Actions of Hip Muscles William F Dostal, Gary L Soderberg and James G Andrews PHYS THER. 1986; 66:351-359.

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Actions of Hip Muscles

WILLIAM F. DOSTAL, GARY L. SODERBERG, and JAMES G. ANDREWS This article describes and explains the moment arm vector (MAV) concept, uses the concept for the quantitative classification of hip muscles according to action, and applies the findings to selected clinical problems. A three-dimensional, straight-line model of hip musculature was used. Measurements made on a matched, dry bone specimen provided muscle attachment point location data for the model. Straight lines of muscle action between attachment sites were simu lated for a variety of hip configurations during simple hip motions in three principal anatomical planes. We used the MAV concept to identify the three contributions of a muscle (flexion-extension, abduction-adduction, and internal-external rota tion) tending to rotate the thigh segment relative to the pelvis. Muscles were classified according to their action or turning effect at 0, 40, and 90 degrees of hip flexion. Certain muscles exhibited significant changes in their action during these simple motions. Model results were verified using an articulated, dry bone specimen with elastic strings stretched between muscle attachment sites. Based on this geometrical model, a "pathological posture" of hip flexion, adduction, and internal rotation was identified, which is a posture prevalent in spastic, brain damaged patients. Key Words: Anatomic models, Hip, Muscles.

A thorough understanding of the kinesiology of hip function, both in normal and pathological circumstances, is vital to the physical therapist. An important part of this understanding concerns the specific action or turning effect of individual muscles and groups of muscles that cross the hip. Degutis described how the location of the line of action of a muscle force with respect to the axes of rotation of a joint contributes to movement combinations at the joint.1 Biomechanical studies by Morrison2 and Paul3 have contributed significantly to the understanding of hip muscle action during various activities. In recent years, the moment arm vector (MAV) concept has been developed and used in bioengineering studies of the musculoskeletal system.3,4 The MAV concept quantitatively identifies the action of a muscle in tending to rotate one body segment relative to the other about three intersecting and mutually perpendicular axes at a joint center common to both segments. This concept, together with the straight-line model of muscle action, has proven useful in understanding the functional role played by hip muscles during gait and other activities of daily living.5-7 Although a mathematical description of the MAV concept is available in the literature, no detailed discussion of the physical or geometrical aspects of this concept has been published.6 The purposes of this paper are 1) to describe and explain the MAV concept, 2) to utilize the MAV concept for the quantitative classification of hip muscles according to

their action in a variety of standard hip configurations, and 3) to apply the findings to selected clinical problems encountered by the physical therapist.
REVIEW OF THE LITERATURE

Dr. Dostal is Supervisor, Neuromuscular Division, Department of Physical Therapy, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 (USA). Dr. Soderberg is Associate Professor and Associate Director, Physical Therapy Education Programs, College of Medicine, University of Iowa, Iowa City, IA 52242. Mr. Andrews is Professor, Mechanical Engineering, College of Engineering, University of Iowa. This article was submitted March 19,1984; was with the authors for revision 37 weeks; and was accepted July 11,1985.

Various approaches have been used to determine the action of muscles. These have included cadaver experiments, electromyography, and geometrical modeling based on cadaver observations in conjunction with analytical procedures.3,4,8-17 Inman used radiographs of cadavers to determine the spatial relationship between hip abductor muscle lines of action and the joint center.9 Olson et al, in a study of hip abduction strength, applied Inman's findings in conjunction with radiographic data of their own to determine hip abductor moment arm values for healthy subjects.13 Both the Inman and the Olson et al studies were restricted to the frontal plane. Pohtilla strung wires through cadaver muscles and used radiographs to determine moment arms for various hip muscles in a sagittal plane study of various hip configurations.14 He also determined the lengthened state of the muscles for various degrees of hip flexion. Paul used two of the three MAV components to specify the actions of hip "muscle equivalents" for a number of typical joint configurations exhibited during gait.3 He did not, however, attach a special name to this vector. Jensen and associates, in a series of publications, described the curved paths taken by selected hip muscles with the joint in the anatomical position.4,10,11 These investigators froze and transversely sectioned cadaver specimens and traced muscle perimeters in serial sections. They then determined the centroid of each muscle cross section and constructed a smoothed line through these centroids, called the centroid line, which represented the muscle's line-of-action. They also defined a "unit moment vector" for each muscle to compare the action
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of selected muscles for straight- and centroid-line muscle models. The unit moment vector is identical to the MAV. We prefer the latter terminology because the magnitude of this vector is equal to the moment arm of the muscle force about the joint, and because the MAV is not a unit vector. All of these methods for establishing the actions of a muscle

require that a significant amount of detailed anatomical information be known and available in precise mathematical form.
METHOD

