rotational hip stability.

2. Clinical Relevance

• - Weakness leads to Trendelenburg gait.
• - Overactivity in TFL dominance patterns.
• - Crucial in single-leg tasks.

3. Origin

• - Ilium (between anterior and posterior gluteal lines)

4. Insertion

• - Greater trochanter

5. Innervation

• - Superior gluteal nerve

6. Actions – Open Kinetic Chain (OKC)

• - Abduction
• - IR (anterior fibers)
• - ER (posterior fibers)

7. Actions – Closed Kinetic Chain (CKC)

• - Pelvic stabilization

8. Associated Ligaments

• - Gluteal aponeurosis

9. Associated Organs

Fascial:

• - Lateral hip fascia

Viscerosomatic:

• - L4–S1

TCM:

• - Gallbladder

VM:

• - Lateral chain tension

Gluteus Medius (Variation)

1. Neurological & Functional Insights

• - Bias on posterior fibers for external rotation and hip stability.
• - Helps differentiate glute med vs. TFL dominance.
• - Important for single‑leg stance refinement.

2. Clinical Relevance

• - Useful in gait retraining.
• - Weakness increases valgus collapse.
• - Supports deceleration and turning mechanics.

3. Origin

• - Posterior ilium (posterior fibers)

4. Insertion

• - Greater trochanter (posterior facet)

5. Innervation

• - Superior gluteal nerve

6. Actions – Open Kinetic Chain (OKC)

• - Abduction
• - ER emphasis

7. Actions – Closed Kinetic Chain (CKC)

• - Posterolateral hip stabilization

8. Associated Ligaments

• - Gluteal fascia

9. Associated Organs

Fascial:

• - Posterolateral hip fascia

Viscerosomatic:

• - L4–S1

TCM:

• - Gallbladder

VM:

• - Posterior hip fascial pull

Deep External Rotators of Hip (General)

1. Neurological & Functional Insights

• - Provide critical posterior stability of hip joint.
• - Control femoral rotation during gait.
• - High proprioceptive density aiding precision.

2. Clinical Relevance

• - Weakness increases IR dominance.
• - Key for pelvic control in athletes.
• - Tightness contributes to posterior hip stiffness.

3. Origin

• - Posterior pelvis

4. Insertion

• - Greater trochanter region

5. Innervation

• - L4–S2 plexus

6. Actions – Open Kinetic Chain (OKC)

• - External rotation

7. Actions – Closed Kinetic Chain (CKC)

• - Femoral control during weight bearing

8. Associated Ligaments

• - Posterior capsule

9. Associated Organs

Fascial:

• - Deep hip fascia

Viscerosomatic:

• - L4–S2

TCM:

• - Bladder / Gallbladder

VM:

• - Pelvic fascial restrictions affecting ERs

Piriformis

1. Neurological & Functional Insights

• - Acts as ER below 60° hip flexion and abductor above 60°.
• - Critical stabilizer of SI joint tensioning.
• - Important in pelvic rotation mechanics.

2. Clinical Relevance

• - Tightness contributes to sciatic nerve irritation.
• - Weakness leads to decreased rotational control.
• - Highly active in cutting and turning motions.

3. Origin

• - Anterior sacrum

4. Insertion

• - Greater trochanter

5. Innervation

• - Nerve to piriformis (S1–S2)

6. Actions – Open Kinetic Chain (OKC)

• - External rotation
• - Abduction (hip flexed)

7. Actions – Closed Kinetic Chain (CKC)

• - SI joint stabilization

8. Associated Ligaments

• - Sacrospinous and sacrotuberous fascial links

9. Associated Organs

Fascial:

• - Posterior pelvic fascia

Viscerosomatic:

• - S1–S2

TCM:

• - Bladder

VM:

• - Sacral tension influencing piriformis

Adductor Brevis

1. Neurological & Functional Insights

• - Functions as stabilizer for hip flexion‑extension transitions.
• - Important contributor to mid‑range adduction strength.
• - Supports pelvic alignment through medial chain.

2. Clinical Relevance

• - Commonly involved in groin strains.
• - Tightness restricts hip abduction.
• - Key in directional changes and acceleration.

