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Pecs

We usually call our pectoral muscles «pecs».  The first thing we need to know is that pectoral muscles are a group of muscles.

The pectoralis major makes up the bulk of the chest muscles in the male and lies under the breast in the female.

 

Origin:

  1. Medial 1/3 of the clavicle.
  2. Anterior aspect of manubrium & length of the body of the sternum.
  3. Cartilaginous attachments of upper 6 ribs.
  4. External oblique’s aponeurosis.

Insertion:

  1. Lateral lip of bicipital groove to the crest of the greater tubercle.
  2. Clavicular fibers insert more distally; sternal fibers more proximally.

It performs four actions:

  1. Flexion of the humerus, as in throwing a ball side-arm, and in lifting a child.
  2. Adducts the humerus, as when flapping the arms.
  3. Rotates the humerus medially, as occurs when arm-wrestling.
  4. Keeps the arm attached to the trunk of the body.
Pain and symptoms associated with the Pectoralis Major muscle
– Chest pain
– Pain in the front of the shoulder
– Pain in the inner arm, inner elbow traveling down to the into the middle and ring fingers
– Breast pain
– Upper back pain between and around the shoulder blades
– Pain when trying to reach behind the body
– Rounded shoulder posture
– Contributor to forward head posture
Activities that cause pain and symptoms of the pectoralis major muscle
– Lifting heavy objects
– Working with your arms out in front of you (computer)
– Driving and horseback riding: both require you to hold your arms up and in front of your body
– Keeping your shoulders rolled forward or pulled up
– Slouching
– Carrying a heavy purse or backpack on one shoulder
– Large breasts

The pectoralis minor is a thin, triangular muscle, situated at the upper part of the chest, beneath the pectoralis major. The pectoralis minor depresses the point of the shoulder, drawing the scapula inferior, towards the thorax, and throwing its inferior angle posteriorly.

 

Origin:

The outer surface of ribs 2-5 or 3-5 or 6.

Insertion:

Medial aspect of the coracoid process of the scapula.

Pain and symptoms associated with the Pectoralis Minor muscle
– Chest pain
– Burning and stabbing like pain in the pectoral (chest) area
– Pain in the front of the shoulder
– Pain in the inner arm, inner elbow traveling down to the into the fourth and fifth fingers
– Numbness in the inside of the forearm, wrist, hand and fingers
– Difficulty reaching forward and up
– Pain in the upper back between the shoulder blades
– Pain when reaching behind the body
– Rounded shoulder posture
Activities that cause pectoralis minor pain and symptoms
– Lifting heavy objects
– Pushing things away from the body
– Push ups
– Lifting objects with arms straight in front of the body
– Working with your arms out in front of you (computer)
– Keeping your shoulders rolled forward or pulled up
– Carrying a heavy purse or backpack on one shoulder
– Hyperventilation, difficulty breathing
– Chronic cough
– Under-wire bras
– Large breasts
– Whiplash

The subclavius is a small triangular muscle, placed between the clavicle and the first rib. Along with the pectoralis major and pectoralis minor muscles, the subclavius muscle makes up the anterior wall of the axilla.

Subclavius

Origin:

First rib about the junction of bone and cartilage.

Insertion:

The lower surface of the clavicle.

The subclavius depresses the shoulder, carrying it downward and forward. It draws the clavicle inferiorly as well as anteriorly. Also, protects the underlying brachial plexus and subclavian vessels from a broken clavicle (the most frequently broken long bone).

Pain and symptoms associated with the subclavius muscle

– Pain below the collarbone
– Pain in the upper arm
– Sends pain down the forearm into the thumb, forefinger, and middle finger
– A reliable indicator of subclavius muscle dysfunction is a pain on the outside of the upper arm that skips over the elbow then extends into the forearm. Pain can also extend to the thumb, index, and middle finger while skipping over the wrist.
– The muscle can tighten restricting circulation to the arm and hand causing tingling and numbness

Activities that cause subclavius pain and symptoms

– Lifting heavy objects
– Working with your arms out in front of you (computer, driving)
– Keeping your shoulders rolled forward
– Sleeping on your side with your arm above your head
– Broken clavicle

 

The serratus anterior is found more laterally in the chest and, forms the medial wall of the axilla.

Serratus anterior

Origin:

Fleshy slips from the outer surface of upper 8 or 9 ribs.

Insertion:

The costal aspect of medial margin of the scapula.

The main action of the serratus anterior is to rotate the scapula, allowing the arm to be raised over 90 degrees. It also holds the scapula against the rib cage – this is particularly useful when upper limb reaches anteriorly (e.g punching).

