hip flexors and hip extensors. hip flexors muscles that flex the femur at the acetabulofemoral joint...
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Hip Flexors and
Hip Extensors
Hip Flexors• Muscles that flex the
femur at the acetabulofemoral joint
– Psoas Major
– Iliacus
– Rectus Femoris
– Sartorius
– Pectineus
– Tensor Fascia Latae
Iliopsoas Muscle Group• They are the
strongest hip flexors and consists of psoas major and iliacus.
• They act on the lumbar spine and femur.
• FYI: psoas major is the filet mignon of a cow
Psoas Major• Psoas means low back
and major means large• Origin:
– Vertebral bodies of T12-L5 and transverse process of L1-L5
• Insertion: – Lesser Trochanter of
Femur• Action:
– Hip Flexion– Trunk Flexion– Anterior Tilt of Pelvis– Lateral Rotation of Hip
(very weak)
Psoas Major• Integrated Function:
–Assists in eccentric deceleration of hip extension
–Assists in eccentric deceleration of femoral medial rotation at heel strike (gait)
–Assists in dynamic stabilization of the lumbo-pelvic-hip complex during functional movements
Psoas Major Tightness• Can cause increased lumbar extension and hip
flexion, causing the pelvis to tip anteriorly• Avoid straight leg sit-ups-flex the hip and knee
joints and perform a crunch to 30 degrees of spinal flexion so psoas will not be engaged
• Perform the following exercises to correct the imbalance:– Supine Posterior Pelvic Tilt– Supine Bridge – Stretch Hip Flexors– Stretch Trunk Extensors– Strengthen Gluteus Maximus and Hamstrings
(hip extensors)
Iliacus• Iliacus refers to the
ilium of the pelvis• Origin:
– Iliac Fossa of Pelvis• Insertion:
– Lesser Trochanter of Femur
• Action: – Hip Flexion– Anterior Tilt of Pelvis– Lateral Rotation of
Hip
Iliacus• Integrated Function:
–Assists in eccentric deceleration of hip extension
–Assists in eccentric deceleration of femoral medial rotation at heel strike (gait)
–Assists in dynamic stabilization of the lumbo-pelvic-hip complex during functional movements
Rectus Femoris of the Quadriceps• Rectus means straight and
femoris refers to the thigh.• Origin:
– Anterior Inferior Iliac Spine of Pelvis
• Insertion: – Tibial Tuberosity of
Tibia by patellar tendon• Action:
– Knee Extension– Flexion of the Thigh– Anterior Tilt of Pelvis
Rectus Femoris
• Integrated Function:–Assists in eccentric deceleration of hip extension and knee flexion during functional movement
Sartorius• Sartorius means tailor • Origin:
– Anterior Superior Iliac Spine of Pelvis
• Insertion: – Proximal Tibia (medial
to tibial tuberosity)• Action:
– Hip Flexion– Hip Abduction– Lateral Rotation of Hip– Anterior Tilt of Pelvis– Knee Flexion
Sartorius• Integrated Function:
–Assists in eccentric deceleration of hip extension, adduction, medial rotation
–Assists in eccentric deceleration of knee extension
–Assists in dynamic stabilization of the acetabulofemoral and tibiofemoral joint
Pectineus• Pectineus means comb
because this muscle has a comb like appearance
• Origin: – Pubis
• Insertion: – Posterior Surface of
Femur (inferior to the lesser trochanter of femur)
• Action: – Hip Flexion– Hip Adduction– Anterior Tilt of Pelvis
Pectineus
• Integrated Function:–Assists in eccentric deceleration of abduction of the femur
–Assists in dynamic stabilization of the lumbo-pelvic-hip complex
Tensor Fascia LataeThe name tells us that this
muscle “tenses” the fascia that lies over the muscles of the thigh
• Origin:– Anterior Superior Iliac Spine
and Anterior Part of Iliac Crest
• Insertion:– Iliotibial Band which attaches to
the Lateral Condyle of Tibia
Tensor Fascia LataeAction:• Flexion of Femur• Abduction of Femur• Medial Rotation of Femur• Anterior Tilt of Pelvis
Integrated Function:• Assists in eccentric deceleration of hip extension• Assists in eccentric deceleration of hip adduction• Assists in eccentric deceleration of lateral rotation of
the hip• Assists in dynamic stabilization of the lumbo-pelvic-
hip complex and tibiofemoral joint
Hip Flexor Mnemonic
• P I R T S:–Pectineus
–Iliopsoas • Psoas Major and Iliacus
–Rectus Femoris
–Tensor Fascia Latae
–Sartorius
Hip Flexor Exercises• Many people excessively train the hip flexors
thinking that they're training the abdominals• Sit-ups, leg raises, "flutter kicks," and
hanging leg raises are all primarily hip flexor exercises
• Most people tend to have tight hip flexors, which can compromise the structural dynamics of the lumbar spine
• Short hip flexors are also associated with low back pain.
Straight-Leg Raise and Hanging Leg Raise• Hanging Leg Raise:
– When hanging in that position, your latissimus dorsi isometrically contracts, so when the rectus abdominis contracts and the legs move anteriorly, there is a pulling by the lats on the lumbar spine.
– This causes stress on the lumbar spine
• Straight-Leg Raise:– Trunk hyperextension may injure the lumbar spine
The Sit-Up • The sit-up imposes
a large compression load on the spine, regardless of the leg being bent or straight
• Sit-ups should not be performed at all by most people
Ouch!
