The semitendinosus muscle originates on the ischial tuberosity and inserts on the tibia. It acts to flex and medially rotate the knee as well as extend the hip. It is innervated by the tibial nerve (L5, S1). The document then provides information on range of motion and testing positions for various motions of the hip, including extension, abduction, adduction, and lateral rotation. It describes the origin, insertion, action and innervation of several muscles involved in each motion.

1. SEMITENDINOSUS
• ORIGIN
Upper inner quadrant of posterior
surface of ischial tuberosity
• INSERTION
Upper medial shaft of tibia below
Gracilis
• ACTION
Flexes and medially rotates knee.
Extends hip
• NERVE
Tibial portion of sciatic nerve (L5, S1)

2. Hip Extension
Range of Motion
– Extension: 115º – 125º to 0º
– Extension beyond midline 0º to 10º - 15º
• Factors Limiting Motion:
– Tension of iliofemoml ligament
– Tension of hip flexor muscles
• Fixation:
– Contraction of Iliocustalis
and Quad rat us lumborum muscles
– Weight of trunk

3. NORMAL AND GOOD
• Prone with legs
extended.
• Stabilize pelvis.
• Patient extends, hip
through range of
motion.
• Resistance is given
proximal to knee joint.

4. NORMAL AND GOOD
Test for isolation of Gluteus
Maximus)
• Prone with knee flexed.
• Stabilize pelvis.
• Patient extends hip, keeping
knee flexed to decrease
action of hamstrings.
• Resistance is given proximal
to knee joint.
• Range of motion will be more
limited than in position
above, owing to tension in
the Rectus femoris

5. FAIR
• Position: prone with legs extended.
• Stabilization: Stabilize pelvis.
• Desired motion: Patient extends leg through range of
motion

6. POOR
• Position: Sidelying with
hip flexed, knee
extended and upper leg
supported.
• Stabilize pelvis.
• Patient extends hip
through range of
motion.
• (Knee may be flexed for
fair and poor to isolate
the action of the
Gluteus Maximus.)

7. TRACE AND ZERO
• Prone.
• Contraction of
Gluteus Maximus will
result in narrowing of
gluteal crease. Lower
and upper sections of
muscle should be pal-
pated.

8. Note
• Patient may lift pelvis
and support leg with
hamstrings, raising leg
from table by extending
lumbar spine.
• Examiner must be
certain that pelvis is
stable and movement
takes place in hip joint.

9. Hip Abduction
• GLUTEUS MEDIUS
• SARTORIUS

10. GLUTEUS MEDIUS
• ORIGIN
Outer surface of ilium between
posterior and middle gluteal
lines
• INSERTION
Posterolateral surface of greater
trochanter of femur
• ACTION
Abducts and medially rotates
hip. Tilts pelvis on walking
• NERVE
Superior gluteal nerve (L4,5,S1)

11. Hip Abduction
• Range of Motion:
Factors Limiting Motion:
Tension of distal band of iliofemoral ligament and
pubocapsular ligament.
Tension of hip adductor muscles
Fixation:
1.Contraction of lateral abdominal muscles and Latissimus
dorsi
2.Weight of trunk

12. NORMAL AND GOOD
• Position: Sidelying with leg slightly
extended beyond midline. Lower knee flexed
for balance.
• Stabilization: Stabilize pelvis.
• Desired motion: Patient abducts leg through
ROM without lateral rotation of the hip.

13. FAIR
• Position: Sidelying with leg slightly extended
beyond midline. Lower knee flexed for balance.
• Stabilization: Stabilize pelvis.
• Desired motion: Patient abducts leg through ROM.

14. POOR
• Supine with legs extended.
• Stabilize pelvis.
• Patient abducts leg through ROM without
allowing leg to rotate.

15. TRACE AND ZERO
• Fibers of the Gluteus medius maybe found
on lateral aspect of ilium above greater
trochanter of femur.
Resistance is given proximal to knee joint.

16. Note
• Patient may bring pelvis
to thorax by strong
contraction of lateral
trunk muscles, thereby
lifting leg through
partial abduc-tion.
• Examiner must stabilize
pelvis to make sure
motion takes place in hip
joint.

17. Note
• Lateral rotation at the hip should be
eliminated, or hip flexors may substitute for
Gluteus medius. Flexion of the hip allows
substitution by the Tensor fasciae Latae.

18. Hip Adduction
1. GRACILIS
2. PECTINEUS
3. ADDUCTOR BREVIS
4. ADDUCTOR LONGUS
5. ADDUCTOR MAGNUS

19. GRACILIS
• ORIGIN
Outer surface of ischiopubic ramus
• INSERTION
Upper medial shaft of tibia below
sartorius
• ACTION
Adducts hip. Flexes knee and medially
rotates flexed knee
• NERVE
Anterior division of obturator nerve (L2,
3)

20. PECTINEUS
• ORIGIN
Pectineal line of pubis and narrow area
of superior pubic ramus below it
• INSERTION
A vertical line between spiral line and
gluteal crest below lesser trochanter of
femur
• ACTION
Flexes, adducts and medially rotates
hip
• NERVE
Anterior division of femoral nerve (L2,
3). Occasional twig from obturator
nerve (anterior division - L2,3)

21. ADDUCTOR BREVIS
• ORIGIN
Inferior ramus and body of
pubis
• INSERTION
Upper third of linea aspera
• ACTION: Adducts hip
• NERVE
Anterior division of obturator
nerve (L2, 3)

22. ADDUCTOR LONGUS
• ORIGIN
Body of pubis inferior and medial to
pubic tubercle
• INSERTION
Lower two thirds of medial linea
aspera
• ACTION
Adducts and medially rotates hip
• NERVE
Anterior division of obturator nerve
(L2, 3)

23. ADDUCTOR MAGNUS
• ORIGIN
Adductor portion: ischiopubic ramus. Hamstring
portion: lower outer quadrant of posterior surface of
ischial tuberosity
• INSERTION
Adductor portion: lower gluteal line and linea aspera.
Hamstring portion: adductor tubercle
• ACTION
Adductor portion: adducts and medially rotates hip.
Hamstring portion: extends hip
• NERVE
Adductor portion: posterior division of obturator
nerve (L2-4). Hamstring portion: tibial portion of
sciatic (L4-S3)

24. Hip Adduction
• Range of Motion:
Factors Limiting Motion:
Contact with opposite leg
When hip is flexed, tension of ischiofemoral ligament.
Fixation: Weight of trunk.

25. NORMAL AND GOOD
• Sidelying with leg resting on table and upper
leg supported in approximately 25º of
abduction.
• Patient adducts leg until it contacts upper
• Resistance is given proximal to knee joint.

26. FAIR
• Sidelying with leg resting on table and
upper leg supported in approximately 25º of
abduction.
• Patient adducts leg until it contacts upper
leg.

27. POOR
• Supine with leg in 45º of abduction.
• Stabilize pelvis.
• Patient adducts leg through ROM without
allowing rotation of hip.

28. TRACE AND ZERO
• Contraction of fibers of adductor muscles
may he palpated on medial aspect of thigh.

29. Hip Lateral Rotation
• SARTORIUS
• GEMELLUS INFERIOR
• GEMELLUS SUPERIOR
• OBTURATOR EXTERNUS
• OBTURATOR INTERNUS
• QUADRATUS FEMORIS
• PIRIFORMIS

30. GEMELLUS INFERIOR
• ORIGIN
Upper border of ischial tuberosity
• INSERTION
Middle part of medial aspect of
greater trochanter of femur
• ACTION
laterally rotates and stabilizes hip
• NERVE
Nerve to quadratus femoris (L4, 5,
S1)