Pain and symptoms associated with the Serratus anterior

– Pain on the side of the chest toward the middle of the ribcage
– Pain down the arm to the fourth and fifth fingers
– Pain below the shoulder blade
– Difficulty breathing
– Inability to take a deep breath
– Sharp pain in the side (side stitch)
– Pain and difficulty reaching behind the body
– Pain and difficulty when pulling shoulders back
– Sensitivity in and around the area of the breast

Activities that cause serratus anterior pain and symptoms

– Swimming
– Tennis
– Chin ups, Push ups
– Weightlifting
– Gymnastics
– Hyperventilation
– Severe coughing

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Six-pack

Six pack has 54M results on Google. Not everybody but a lot of people desires a «six-pack», others simply need to strength their middle section to relief or avoid pain or bad postures.

AbdomenThe transverse abdominal muscle (TVA) is a very important core muscle which is vital in maintaining good posture. It helps to compress the ribs and viscera, providing thoracic and pelvic stability.

The transverse abdominal and the segmental stabilizers of the spine work in tandem.

Without a stable spine, the nervous system fails to recruit the muscles in the extremities, and functional movements cannot be performed.

The TVA is vital to back and core health. Also has the effect of pulling in the abdomen. Training only the rectus abdominis muscle will not and can not give one a «flat» belly. This goal is achieved only through training the TVA.

Recently, the transverse abdominal muscle has become the subject of debate between kinesiologists, strength trainers, and physical therapists. The two positions on the muscle are:

  1. The muscle is effective and capable of bracing the human core during heavy lifts.
  2. It is not.

Anyway, how to do a stomach vacuum:

Origin:

  1. Front of the iliac crest.
  2. Inguinal ligament.
  3. Costal cartilages of the lower 6 ribs.
  4. Thoracolumbar fascia.

Insertion:

Linea alba.

Rectus Abdominis is the most superficial of the abdominal muscles. It is this muscle which forms the six-pack shape! It is a paired muscle running vertically on each side of the anterior wall of the abdomen. There are two parallel muscles, separated by a midline band of connective tissue called the linea alba.

Origin:

  1. Crest of the pubis.
  2. Pubic symphesis.

Insertion:

  1. Xiphoid process (base of the sternum).
  2. 5th,6th and 7th costal cartilages.

The six-pack flexes the lumbar spine, as when doing a so-called «crunch» sit up. The rib cage is brought up to where the pelvis is when the pelvis is fixed:

or the pelvis can be brought towards the rib cage (posterior pelvic tilt) when the rib cage is fixed, such as:

The Rectus Abdominis assists with breathing and plays an important role in respiration when forcefully exhaling. It also helps in creating intra-abdominal pressure, such as when exercising or lifting heavy weights.

Pain and symptoms associated with the Rectus Abdominis muscle
– Pain that runs horizontal across the mid back under the shoulder blade
– Pain that runs horizontal across the low back
– Pain around the sternum between the breasts (not shown)
– Pain in the low abdomen
– Feeling bloated
– Heartburn and indigestion
– Testicle pain
– Pain in the pelvic area
Activities that cause rectus abdominis pain and symptoms
– Over exercising muscles (sit-ups and leg-ups)
– Shallow breathing
– Chronic coughing
– Sitting for long periods of time
– Sitting in a twisted position
– Childbirth
– Abdominal surgery
– Scars from abdominal surgery
– Chronic Constipation
– Carrying a heavy backpack

The external oblique is situated on the lateral and anterior parts of the abdomen. It is broad, thin, and irregularly quadrilateral. It is the largest and the most superficial (outermost) of the three flat muscles of the lateral anterior abdomen. The obliques wrap around the trunk on each side to form our waists and join to the linea alba, a band of connective tissue running down the front of the abdomen.

Origin:

Lowest 8 ribs.

Insertion:

  1. Front 1/2 of the iliac crest.
  2. Linea alba.

The external oblique pulls the chest downwards and compresses the abdominal cavity, which increases the intra-abdominal pressure. It also has limited actions in flexion and rotation of the vertebral column.

The internal oblique muscle is the intermediate muscle of the abdomen, lying deep to the external oblique and just superficial to the transverse abdominal muscle. The internal obliques wrap around the waist and insert into the linea alba, a cord-like strip of connective tissue running down the center of the abdomen.

The internal oblique performs two major functions. First, as an accessory muscle of respiration, it acts as an antagonist to the diaphragm, helping to reduce the volume of the chest cavity during exhalation. When the diaphragm contracts, it pulls the lower wall of the chest cavity down, increasing the volume of the lungs. When the internal obliques contract they compress the organs of the abdomen, pushing them up into the diaphragm which intrudes back into the chest cavity reducing the volume of the air filled lungs, producing an exhalation.

Also, its contraction rotates and side-bends the trunk by pulling the rib cage and midline towards the hip and lower back, of the same side.