The MAV was used in this study to specify the action of hip muscles. Again, the MAV concept quantitatively identifies the action of a muscle in tending to rotate one body segment relative to another about three intersecting and mutually perpendicular axes through a joint center common to both segments. If the joint axes, as in this study, are of flexionextension, abduction-adduction, and internal-external rotation, then the corresponding components of the MAV specify the muscles' relative contributions to the production of a flexion or extension, abduction or adduction, and internal or external rotation moment. The most general expression relating the moment (M) to the MAV d is M = fd where f is the magnitude of the muscle force producing the moment. In our study, we used a three-dimensional hip muscle model. Therefore, the MAV d always had three components, one for each principal orthogonal anatomical plane (sagittal, frontal, and transverse). If the moment were expressed in newton-meters, then the force would be expressed in newtons and the MAV in meters. Centimeters were the units used in this work because, given the magnitude of the

Fig. 1. A) The femur in a convenient, laboratory-based reference frame, B) standardized reference frames embedded in the pelvis and femur, and C) the zero hip joint configuration.

TABLE 1 Components of Moment Arm Vectors for the Zero Joint Configuration (cm) Planes of Motiona Muscles Sartorius Rectus femoris Gracilis Pectineus Adductor longus Adductor brevis Adductor minimus Adductor magnus (middle) Adductor magnus (posterior) Gluteus maximus Gluteus medius (anterior) Gluteus medius (middle) Gluteus medius (posterior) Gluteus minimus (anterior) Gluteus minimus (middle) Gluteus minimus (posterior) Tensor fasciae latae Piriformis Obturator internus Gemellus superior Gemellus inferior Quadratus femoris Obturator externus Biceps femoris Semitendinosus Semimembranosus Iliopsoas Abbreviation Frontal Sagittal -4.0 -4.3 -1.3 -3.6 -4.1 -2.1 -0.9 Transverse -0.3 -0.2 -0.3

SAR RF GRA PEC ADL ADB

AD Ml AD MID AD POST G MAX G MED ANT G MED MID G MED POST G MIN ANT G MIN MID G MIN POST

-3.7 -2.3

7.1 3.2 7.1 7.6 7.6 6.2 3.4 0.7

-6.7 -6.0 -4.3 -5.8 -5.3 -3.9 -5.2 -2.1

1.0 0.7 0.5 0.0

-0.3

3.9 5.8 4.6 0.8 1.4 1.9

-1.0 -0.2

0.4
-2.1

2.3 0.1
-2.4

1.7
-0.3 -1.4

0.3
-3.9

TFL PIR
OB IN GEM SUP GEM INF QUAD FEM OB EX BI FEM SEM TEN SEM MEM PM/I

0.0
-3.1 -3.2 -3.1 -3.3 -3.4 -0.4 -0.6

0.7
-0.1

0.9 4.4 2.4 1.9 0.9 0.4

-0.7

0.1 0.3 0.3 0.4 0.2

-0.7

5.4 5.6 4.6

-1.8

0.5 0.3 0.5

" Frontal plane: + = adduction, - = abduction. Sagittal plane: + = extension, - = flexion. Transverse plane: + = internal rotation, - = external rotation.

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PRACTICE

results obtained, centimeters provided convenient units. A more detailed description and an explanation of the MAV are found in the Appendix. The mathematical derivation of the MAV is based on the vector cross-product expression.6 Our application of the MAV concept to the study of hip muscle action required exact anatomical data. Approximate hip muscle attachment points were marked on the bony pelvis and femur of an adult male dry bone specimen. The coordinates of the attachments and those of key bony landmarks were measured in a convenient, laboratory-based reference frame (Fig. 1A). The coordinate data then were reexpressed in terms of standardized reference frames embedded in the pelvis and femur (Fig. 1B). We adopted a standard hip position or configuration called the zero joint configuration (Fig. 1C). In the zero joint configuration, the orientation of the femur relative to the pelvis was similar to the anatomical position. All hip configurations were expressed relative to this zero joint configuration. All steps in the methodology have been detailed elsewhere.6,18 The straight-line model of muscle behavior represented the force transmitted by a muscle as directed along the straight line connecting the approximate origin point of the muscle on the pelvis and the approximate insertion point on the femur. Muscles with broad regions of attachment were assigned multiple line representations. These muscles included

