Kjartan Vaarbakken1, Harald Steen2, Gunnar Samuelsen3, Hans A Dahl4, Trygve B Leergaard5, Britt Stuge6. 1. Department of Orthopaedics, Oslo University Hospital, PO Box 4956 Nydalen, N-0424 Oslo, Norway. Electronic address: kjartan.varbakken@yahoo.no. 2. Department of Orthopaedics, Oslo University Hospital, PO Box 4956 Nydalen, N-0424 Oslo, Norway. Electronic address: harald.steen@ous-hf.no. 3. Ullevål and Tåsen Physical Therapy and Exercise Inc., Tåsen Senter, PO Box 22, Tåsen, N-0801 Oslo, Norway. Electronic address: gsamuels@broadpark.no. 4. Department of Anatomy, Institute of Basic Medical Sciences, University of Oslo, PO Box 1105, Blindern, N-0317 Oslo, Norway. Electronic address: h.a.dahl@medisin.uio.no. 5. Department of Anatomy, Institute of Basic Medical Sciences, University of Oslo, PO Box 1105, Blindern, N-0317 Oslo, Norway. Electronic address: t.b.leergaard@medisin.uio.no. 6. Department of Orthopaedics, Oslo University Hospital, PO Box 4956 Nydalen, N-0424 Oslo, Norway. Electronic address: britt.stuge@medisin.uio.no.
Abstract
BACKGROUND: The small muscles of the pelvis and hip are often implicated in painful conditions. Although the quadratus femoris and obturator externus are usually described as external rotators of the hip, little is known about how they change their lengths and moment arms during human movement. Therefore, more precise measurements defining the positions and directions for their maximal strength and stretch are needed to better describe their functions and guide the clinical approach to pain. METHODS: Repeated measurements of the muscle lengths and range of motion were obtained using wires simulating dissected muscles on human cadaver hips. The lengths were measured at every 15° of flexion with and without maximal range of ab/adduction, rotation, and combinations of the two motions. Measurements were obtained from normal hips (n=3), and movement-lengthening relations were later differentiated into movement-moment arm relations. FINDINGS: The quadratus femoris showed maximum lengthening by flexion, adduction or abduction, and internal rotation, with the largest moment arms observed for extension in the deduced force-length efficient range of 60-90° flexion. The obturator externus showed maximum lengthening by extension, abduction, and internal rotation, with the largest moment arms observed for flexion and adduction in the deduced force-length efficient range around the hip's neutral position. INTERPRETATION: Our findings indicate that maximal strength of the quadratus femoris muscle will be delivered in a flexed position towards extension, while maximal strength of the obturator externus muscle will be delivered in an extended position towards flexion and adduction.
BACKGROUND: The small muscles of the pelvis and hip are often implicated in painful conditions. Although the quadratus femoris and obturator externus are usually described as external rotators of the hip, little is known about how they change their lengths and moment arms during human movement. Therefore, more precise measurements defining the positions and directions for their maximal strength and stretch are needed to better describe their functions and guide the clinical approach to pain. METHODS: Repeated measurements of the muscle lengths and range of motion were obtained using wires simulating dissected muscles on human cadaver hips. The lengths were measured at every 15° of flexion with and without maximal range of ab/adduction, rotation, and combinations of the two motions. Measurements were obtained from normal hips (n=3), and movement-lengthening relations were later differentiated into movement-moment arm relations. FINDINGS: The quadratus femoris showed maximum lengthening by flexion, adduction or abduction, and internal rotation, with the largest moment arms observed for extension in the deduced force-length efficient range of 60-90° flexion. The obturator externus showed maximum lengthening by extension, abduction, and internal rotation, with the largest moment arms observed for flexion and adduction in the deduced force-length efficient range around the hip's neutral position. INTERPRETATION: Our findings indicate that maximal strength of the quadratus femoris muscle will be delivered in a flexed position towards extension, while maximal strength of the obturator externus muscle will be delivered in an extended position towards flexion and adduction.
Authors: Manuel Wong-On; Antonio Turmo-Garuz; Rafael Arriaza; Jose Manuel Gonzalez de Suso; Luis Til-Perez; Xavier Yanguas-Leite; David Diaz-Cueli; Xavier Gasol-Santa Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-02-10 Impact factor: 4.342