Origin:

  1. Iliac crest.
  2. Inguinal ligament.
  3. Thoracolumbar fascia.

Insertion:

  1. Lower 3-4 ribs.
  2. Linea alba.

Pain and symptoms associated with the External and Internal Oblique muscles

– Pain in the side, in the waist area
– Pain in the groin area
– Pain in the low abdomen
– Heartburn and indigestion
– Testicle pain
– Bladder pain and incontinence
– Pain in the pelvis area

Activities that cause obliques muscle pain and symptoms

– Abdominal scars from surgery
– Over exercising muscles (twisting and side bending exercises)
– Rowing
– Raking leaves
– Lifting using tools like shovels or pitchforks
– Chronic coughing
– Sitting for long periods of time
– Slouching posture

The Quadratus Lumborum, or QL, can perform different actions:

  1. Lateral flexion of the vertebral column, with ipsilateral contraction.
  2. Extension of the vertebral column, with bilateral contraction.
  3. Elevates the Ilium (bone), with ipsilateral contraction.

 

Origin:

  1. Posterior iliac crest.
  2. Iliolumbar ligament.

Insertion:

  1. Twelfth rib.
  2. Transerve processes of L1-L4.

This muscle is a common source of lower back pain. The QL connects the pelvis to the spine and is capable of extending the lower back when contracting bilaterally. When the lower fibers of the erector spinae are weak or inhibited, the QLs pick up the slack. Given their mechanical disadvantage, constant contraction while you are seated can overuse the QLs, resulting in muscle fatigue. A constantly contracted QL, like any other muscle, will experience decreased blood flow. In time, adhesions in the muscle and fascia may develop, the end point of which is the muscle spasm.

Pain and symptoms associated with the Quadratus Lumborum muscle

– Pain in the low back, constant deep aching even at rest
– Pain in the hips and buttocks
– Groin pain
– Pelvic pain
– Pain down the front of the thigh
– Low abdominal pain
– Stabbing back and or abdominal pain when coughing or sneezing

Activities that cause quadratus lumborum pain and symptoms
– Lifting heavy objects
– Twisting while lifting
– Sleeping on a mattress that is too soft
– Horseback riding
– Golfing
– Kayaking
– Leg length discrepancy – one leg shorter than other. This can be the way you were born or due to injury. It is often seen after a leg has been in a cast or splint.
– The QL muscles are often affected when you slip and or fall

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The erector spinae

The erector spinae is not just one muscle, but a bundle of muscles and tendons: Iliocostalis lumborum, Iliocostalis thoracis, Iliocostalis cervicis, Longissimus thoracis, Longissimus cervicis, Longissimus capitis, Spinalis thoracis, Spinalis cervicis, and Spinalis capitis. Paired, they run more or less vertically. It extends throughout the lumbar, thoracic and cervical regions, and lies in the groove to the side of the vertebral column.Erectores espinales

Erector spinae is covered in the lumbar and thoracic regions by the thoracolumbar fascia, and in the cervical region by the nuchal ligament.

This large muscular and tendinous mass varies in size and structure at different regions. In the sacral region, it is narrow and pointed, and at its origin chiefly tendinous in structure. In the lumbar region, it is larger and forms a thick fleshy mass. Further up, it is subdivided into three columns. These diminish in size as they ascend to be inserted into the vertebrae and ribs.

Some of its fibers are continuous with the fibers of origin of the gluteus maximus.

The erector spinae functions to straighten the back and provides for side-to-side rotation. Also maintains the correct curvature of the spine.

Symptoms and pain associated with the iliocostalis lumborum

– Pain in the low back
– Pain concentrated in the buttock
– Occasionally pain in the low abdomen

Activities that cause iliocostalis lumborum pain and symptoms

– Bending and twisting when lifting
– Straining when trying to lift something too heavy
– Whiplash of the lower back
– Extended periods of sitting in a car or plane

 

Pain and symptoms associated with the longissimus thoracis

– Pain in the back starting at the bottom of the ribcage extending down into the buttocks, pain is often more significant at the bottom of the buttock.

– Pain in the back starting at the bottom of the ribcage extending down to the top of the hip, pain is often more significant at the top of the back of the hip and buttock

– Difficulty standing when rising from a sitting position

Activities that cause pain and symptoms of the longissimus thoracis

– Bending and twisting when lifting
– Straining when trying to lift something too heavy
– Whiplash of the lower back
– Extended periods of sitting in a car or plane

Symptoms and pain associated with the iliocostalis thoracis

– Pain in the upper back around the shoulder blade concentrated toward the bottom of the shoulder blade
– Pain in the back running from the top of the shoulder blade down to the upper hip bone. Pain tends to be more concentrated toward the bottom of the ribs.
– Chest pain
– Pain in the abdomen area below the ribcage and toward the side

Activities that cause iliocostalis thoracis pain and symptoms

– Bending and twisting when lifting
– Straining when trying to lift something too heavy
– Whiplash of the lower back
– Extended periods of sitting in a car or plane

Pain and symptoms associated with semispinalis cervicis muscle 

– Pain in the back of the upper neck extending up into the back of the head
– Headaches
– Tenderness in the back of the head and/or neck
– Tingling and burning in the scalp