Hip Flexor Exercises• Standing Hip Flexion
Machine
• Standing Hip Flexion with Tubing
• SB or TRX Jackknife
(hip flexion)
• Walking
• Running
• Biking
• Elliptical Machine
Hip Flexor Standing Stretch
Kneeling Hip Flexor Stretch
Hip Flexor Stretch Using A Bench or Stretching Table
To perform this stretch lie on the edge of a table, flex the knee and hip towards the chest, allowing the opposite leg to hang down
Hip Extensors
• Muscles that extend the femur at the acetabulofemoral joint
–Gluteus Maximus
–Hamstrings
Gluteus Maximus• Largest muscle
in the human body
• Superficial muscle responsible for the roundness of the buttock region
Gluteus MaximusOrigin: • Posterior Sacrum,
Posterior Iliac Crest, and Superior Gluteal Line of Ilium
Insertion
• Gluteal Tuberosity of Femur and Iliotibial Band
Gluteus Maximus• Action
– Hip Extension– Lateral Rotation of Hip– Posterior Tilt of Pelvis– Largest extensor and lateral rotator of the hip– Primarily contracts during forceful extension or
lateral rotation • Running, jumping or climbing stairs
• Integrated Function:– Eccentric deceleration of hip flexion and medial hip
rotation– Assists in dynamic stabilization of the sacroiliac
joint and lateral knee via the iliotibial band
Hamstrings• Semimembranosus
• Semitendinosus
• Biceps Femoris
(Long Head)
• Biceps Femoris
(Short Head)
SemimembranosusOrigin
• Ischial tuberosity
Insertion
• Posterior surface of medial condyle of the tibia
Action
• Extension of hip
• Flexion of knee
• Posterior tilt of Pelvis
SemitendinosusOrigin• Ischial Tuberosity of
Pelvis
Insertion• Anterior and medial
surface of the shaft of the tibia just below the condoyle
Action• Extension of hip• Flexion of knee• Posterior tilt of Pelvis
Biceps Femoris (Long Head)Origin• Ischial Tuberosity of
PelvisInsertion• Head of the Fibula
(lateral)Action• Extension of Hip• Flexion of knee• Posterior tilt of
Pelvis
Biceps Femoris (Short Head)Origin• Linea Aspera of
Femur (on the central shaft of femur)
Insertion• Head of the Fibula
(lateral)Action• Flexion of Knee
Hamstrings
• Integrated Function:–Assists in eccentric deceleration of hip
flexion and knee extension
–Assists in dynamic stabilization of the lumbo-pelvic hip complex during functional movements
–Assists in dynamic stabilization of the tibio-femoral joint
Hip Extensor Exercises• Deadlift
– Single-leg, DB, BB• Squat
– BW, SB, DB, BB Back Squat, BB Front Squat, BOSU, Disk, Single-leg, MB, Free Motion
• Lunge– BW forward/reverse,
DB, BB, SB, BOSU, Disk, MB, Free Motion
• Step-Up– BW, DB, BB, MB
• Hamstring Curls• Prone leg curl, SB,
Standing Free Motion
• Stair Climbing • Running
DB Deadlift• Joint Actions:
– Hip Extension– Knee Extension– Plantarflexion– Trunk Extension
• Primary Muscles Strengthened:– Gluteus Maximus– Hamstrings– Quadriceps– Gastrocnemius and Soleus (Calves)– Erector Spinae
Performing the DB Deadlift• Stand tall, retract scapulas and draw in
navel towards spine while squeezing the glutes
• Important that the hip, knee and toes are tracking in line
• Activate the core-watch for compensation in your client
• Keep arms staight at all times
Performing the DB Deadlift• Lower the weights down as deep as
neutral spine angles can be maintained.
• Ensure no compensations of the knee ankle or hip
• Return to the starting position, pushing through the glutes (to keep pressure off the lower back) and keeping the head & chest up, this will ensure that pressure is not placed solely on the lower back.
BB Deadlift
BB Back Squat and BB Front Squat• Joint Actions:
– Hip Extension– Knee Extension– Plantarflexion– Trunk Extension
• Primary Muscles Strengthened: – Gluteus Maximus– Hamstrings– Quadriceps– Gastrocnemius and Soleus (calves)– Erector Spinae
BB Back Squat and BB Front Squat
BB Back Squat• Common Mistakes:
– Heels rise up off the ground causing excessive knee flexion (knees over toes)
– Hyperextending/Hyperflexing the spine
– Allowing the knees to abduct or adduct during the movement
– Forward Lean
• BB Front Squats decrease spinal load (torque, compression, and flexion) and improve back posture
• BB Front Squats are safer than the BB Back Squat
Leg Press Machine• Common Mistakes:
– The potential danger in this exercise is seen when you bring the knees in close to the chest on the eccentric phase. This rounds the lumbar spine and increases the pressure on the spinal discs. The high compressive forces can cause the discs to herniate (rupture)
– Knees over toes
– Shifting of hips or allowing glutes to rise
– Heels off platform
– Knees adduct or abduct
Lunge• Joint Actions:
– Hip Extension, Knee Extension, Plantarflexion• Primary Muscles Strengthened:
– Gluteus Maximus, Hamstrings, Quadriceps, Gastrocnemius and Soleus
• Common Mistakes:– Leaning forward– Knees contacting floor– Pushing off of toes– Rear leg rotates– Increase in lumbar curve
Step-Up• The step should be
high enough to create a 90 degree angle at the knee joint when the foot is on the step
• Keep the spine neutral• Variations include
DB’s, BB and MB• Make sure leg on step
is doing most of the work
Additional Exercises• SB Leg Curl
• Single-Leg SB Leg Curl
Additional Exercises• Seated Chair Scoot
• Knee Flexion with Tubing–Prone
–Standing
• Manual Knee Flexion–Using your hands as resistance
Hip Extensor Stretches