(From J.G.

Fleagles Primate Adaptation & Evolution, 1988)

The Lower
Extremity:

Functional
Consequences
of Bipedality

Form
Follows
Function
(From R.M. Alexanders The Human Machine, 1992)
Bipedal Locomotion
ONLY in humans!!!
Why are we so unique?
MUST STAND UPRIGHT!
4 Design Considerations for
Bipedal Gait and Upright Posture



1) Stability in Upright Posture
2) Ability to Raise & Control Trunk
Over Hindlimbs
3) Ability to Balance on One Leg
4) Walk with Feet Underneath Body
Stability

lower extremities
larger & heavier than
upper extremities
Weebles wobble but
they dont fall down!
Ability to Raise
& Control Trunk
Over Hindlimbs
Gluteus
Maximus
sacral
attachment
W
T
W
T
m
Ability to Balance
on One Leg
Well-developed
Hip Abductors
gluteus medius
gluteus minimus
ANGLE OF FEMUR
14-15 degrees

moves CM more directly over
base of support

DONT HAVE TO SHIFT
LATERALLY WHEN YOU
WALK!
head
neck
lesser
trochanter
Obturator foramen
ischium
ilium
pubis
sacrum
acetabulum
greater
trochanter
ANTERIOR VIEW
POSTERIOR VIEW
Comparison to Shoulder
the hip is a weight bearing joint
both are ball-and-socket joints
acetabulum much deeper than glenoid fossa
both have a labrum to increase depth of the socket
hip has more bony support than shoulder
left and right shoulder girdles are more
independent than the corresponding portions of the
pelvis/femur
Gender
Females have pelvic
girdles that are lighter,
thinner and wider than
their male counterparts.
The female pelvis flares
out more laterally in the
front and the sacrum is
wider in the back,
creating a broader pelvic
cavity than males.
Pelvic movement
Concomitant movement of the pelvic girdle
and the thigh at the hip joint are necessary
for efficient joint actions.
Movements of the pelvis are described by
monitoring the ilium - specifically the
anterior superior iliac spine.
Anterior Tilt
forward tilting and
downward
movement of the
pelvis

occurs when the hip
extends
Posterior Tilt
tilting of the pelvis
posteriorly

occurs when the
hip flexes

Lateral Tilt
tilting of the pelvis from neutral
position to the right or left
lateral tilt tends to occur
naturally when you support
your weight on your leg
this allows you raise your
opposite leg enough to swing
through during gait
Pelvic Rotation
rotation of the pelvis defined by the
direction in which the anterior aspect
of the pelvis moves
occurs naturally during unilateral leg
movements (walking)
as the right leg swings forward
during gait the pelvis rotates left
sagittal view of right hip
capitis femoris ligament
(round ligament)
acetabular
labrum
Hip Joint
The femoral head and
acetabulum have large
amounts of spongy,
trabecular bone to help
attenuate forces.
Approximately 70% of
the head of the femur
articulates with the
acetabulum.
iliofemoral
(Y-shaped)
anterior view of
right hip
pubofemoral ligament

Hip Ligaments
Resists extension,
internal rotation and
some external rotation.
Resists abduction and
some external rotation.
posterior view of right hip
ischiofemoral ligament
Hip Ligaments
Resists adduction and
internal rotation.
Note: none of these
ligaments restrict
flexion.
Femoral Neck
The neck holds the femur
away from the pelvis.
It is formed by cancellous
trabecular bone and reinforced
with cortical bone, particularly
on the inferior portion.
The angle of inclination is
measured in the frontal plane
and typically ranges from 90
to 135 degrees.
Coxa Vara
If the angle of inclination is
less than 125 degrees it is
termed coxa vara.
This shortens the limb,
increases the effectiveness of
the abductors, reduces the load
on the femoral head and
increases the load on the
femoral neck.
Coxa Valga
If the angle of inclination is
greater than 125 degrees it is
termed coxa valga.
This lengthens the limb,
reduces the effectiveness of
the abductors, increases the
load on the femoral head and
reduces the load on the
femoral neck.
Angle of Anteversion
The angle of the femoral neck
in the transverse plane is
termed the angle of
anteversion.
Normally the femoral neck is
rotated anteriorly 12 to 14
degrees with respect to the
femur.
Excessive Anteversion
Excessive anteversion beyond
14 degrees causes the head of
the femur become uncovered.
In order to keep the head of
the femur within the
acetabulum a person must
internally rotate the femur.
Retroversion
If the angle of anteversion is
reversed so that it moves
posteriorly, it is termed
retroversion.
This condition causes the
person to externally rotate the
femur.
Hip Range of Motion
Movement Range
flexion 70-140
o

hyperextension 4-15
o

adduction 20
o

abduction 30
o

internal rotation 70
o

external rotation 90
o

Primary Hip Flexors

psoas major

iliacus

(aka iliopsoas)
Assisting Hip Flexors:
pectineus

rectus femoris

sartorius

tensor fascia latae
Assisting Hip Flexors:
pectineus

tensor fascia latae

sartorius

rectus femoris

Hip Extensors

Gluteus maximus

Hamstrings

biceps femoris

semitendinosus

semimembranosus
semimembranosus semitendinosus biceps femoris
B T M
medial
lateral
Biceps Femoris
long head short head
gluteus maximus
gluteus medius & minimus
Hip Extensor Hip Abductors
pectineus
adductor brevis
adductor longus
adductor magnus
Hip Adductors
anterior view
Hip Adductors
posterior view
gracilis
Medial Rotation
of the Hip
due primarily to the
gluteus medius and
minimus
extension of hip tends to
laterally rotate femur so
medial rotators needed to
neutralize this effect
not usually performed
against resistance, thus not a
lot of muscular support
medial much weaker than
lateral rotation
Assisting Muscles
semimembranosus, semitendinosus,
tensor fascia latae, and hip adductors
Lateral Rotation of the Hip
lateral rotation - 5 muscles
lateral rotation is a natural
movement in human gait to
accommodate pelvic
rotation
Phases of Walking
Muscle Footstrike Midsupport Toe-off Swing Decel.
Dorsiflexors *** ** ** ** **
Intrinsic Foot ***
Gluteus Maximus * ** *** *
Gluteus Medius ** *** ** *
Gluteus Minimus ** *** ** *
Hamstrings *** ** ** * **
Iliopsoas ***
Plantar Flexors * **
Quadriceps * *** ** *
Sartorius ** *
Tensor Fascia Latae * ** * ***
Thigh Adductors ** ** * ** *
Muscle Activity During Walking
Hip Fractures
occurs in neck of femur
usually due to a decreased bone mineral density
87% are 65 or older
current annual cost is more than $9.8 billion
accounts for more hospital days, by far, than any
other musculoskeletal injury
results in increased mortality, reduced mobility,
and, for many, the inability to live independently

American Academy of Orthopaedic Surgeons
Hamstring Injuries
few activities require simultaneous hip
flexion and knee extension
usually little hamstring stretch except for
specific exercises
hamstrings susceptible to strain due to this poor
extensibility
injuries most often occur during sprinting -
particularly when muscle is fatigued
Hamstring Injuries - Theories
overstretching of muscle
for example: during overstriding
development of maximal tension when
muscle is fully elongated
development of max tension necessary to act
antagonistically to quads which are stronger
Which side of the body do you use a cane on
when your hip is hurt?
W
opposite
hurt
leg
W
same
hurt
leg