Manual Muscle Testing
Hip Extension
Hip Abduction
Hip Internal Rotation
Hip Adduction
External Rotation
Sartorius
Gluteus Maximus
Origin: Posterior gluteal line of the ilium, iliac crest, dorsum of the sacrum and coccyx, sacrotuberous ligament
Insertion: IT band, gluteal tuberosity of the femur
Nerve Innervation: Inferior Gluteal L5-S2
Semitendinosus
Origin: Ischial tuberosity
Insertion: Proximal aspect of the medial surface of the tibia
Nerve Innervation: Tibial portion of the sciatic nerve L5-S2
Semimembranosus
Origin: Ischial tuberosity
Insertion: Medial condyle of the tibia
Nerve Innervation: Tibial portion of the sciatic nerve L5-S2
Biceps Femoris
Origin: Long Head – Ischial tuberosity, Short Head – Lateral lip of the linea aspera and the lateral intermuscular septum
Insertion: Head of the fibula
Nerve Innervation: Sciatic L5-S2
How To Test: Patient lies prone and extends hip back. The examiner applies a downward pressure on the patient’s posterior femur
Gluteus Medius
Origin: Outer surface of the ilium between the anterior and posterior gluteal lines
Insertion: Greater trochanter of the femur
Nerve Innervation: Superior gluteal L4-S1
Gluteus Minimus
Origin: Outer surface of the ilium between the anterior and posterior gluteal lines
Insertion: Greater trochanter of the femur
Nerve Innervation: Superior gluteal L4-S1
Tensor Fascia Latae
Motion: Also assists with flexion of the hip with in abduction
Origin: ASIS, anterior aspect of the outer lip of the iliac crest
Insertion: IT band approximately one-third down the thigh
Nerve Innervation: Superior gluteal L4-S1
How To Test: Patient lies on unaffected side and raises affected leg straight up until there is about a 45 degree angle between the legs. The examiner then applies a downward force onto the affected leg. To isolate the tensor fascia latae, the patient flexes affected hip 45 degrees prior to abduction.
Adductor Magnus
Origin: Inferior rami of the pubis and ischium, ischial tuberosity
Insertion: Linea aspera, and adductor tubercle
Nerve Innervation: Obturator and sciatic L2-L4
Adductor Longus
Origin: Anterior aspect of the pubis
Insertion: Linea aspera along the middle third of the femur
Nerve Innervation: Obturator L2-L4
Adductor Brevis
Origin: Inferior ramus of the pubis
Insertion: Upper portion of the linea aspera
Nerve Innervation: Obturator L2-L4
Pectineus
Origin: Pectineal line of the pubis
Insertion: A line from the lesser trochanter to the linea aspera
Nerve Innervation: Femoral L2-L4
Gracilis
Origin: Body and ramus of the pubis
Insertion: Proximal aspect of the medial surface of the tibia
Nerve Innervation: Obturator L2-L3
How To Test: Patient lies on affected side while the examiner supports the unaffected leg. The patient then adducts affected leg and the examiner applies a downward force onto the distal femur.
Gluteus Medius
Origin: Outer surface of the ilium between the anterior and posterior gluteal lines
Insertion: Greater trochanter of the femur
Nerve Innervation: Superior gluteal L4-S1
Gluteus Minimus
Origin: Outer surface of the ilium between the anterior and posterior gluteal lines
Insertion: Greater trochanter of the femur
Nerve Innervation: Superior gluteal L4-S1
Tensor Fascia Latae
Motion: Also assists with flexion of the hip with in abduction
Origin: ASIS, anterior aspect of the outer lip of the iliac crest
Insertion: IT band approximately one-third down the thigh
Nerve Innervation: Superior gluteal L4-S1
How To Test: Patient sits with legs off table with a rolled towel under the test thigh. Patient then turns lower leg outward and the examiner pushes an inward force on the tibia while stablizing the femur.
Piriformis
Origin: Anterior surface of the sacrum, sacrotuberous ligament
Insertion: Greater trochanter of the femur
Nerve Innervation: Sacral nerves 1 and 2
Gemellus Superior
Gemellus Inferior
Obturator Internus
Obturator Externus
Quadratus Femoris
How To Test: Patient sits with legs off table with a rolled towel under the test thigh. Patient then turns lower leg inward and the examiner pushes an outward force on the tibia while stablizing the femur
Iliacus
Motion: Hip flexion
Origin: Superior two-thirds of the iliac fossa, iliac crest, anterior sacroiliac and iliolumbar ligaments
Insertion: Tendon of the psoas major, body of the femur
Nerve Innervation: Femoral L2-L3
How To Test: Patient is seated with legs hanging off table with pelvis stabilized. Patient brings knee upward while keeping knee in flexion. Downward force is then applied on the distal femur.
Psoas
Motion: Hip flexion
Origin: Sides of vertebral bodies and intervertebral discs of T12-L5 and transverse processes of L1-L5
Insertion: Lesser trochanter of femur
Nerve Innervation: Femoral L2-L3
How To Test: Patient is seated with legs hanging off table with pelvis stabilized. Patient brings knee upward while keeping knee in flexion. Downward force is then applied on the distal femur.
Motion: Hip flexion, abduction, and external rotation, knee flexion
Origin: ASIS, upper aspect of the iliac notch
Insertion: Proximal aspect of the medial surface of the tibia
Nerve Innervation: Femoral L2-L3
How To Test: Patient flexes his or her hip and brings the foot of the test leg toward the opposite knee. The examiner then pushes inward on the femur and down and outward on the medial shin
Videos taken from YouTube
Top video: http://youtu.be/A_HEOiOXNTs
Bottom video: http://youtu.be/UaipaBZGiYQ
Hip Flexion
References
Muscle and Sensory Testing Third Edition