Activities that cause semispinalis cervicis pain and symptoms

– Blow to the back of the head
– Whiplash
– Cervical collar
– Holding shoulders up due to stress
– Stress

Pain and symptoms associtated with the longissimus capitis muscle

– Pain behind and/or just beneath the ear
– Pain sometimes is felt slightly down the neck and behind the eyes
– Headaches
– Tenderness in the back of the head and neck
– Numbness and/or tingling in the scalp

Activities that cause longissimus capitis pain and symptoms

– Tension headaches
– Cluster headaches
– Whiplash
– Degenerative disc disease
– Herniated disc
– Bulging disc
– Prolapsed disc
– Intervertebral or Vertebral stenosis
– Vertebral vascular disorder
– Cervical spine hyperlordosis
– Military neck
– Thoracic spine hyperkyphosis
– Scoliosis
– Spasmodic Torticollis (Wryneck Syndrome)
– Eye Strain
– Ocular disease
– Mastoiditis

Ppain and symptoms associated with the semispinalis capitis

– Pain in the back of the upper neck extending up into the back of the head
– Band of pain going around the top head
– Pain in the temple region going down to the eye
– Headaches
– Tenderness in the back of the head and neck
– Numbness in the scalp

Activities that cause semispinalis capitis pain and symptoms

– Blow to the back of the head
– Whiplash
– Cervical collar
– Holding shoulders up due to stress
– Stress

 

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Pelvic region

The pelvic region of the trunk is the lower part of the trunk, between the abdomen and the thighs. It includes several structures:

  • the bony pelvis (or pelvic skeleton), which is the part of the skeleton embedded in the pelvic region of the trunk, subdivided into:
    • the pelvic girdle (i.e., the two hip bones), which connects the spine to the lower limbs, and
    • the pelvic region of the spine (i.e., sacrum, and coccyx)
  • the pelvic cavity, defined as a small part of the space enclosed by the bony pelvis, delimited by the pelvic brim above and the pelvic floor below; also subdivided into:
    • the greater (or false) pelvis, above the pelvic brim
    • the lesser (or true) pelvis, below the pelvic brim
  • the pelvic floor (or pelvic diaphragm), below the pelvic cavity
  • the perineum, below the pelvic floor

So, as you imagine, there are a lot of muscles in this region. Let´s focus on the muscles of the hip.

Pelvic region

Posterior muscle groupTensor fascia latae

· Tensor fasciae latae muscle: Assist in keeping the balance of the pelvis while standing, walking or running. Medial rotation and flexion of the hip. Assist weakly with the extension of the knee, lateral rotation of the leg at the knee. Also stabilizes the hip and the knee during standing.

Origin:
anterior aspect of iliac crest
anterior superior iliac spine (ASIS)

Insertion: anterior aspect of IT band, below greater trochanter

Pain and symptoms associated with the Tensor Fasciae Latae muscle and Iliotibial Band

– Pain in deep in the hip going down the outside of the thigh
– Pain at the front of the hip joint
– Discomfort sitting
– When standing from a sitting position you tend to stand-up leaning forward at the waist with your knees bent. Straightening to a full standing position is slow with a feeling of stiffness as well as painful
– While standing knees and hips tend to be flexed (bent)
– Pain intensives when foot hits the ground while walking or running

ITBS is the most common pain syndromes in runners, weight lifters, dancers, tennis players and basketball players. Pain or a stinging burning sensation is felt on the outside of the thigh down to the lower knee. Pain is more pronounced when the foot hits the ground while walking or running. Pain from trigger points in the tensor fasciae latae muscle is often diagnosed as bursitis of the hip or thinning of the hip cartilage.

Activities that cause tensor fasciae latae muscle and iliotibial band muscle pain and symptoms

– Too much walking when not in shape
– Running
– Climbing
– Cycling
– Dancing
– Court sports (tennis, basketball, volleyball)

· Gluteus maximus: When the gluteus maximus takes its fixed point from the pelvis, it extends the acetabula femoral joint and brings the bent thigh into a line with the body. Taking its fixed point from below, it acts upon the pelvis, supporting it and the trunk upon the head of the femur; this is especially obvious in standing on one leg.

Origin:
1. outer rim of ilium (medial aspect)
2. dorsal surface of sacrum and coccyx
3. sacrotuberous ligament

Insertion:
1. IT band (primary insertion)
2. gluteal tuberosity of femur

Its most powerful action is to cause the body to regain the erect position after stopping, by drawing the pelvis backward, being assisted in this action by the biceps femoris (long head), semitendinosus, semimembranosus, and adductor Magnus.

The lower part of the muscle also acts as an adductor and external rotator of the limb. The upper fibers act as abductors of the hip joints.