3. Origin

• - Inferior pubic ramus

4. Insertion

• - Proximal linea aspera

5. Innervation

• - Obturator nerve (L2–L4)

6. Actions – Open Kinetic Chain (OKC)

• - Adduction
• - Flexion assistance

7. Actions – Closed Kinetic Chain (CKC)

• - Pelvic medial stabilization

8. Associated Ligaments

• - Pubofemoral ligament (indirect influence)

9. Associated Organs

Fascial:

• - Medial thigh fascia

Viscerosomatic:

• - L2–L4

TCM:

• - Liver meridian

VM:

• - Pelvic floor–adductor linkage

Adductor Longus

1. Neurological & Functional Insights

• - Major contributor to adduction and stabilizing stance.
• - Active in both flexion and extension ranges.
• - Part of anterior pelvic sling.

2. Clinical Relevance

• - Frequently strained in sports.
• - Overactivity seen in pelvic instability.
• - Key in frontal and transverse plane control.

3. Origin

• - Pubic body

4. Insertion

• - Middle linea aspera

5. Innervation

• - Obturator nerve

6. Actions – Open Kinetic Chain (OKC)

• - Adduction
• - Flexion (early), extension (late)

7. Actions – Closed Kinetic Chain (CKC)

• - Medial stabilization

8. Associated Ligaments

• - Pubic symphysis fascial links

9. Associated Organs

Fascial:

• - Adductor fascia

Viscerosomatic:

• - L2–L4

TCM:

• - Liver

VM:

• - Medial chain tension patterns

Adductor Magnus

1. Neurological & Functional Insights

• - Has both extensor and adductor functions.
• - Provides powerful posterior/medial hip stability.
• - Links posterior chain with medial chain.

2. Clinical Relevance

• - Important in sprinting and cutting.
• - Tightness reduces hip rotation mobility.
• - Weakness increases valgus strain.

3. Origin

• - Ischial tuberosity
• - Inferior pubic ramus

4. Insertion

• - Linea aspera
• - Adductor tubercle

5. Innervation

• - Obturator + Tibial division of sciatic nerve

6. Actions – Open Kinetic Chain (OKC)

• - Adduction
• - Extension (posterior fibers)

7. Actions – Closed Kinetic Chain (CKC)

• - Posteromedial pelvic stability

8. Associated Ligaments

• - Ischiofemoral fascia

9. Associated Organs

Fascial:

• - Posterior medial fascia

Viscerosomatic:

• - L2–S1

TCM:

• - Liver / Kidney

VM:

• - Posterior pelvic fascial links

Gracilis

1. Neurological & Functional Insights

• - Biarticular adductor contributing to knee flexion.
• - Supports medial knee stability.
• - Important in fine control of adduction.

2. Clinical Relevance

• - Commonly strained in sudden directional changes.
• - Weakness increases medial knee instability.
• - Important in rehabilitation of groin injuries.

3. Origin

• - Inferior pubic ramus

4. Insertion

• - Pes anserinus (medial tibia)

5. Innervation

• - Obturator nerve

6. Actions – Open Kinetic Chain (OKC)

• - Adduction
• - Knee flexion

7. Actions – Closed Kinetic Chain (CKC)

• - Medial chain stabilization

8. Associated Ligaments

• - Pes anserinus fascial structures

9. Associated Organs

Fascial:

• - Medial thigh fascia

Viscerosomatic:

• - L2–L4

TCM:

• - Liver

VM:

• - Medial fascial chain

Pectineus

1. Neurological & Functional Insights

• - Hybrid flexor–adductor with key stabilizing role.
• - Supports early swing‑phase hip mechanics.
• - Assists in fine pelvic positioning.

2. Clinical Relevance

• - Important in groin rehab.
• - Weakness reduces hip flexion–adduction synergy.
• - Can compensate for iliopsoas inhibition.

3. Origin

• - Superior pubic ramus

4. Insertion

• - Pectineal line of femur

5. Innervation

• - Femoral nerve ± Obturator nerve

6. Actions – Open Kinetic Chain (OKC)

• - Adduction
• - Flexion

7. Actions – Closed Kinetic Chain (CKC)

• - Anterior pelvic stabilization

8. Associated Ligaments

• - Anterior hip capsule

9. Associated Organs

Fascial:

• - Anterior groin fascia

Viscerosomatic:

• - L2–L3

TCM:

• - Liver

VM:

• - Anterior pelvic fascial tension

MASTER REFERENCES – Hip 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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