The Muscles that Adduct the Femur at the Acetabulofemoral (Hip) Joint

1. The Muscles that Adduct the Femur at the Acetabulofemoral (Hip) Joint

2. Hip Adductors • There are five primary muscles that adduct the femur • They all cross the hip joint • The 5 muscles that adduct the femur at the hip joint from lateral to medial are: • Pectineus • Adductor Longus • Gracilis • Adductor Brevis • Adductor Magnus (People Love Getting Back Money)

3. Hip Adductors • Adductors work with the abductors to keep the pelvis stable during flexion and extension (walking, running, climbing…) • Adductors and Abductors must be balanced in strength and flexibility • Adductors are difficult to condition because they influence balance. (Side lying activities are best so they can work against gravity) • If abductors overpower adductors, the pelvis will tilt to the side of the strong abductors. • It would be the same if the adductors overpower the abductors

4. Pectineus Pectineus means comb because this muscle has a comb like appearance. O: Pubis I: Posterior Surface of Femur (inferior to the lesser trochanter of femur) A: • Adduction of Hip • Flexion of Hip • Anterior Tilt of Pelvis

5. Pectineus • Integrated Function: • Assists in eccentric deceleration of abduction of the femur • Assists in eccentric deceleration of lateral rotation of the hip • Assists in dynamic stabilization of the lumbo-pelvic-hip complex

6. Gracilis This muscle means graceful and slender O: Pubis I: Medial surface of tibial shaft, just posterior to sartorius A: • Adduction of Hip • Flexion of Hip • Anterior Tilt of Pelvis • Flexion of Knee

7. Gracilis • Integrated Function: • Assists in eccentric deceleration of hip abduction • Assists in eccentric deceleration of knee extension • Assists in dynamic stabilization of the hip and knee

8. Transplantation of the Gracilis • Weaker member of the adductor group, it can be removed without noticeable loss of function and surgeons often transplant the muscle with its nerve and blood vessels to replace a damaged muscle in the hand. • Once in the hand it produces digital flexion and extension.

9. Adductor Longus This muscle tells us that it is an adductor and long O: Pubis I: Linea Aspera of the Femur A: • Adduction of Hip • Flexion of Hip • Anterior Tilt of Pelvis

10. Adductor Brevis This muscle is an adductor and short. O: Pubis I: Linea Aspera of Femur A: • Adduction of Hip • Flexion of Hip • Anterior Tilt of Pelvis

11. Adductor Magnus Largest and Deepest Adductor O: Pubis and Ischial Tuberosity I: Linea Aspera of Femur Adductor Tubercle of Femur (above condyle on medial side) A: • Adduction of Hip • Extension of Hip • Posterior Tilt of Pelvis Adductor Hiatus: an opening for the femoral artery and vein to pass through

12. Adductor Longus, Brevis, and Magnus • Integrated Function: • Assists in eccentric deceleration of hip adduction and lateral rotation • Assists in dynamic stabilization of the lumbo-pelvic-hip complex during functional movements • The Adductor Magnus assists in eccentric deceleration of hip flexion

13. Groin Pull • Depending on the severity, a groin pull can range from a slight stretching, to a complete rupture of the hip adductor muscles. • Of the hip adductors, it is Adductor Longus that is most susceptible to injury, and the most common place of injury on Adductor Longus is insertion. • This can result from the quick starts and stops of kicking and running sports. These injuries are especially common in soccer but are also seen in racket sports, basketball, hockey, volleyball, and football.

14. How to Prevent and Treat a Groin Pull • Proper warm up and stretching is key to injury prevention • Stretch the Hip Adductors and Hip Flexors • Treatment: • For immediate relief, follow the R.I.C.E. treatment plan. Rest, Ice, Compression and elevation are the best immediate treatment for all pulls and strains. • Avoid aggravating activities for the first 1 to 2 weeks. • Once activity is started again, ice the muscle after exercise to reduce any swelling. After applying the ice, wrap the thigh to keep it compressed.

15. Supine SB Squeeze • This exercise can be performed standing, side lying or supine • Back supported and core engaged • Hip flexion to about 45 or 90 degrees • Adduct Hips and squeeze

16. Lateral Lunge • Joint Actions: • Hip Adduction (trailing leg) • Hip Extension (lead leg) • Knee Extension (lead leg) • Ankle Plantarflexion (lead leg) • Primary Muscles Strengthened: • Hip Adductors (trailing leg) • Gluteus Maximus and Hamstrings (lead leg) • Quadriceps (lead leg) • Adductor Magnus (lead leg) • Gastrocnemius and Soleus (lead leg

17. Lateral Lunge • Lateral lunges are problematic because to reach parallel requires a great deal of flexibility of the hip adductors. • Not everyone has this ability and will not be able to reach parallel with the leg they step out with.

18. Lateral Lunge • You must have adequate CORE strength and functional flexibility in the Lumbo Pelvic Hip Complex (LPHC), and calves, in order to perform this movement without compensation • Some common compensations: • Low back arches – stretch Psoas / Rectus Femoris (hip flexors) • External Rotation of Back Foot/Knee – stretch Gastroc / Soleus (calves).

20. Performing the Lateral Lunge • Keep upper torso erect. (Leaning forward may be a result of poor hip joint flexibility.) • From optimal postural alignment, draw your lower abdomen inward toward your spine • While maintaining optimal spinal alignment, step laterally and descend slowly by bending at the hips, knees and ankles.  • Your pelvis should stay square to the front as your torso stays erect.

21. Performing the Lateral Lunge • During the descent maintain weight distribution between the heels and mid-foot. • Do not allow the feet to cave inward or shift outward.   • The knees should track between the first and second toes. • Perform downward reps slowly and concentrate on the descent and the alignment of your body. • Only descend down as far as you can maintain optimal alignment 

22. Lateral Step-Up • Joint Actions: • Hip Adduction (trailing leg) • Plantarflexion (trailing leg) • Hip Extension (lead leg) • Knee Extension (lead leg) • Plantarflexion (lead leg) • Primary Muscles Strengthened: • Hip Adductors (trailing leg) • Gastrocnemius and Soleus (trailing leg) • Gluteus Maximus and Hamstrings (lead leg) • Quadriceps (lead leg) • Gastrocnemius and Soleus (lead leg)

23. Lateral Step-Up • Begin standing sideways next to a box or bench • Step up with the inside leg • Place entire foot on box • Keep back, head and shoulders aligned • Keep knees and toes pointing forward

24. Standing Adductor Stretch • Begin with one leg straight and the opposite leg bent. • Both feet are pointed straight ahead. • Draw your belly button inward. • Slowly move in a sideways motion toward the bent leg until you feel a stretch in the straight leg groin area. • Hold for 20-30 seconds, repeat for 2-3 reps. • Switch sides and repeat directions.

25. Supine Straight Leg Adductor Stretch with Rope • Preparation : • Strap rope around the forefoot • Movement :Use the rope to Abduct the leg until first resistance is felt, hold for 20 sec. repeat for 3-4 reps.

26. Adductor Stretch Seated on SB • Seated on ball, assume a side lunge position. • Keep extended leg straight with your weight on bent leg. • Draw your belly button inward and then perform a posterior pelvic tilt. • Shift your weight toward the front foot until a slight resistance barrier (stretch) is felt on the straight leg. • Hold for 20-30 seconds, repeat for 2-3 reps. • Explore different hip positions to find specific "tight spots".

27. Seated and Supine Hip Adductor Stretch

28. Adductor Magnus Stretch