Pain and symptoms associated with the Gluteus Maximus muscle

– Low back pain
– Outer hip pain near and or around the joint
– Pain around the tailbone
– Pain and burning in the buttocks
– Increased pain when walking uphill or up an incline
– Inability or increased pain when you bend over to touch your toes

Activities that cause gluteus maximus pain and symptoms

– Jumping
– Falls
– Swimming especially when using the flutter kick
– Climbing
– Deep knee bends
– Repetitive lifting of heavy objects with knees bent (this may protect your back, but puts enormous strain on the glute max)
– Prolonged sitting on hard surfaces
– Sitting for long periods
– Prolonged sitting on a wallet

· Gluteus medius: with the leg in neutral position, it works with the gluteus minimus to pull the thigh away from the midline (abduct the thigh). During gait, supports the body on one leg, in conjunction with the tensor fasciae latae muscle to prevent the pelvis from dropping to the opposite side. With the hip flexed, it works with the gluteus minimus to rotate the hip. With the hip extended, both externally rotate the thigh.

Origin:
1. outer aspect of ilium (between iliac crest and anterior and posterior gluteal lines)
2. upper fascia (AKA gluteal aponeurosis)

Insertion: superior aspect of greater trochanter

Pain and symptoms associated with the Gluteus Medius muscle

– Pain in the lower back around the beltline
– Pain in the hip
– Pain in the buttock
– Pain can extend down the outside of the leg
– Pain can extend into back of the leg
– Pain when lying on the affected side
– Pain will prevent sitting on the afflicted buttock
– Pain worsens when sitting or standing for extended periods of time
– Pain when sitting slouched

Activities that cause gluteus medius pain and symptoms

– Sitting for long periods of time with legs crossed
– Standing on hard surfaces for an extended time
– Walking and carrying a heavy item
– Carrying a child on the hip
– Always carrying heavy objects on one side such as filled buckets, heavy briefcase, etc.
– Aerobic exercise
– Running
– Weightlifting

· Gluteus minimus: with the leg in neutral position, it works with the gluteus medius to pull the thigh away from the midline (abduct the thigh). During gait, supports the body on one leg, in conjunction with the tensor fasciae latae muscle to prevent the pelvis from dropping to the opposite side. With the hip flexed, it works with the gluteus medius to rotate the hip. With the hip extended, both externally rotate the thigh.

Origin: outer aspect of ilium (between anterior and inferior gluteal lines)

Insertion:
1. greater trochanter (anterior to medius)
2. articular capsule of hip joint

Pain and symptoms associated with the Gluteus Minimus muscle

– Pain in buttocks
– Pain on the outside of the hip
– Pain in the back and outside of the thigh
– Pain in the back of the calf down to the ankle
– Numbness in buttocks, hip and thigh traveling down to ankle
– Pain while walking
– Difficulty rising from a sitting position
– Difficulty crossing your legs
– Pain while laying on affected side

Activities that cause gluteus minimus pain and symptoms

– Sitting for long periods of time with legs crossed
– Sitting on a wallet in the back pocket
– Walking and carrying an heavy item
– Carrying a child on the hip
– Limping for extended periods of time
– Standing with weight unequally distributed on legs

Ventral hip muscle group

· Piriformis: laterally rotates the femur with hip extension and abducts the femur with hip flexion. When the hip is flexed to 90 degrees, piriformis abducts the femur at the hip and reverses primary function, internally rotating the hip when the hip is flexed at 90 degrees or more.

 

Origin: pelvic surface of sacrum (anterior portion)

Insertion: medial surface of greater trochanter (through greater sciatic foramen)

Pain and symptoms associated with the Piriformis muscle

– Low back pain at the base of the spine
– Buttock pain
– Hip pain around the hip joint
– Aching pain, burning or tingling sensations down into the back of the thigh which occasionally extends into the lower leg and/or sole of the foot
– Pelvic pain
– Difficulty or inability to cross your legs
– Difficulty or inability to spreading leg side to side
– Difficulty or inability to step out widely
– Sitting for long periods of time increases pain and discomfort in the hip and/or back of the thigh
– Lying down will often help diminish pain but will not totally alleviate it

– The sciatic nerve runs under the piriformis. The piriformis muscle will sometimes agitate the nerve causing symptoms of sciatica which include pain, tingling, and numbness in the buttock, hip, back of the thigh, back of the calf which extends to the bottom of the foot. This is known as piriformis syndrome. In approximately 15% of the population, the sciatic nerve runs directly through the piriformis muscle. These people are more like to have symptoms of sciatica.
– Women are more prone to problems with piriformis muscle pain.

Activities that cause piriformis pain and symptoms

– Activities and sports requiring quick abrupt changes in directions
– Tennis
– Football
– Soccer
– Basketball
– Twisting while lifting
– Sitting excessively

· External obturator muscle: acts as the lateral rotator of the hip joint. As a short muscle around the hip joint, it stabilizes the hip joint as a postural muscle.

Origin:
1. medial surface of obturator foramen
2. external surface of obturator membrane

Insertion: trochanteric fossa of femur

· Internal obturator muscle: helps laterally rotate femur with hip extension and abduct femur with hip flexion, as well as to steady the femoral head in the acetabulum.

Origin:
1. internal aspect margins of obturator foramen
2. obturator membrane

Insertion: medial aspect of greater trochanter (through lesser sciatic foramen)

· Quadratus femoris: it is a strong external rotator and adductor of the thigh, but also acts to stabilize the femoral head in the Acetabulum.

Origin: lateral aspect of ischial tuberosity

lateral aspect of ischial tuberosity

Insertion: quadrate line (along posterior aspect of femur and intertrochanteric crest)

quadrate line (along posterior aspect of femur and intertrochanteric crest)

Symptoms and pain associated with the rectus femoris muscle

– Knee pain that feels as if it originates under the knee cap
– Pain in the front of the thigh extending down into the inside of the knee
– Weak knee
– Stiff knee
– Inability to fully straighten knee
– Pain walking down stairs
– Restless Leg Syndrome
– Sharp pain deep in the front of the thigh while sleeping

Activities that cause rectus femoris pain and symptoms

– Cycling
– Climbing
– Running and power walking
– Swimming
– Kicking a football or soccer ball
– Swimming
– Wearing high heel shoes
– Sitting excessively

Dorsal hip muscle group

· Psoas major: contributes to flexion in the hip joint. On the lumbar spine, unilateral contraction bends the trunk laterally while bilateral contraction raises the trunk from its supine position.

 

Origin:
1. transverse processes of L1-L5
2. vertebral bodies of T12-L4 and the intervening intervertebral discs

Insertion: iliopsoas tendon to the lesser trochanter of the femur

· Psoas minor: is a weak flexor of the lumbar vertebral column.

Origin:

Lateral surface bodies of T12 and L1 vertebrae and intervening intervertebral disc

Insertion Pectineal line and iliopubic eminence

· Iliacus: is important for lifting (flexing) the femur forward. From its origin in the lesser pelvis, the iliacus acts exclusively on the hip joint.

Origin:

inner surface of upper iliac fossa

Insertion:

iliopsoas tendon to the lesser trochanter of the femur

Pain and symptoms associated with the Iliopsoas muscles

– Low back pain
– Abdomen pain
– Groin pain
– Leg pain
– Pelvic pain
– Difficulty standing from a sitting position
– Severe pain or inability to do sit-ups or crunches
– Tendency to walk with feet turned out
– Extreme dysfunction in the iliopsoas can cause pain under the shoulder blade that extends down to the top of the hip.

Activities that cause iliopsoas pain and symptoms

– Sitting for long periods of time
– Sleeping on your side in the fetal position
– Being overweight
– Strenuous running
– Climbing stairs
– Sit ups, crunches and leg ups
– Slumping posture

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The thigh

The thigh is the area between the pelvis and the knee. We divide the thigh into three compartments: anterior, medial, and posterior.

Anterior compartment muscles

SartoriusIt is the longest muscle in the body. It assists in flexing, weak abduction and lateral rotation of the hip, and knee flexion.
Origin:
anterior superior iliac spine (ASIS)
Insertion:
1. upper medial surface of body of tibia

Pain and symptoms associated with the Sartorius muscle– Burning stinging pain under the skin starting at the outside of the bottom of the hip, traveling down the thigh to the inside of the knee (pain and/0r stinging can occur anywhere along the muscle)
– Inside of knees may be painful or hypersensitive
– Sleeping with a pillow between the knees often eases painActivities that cause sartorius muscle pain and symptoms

– Sitting with legs up and crossed for long periods of time (recliners, sleeping)
– Slipping or a misstep
– Sports that require planting one foot and making a sharp turn (basketball, football)
– Walking with an extended long stride

Quadriceps femoris: It is the knee extensor muscle.  As a group, the quadriceps femoris is crucial in walking, running, jumping and squatting. It´s subdivided into four separate «heads»:


Rectus femoris: It is the only muscle of the group which crosses the hip joint and is a powerful knee extensor when the hip is extended but is weak when the hip is flexed.
Origin:
1. anterior head: anterior inferior iliac spine (AIIS)
2. posterior head: ilium just above the acetabulum
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament

Pain and symptoms associated with the Rectus Femoris muscle

– Knee pain that feels as if it originates under the knee cap
– Pain in the front of the thigh extending down into the inside of the knee
– Weak knee
– Stiff knee
– Inability to fully straighten knee
– Pain walking down stairs
– Restless Leg Syndrome
– Sharp pain deep in the front of the thigh while sleeping

Activities that cause rectus femoris pain and symptoms

– Cycling
– Climbing
– Running and power walking
– Swimming
– Kicking a football or soccer ball
– Swimming
– Wearing high heel shoes
– Sitting excessively

Vastus lateralis or externus: It´s the largest part of the quadriceps femoris.
Origin:
1. greater trochanter
2. lateral lip of linea aspera
3. lateral intermuscular septum
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament

Pain and symptoms associated with the Vastus Lateralis– Knee pain
– Pain on the side of the thigh extending down into the front and back of the knee
– Pain under the buttock extending toward the hip joint
– Pain occasionally descends into the back of the calf
– Locked knee
– Extended walking increases pain in the thigh and kneeActivities that cause vastuslateralis pain and symptoms

– Climbing
– Skiing
– Sitting excessively
– Immobilizing the knee ie. casting, inflexible knee brace.

Vastus medialis: It is the deeper muscle of the quadriceps muscle group. The intern is the most difficult to stretch once maximum knee flexion is attained. It can´t be further stretched by hip extension as the rectus femoris can, nor is it accessible to manipulate with massage therapy to stretch.

Origin:
1. intertrochanteric line of femur
2. medial aspect of linea aspera
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament

Pain and symptoms associated with the Vastus Medialis– Pain on the inside of the knee extending half way up the front of the thigh
– Persistent pain in the knee joint
– Can cause the knee to ‘buckle’ (trick knee)
– People often sleep with a pillow between the knees to relieve the painActivities that cause vastusmedialis muscle pain and symptoms

– Deep knee bends
– Running
– Step masters or running stairs

Vastus intermedius: It contributes to correct tracking of the patella.

Origin:
anterior lateral aspect of the femoral shaft
Insertion:
1. common quadriceps tendon into patella
2. tibial tuberosity via patellar ligament

Pain and symptoms associated with the Vastus Intermedius muscle

– Pain down the middle of the front of the thigh
– Pain increases when walking
– Contributes to weak buckling knees
– Pain greatly increases when climbing stairs
– Problems straightening the knee after sitting
– Stiffness in the knee causes a limp

Activities that cause vastusintermedius pain and symptoms

– Climbing
– Running
– Over exercise of the quadriceps muscles
– Overuse of the knee
– Sitting for long periods of time


Medial compartment muscles

Gracilis: Is the most superficial muscle of the medial side. It adducts, medially rotates and flexes the hip, and aids in flexion of the knee.
Origin:
body of pubis & inferior pubic ramus
Insertion:
1. medial surface of proximal tibia, inferior to tibial condyle

Pain and symptoms associated with the Gracilis muscle– Hot stinging pain under the skin on the inside of the thigh
– Pain is constant even at rest, changing position does not subside painActivities that cause gracilis muscle pain and symptoms

– Sitting with legs crossed for long periods of time
– Horseback riding
– Skiing
– Slipping or a misstep
– Doing the splits

Pectineus: It is the most anterior adductor of the hip. Its primary function is hip flexion. Also, it adducts and medially rotates the thigh.

Origin:
1. pectineal line of the pubis
2. superior pubic ramus
Insertion:
1. the pectineal line of the femur
2. (just below the lesser trochanter on the posterior aspect of the femur)

Pain and symptoms associated with the Pectineus muscle

– Pain in the fold where the leg joins the body
– Groin pain
– Pelvic pain
– Pain increases when walking
– Sleeping with a pillow between the knees eases the pain

Activities that cause pectineus muscle pain and symptoms

– Sitting with legs up and crossed for long periods of time (recliners, sleeping)
– Slipping or a misstep
– Spreading legs too far apart vertically or horizontally
– Power walking
– Gymnastics
– Splits
– Horseback riding
– Lifting with legs spread too far apart
– Hip replacement surgery

The pectineus is often injured when a person starts a regimen of power walking. During power walking, a person will often extend their stride, reaching farther than they would in a normal stride. Overextension, while walking or running, can stain the pectineus.

The adductor muscle group is used pressing the thighs together to ride a horse, kicking with the inside of the foot in soccer or swimming. They contribute to flexion of the thigh when running or against resistance (squatting, jumping…)


Adductor brevis: immediately deep to the pectineus and adductor longus, the adductor brevis pulls the thigh medially. Also stabilizes the movements of the trunk when standing on both feet,m or to balance when standing on a moving surface. Primarily known as a hip adductor, it also functions as a hip flexor.

Origin:
body & inferior ramus of pubis
Insertion:
superior portion of linea aspera

Pain and symptoms associated with the adductor brevis muscle

– Groin pain during activity, pain subsides with rest
– Pain in the front of the outer upper thigh near the hip joint
– Deep pain in the hip joint
– Stiffness in the hip especially when turning the leg outward
– Pain above the knee
– Pain can descend down into the shin
– Pain increases while carrying objects
– Restricted movement in the hip and thigh

Activities that cause adductor brevis muscle pain and symptoms

– Sitting with legs crossed for long periods of time
– Horseback riding
– Slipping on ice or slick surfaces
– Moving legs too far apart horizontally or vertically

Adductor longus: Adducts the thigh and medially rotate.

Origin:
anterior surface of pubis, just inferior to the pubic tubercle
Insertion:
medial lip of linea aspera on middle half of femur

Pain and symptoms associated with the adductor longus muscle

– Groin pain during activity, pain subsides with rest
– Pain in the front of the outer upper thigh near the hip joint
– Deep pain in the hip joint
– Stiffness in the hip especially when rotating the knee outward
– Pain above the knee
– Pain can descend down into the shin
– Restricted movement in the hip and thigh
– Pain is greater when carrying something

Activities that cause adductor longus muscle pain and symptoms

– Sitting with legs crossed for long periods of time
– Horseback riding
– Slipping on slippery surfaces
– Moving legs too far apart horizontally or vertically

Adductor magnus: Powerful adductor of the thigh made especially active when the legs are moved from a widespread position to one in which the legs parallel each other.

 Origin:
1. anterior fibers: inferior pubic ramus
2. oblique fibers: ischial ramus
3. posterior fibers: ischial tuberosity
Insertion:
1. proximal 1/3 of linea aspera
2. adductor tubercle

Pain and symptoms associated with the adductor magnus muscle

– Groin pain during activity, pain lessens at rest
– Pain in the front of the inner upper thigh
– Pain and stiffness in the hip and knee that is often felt throughout the inner thigh
– Deep and or sharp pelvic pain that can affect the vagina, rectum, prostate, and bladder

Trigger points in the adductor magnus can cause pain deep in the pelvic area. Pain may present as a dull ache or a sharp stabbing pain. Those suffering from adductor magnus symptoms often sleep with a pillow in between the knees to ease pain.

Activities that cause adductor magnus muscle pain and symptoms

– Sitting with legs crossed for long periods of time
– Climbing stairs
– Horseback riding
– Skiing
– Slipping on ice
– Moving legs too far apart horizontally or vertically

Posterior compartment muscles
Biceps femoris: It has two parts or «heads». Both heads perform knee flexión. The long head (1 of the three hamstring muscles) is involved in hip extension. It is a weaker flexor when the hip is extended as well as a weaker hip extender when the knee is flexed. When the knee is semiflexed, the biceps femoris rotates the leg slightly outward.
Origin:
1. long head: ischial tuberosity
2. short head: lateral lip of linea aspera and the lateral intermuscular septum
Insertion:
1. head of fibula
2. maybe to the lateral tibial condyle

Pain and symptoms associated with the biceps femoris muscle– Pain in the back of the knee
– Pain toward the outside of the knee going up the outside of the thigh
– Pain worsens while walking
– Pain in the back of the leg when rising from a sitting position
– Persistent sitting can cause pain in the anterior thigh and deep in the buttock
– Pain when rising from a sitting positionActivities that cause biceps femoris muscle pain and symptoms

– Sitting for long periods of time
– Sitting on a chair with a small seat in which the edge puts pressure on the thigh
– Sitting on a hard surface putting pressure on the hamstrings
– Poorly conditioned athletes frequently injury the hamstrings
– Football
– Soccer
– Swimming
– Cycling

Semimembranosus: It helps to extend the hip joint and flex the knee. Also medially rotates the femur when the hip is extended. It can counteract the forward bending at the hip joint.

Origin:
ischial tuberosity

Insertion:
1. posterior medial aspect of medial tibial condyle
2. fibers join to form most of oblique popliteal ligament (& medial meniscus)

Pain and symptoms associated with the Semimembranosus muscle– Pain just below the buttock
– Pain down the back of the thigh and into the knee, occasionally going into the upper calf
– Pain intensifies while walking
– Deep aching pains in thigh and knee while sleeping
– Deep pain in the back of the thigh when rising from a seated positionActivities that cause semimembranosus muscle pain and symptoms

– Sitting for long periods of time
– Sitting on a hard surface putting pressure on the hamstrings
– Poorly conditioned athletes frequently injury the hamstrings
– Kicking a ball (football, soccer)
– Hurdles
– Doing the splits

Semitendinosus: It lies between the other two muscles. Collectively flex the knee and extend the hip.

Origin:
ischial tuberosity

Insertion:
1. medial aspect of tibial shaft
2. contributes to the pez anserine

 

Pain and symptoms associated with the Semitendinosus muscle

– Pain just below the buttock
– Pain down the back of the thigh and into the knee, occasionally going into the upper calf
– Pain intensifies while walking
– Aching pain down the back of the thigh while sleeping
– Deep pain when rising from seated position

Activities that cause semitendinosus muscle pain and symptoms

– Sitting for long periods of time
– Sitting on a hard surface putting pressure on the hamstrings
– Poorly conditioned athletes frequently injury the hamstrings
– Kicking a ball (football, soccer)
– Hurdles
– Doing the splits