the gluteus medius and gluteus minimus, each of which was divided into anterior, middle, and posterior segments; the adductor magnus was divided into minimus, middle, and posterior segments. Hip muscles that wrapped around bone or soft tissue during part or all of a hip movement were assigned fictitious attachments near the first point of contact with the obstruction. These muscles included the iliopsoas and obturator externus. The gluteus maximus muscle represented a special case that we will discuss later. Two-joint muscles that crossed both the hip and the knee also were assigned fictitious attachments that closely approximated their true locations at the distal end of the femur. As with the mathematical derivation of the MAV, details relating to the muscle model, coordinate data for bony landmarks and muscle attachment points, and reliability information pertaining to the procedures for identifying, marking, and measuring coordinates have been presented elsewhere.6,18 Coordinate data for 27 hip muscles were used to calculate MAVs for a number of hip configurations. These included the zero joint and other hip configurations occurring during simple movements of the thigh relative to the pelvis in the three principal anatomical planes. Muscles were classified according to action for the zero joint configuration and for 40 and 90 degrees of hipflexion.The actions or turning effects of these 27 muscles were based on the three MAV components for each muscle in each of these three hip configurations.

TABLE 2 Classification of Musclesa According to Action at 0, 40, and 90 Degrees of Hip Flexion Action Degrees Extension All BI FEM SEM TEN SEM MEM AD POST AD MIDb Flexion RF SAR PM/I TFLb Adduction ADB ADL AD Ml AD MIDc,d GRA PECb OB EX Abduction
TFLc,d
b

Internal Rotation

External Rotation QUAD FEMb,d

PIR

0 and 40 only

PECC

0 and 90 only 40 and 90 only QUAD FEMC

AD POSTb,d

G MED ANTC G MED MID G MED POST G MIN ANTC G MIN MID G MIN POST SARb,d
RFb,d

GEM SUP OB IN GEM INF

GEM SUPC

G MED ANT G MIN ANT G MED MIDC G MIN MIDC

OB EXc

0 only 40 only 90 only

G MAXe

ADLb

QUAD FEM

PIR G MED POSTb OB IN G MED POST G MIN POST PIRd

GRAd AD MIDd ADBd ADLd

See Table 1 for a guide to muscle abbreviations. Secondary action at 0 degrees. c Secondary action at 40 degrees. d Secondary action at 90 degrees. e Model not valid for flexed configurations.
b

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RESULTS AND DISCUSSION Table 1 presents components of MAVs for all hip muscles for the zero joint configuration. Note that for the adductor magnus muscle, components are given for each of the three segments (minimus, middle, posterior). Components are given also for each of the segments of the gluteus medius and gluteus minimus muscles. Table 1 illustrates that, for the sartorius muscle, for example, the dominant action (turning effect) was flexion (-4.0), followed closely by abduction (-3.7). This muscle had only a relatively small external rotation component in the zero joint configuration (-0.3). We considered numerous possible criteria for classifying muscles according to action using the MAV component values. The first criterion proved to be both useful and convenient. For each muscle, the action corresponding to the largest MAV component was called the primary action. If, of the remaining two MAV components, either one was equal to or greater than 50% of the largest component value, the corresponding action was designated the secondary action. The muscle then was assigned to two different functional groups for that joint configuration. The 50% cutoff level, although somewhat arbitrary, was high enough that muscles often exhibited secondary actions. No muscle was found to have two secondary actions for the zero joint configuration. The rectus femoris muscle may be used to illustrate the functional classification scheme (Tab. 1). In the zero joint configuration, the largest MAV component for the rectus femoris was that for flexion (-4.3). The next largest component, having a value greater than 53% of the largest component, corresponded to abduction (-2.3). The component for external rotation (-0.2) was very small in comparison with both other actions. The rectus femoris, in the zero joint configuration, therefore, was primarily a flexor and secondarily an abductor according to this classification scheme. Thus, we included it in two functional groups in the zero joint configuration. Table 2 lists the functional groups of hip muscles for various hip configurations and various collections of hip configurations. Based on the straight-line muscle model and MAV concept, the functional groups of hip muscles generally were consistent with traditional anatomical and clinical descriptions of muscle action for the zero joint configuration. Note that those muscles having a secondary action in addition to their primary action are identified in Table 2. The rectus femoris muscle, for example, appeared in theflexorgroup and in the abductor group. Note also that, to use Table 2 to classify hip muscles according to action for any single joint configuration (0, 40, 90 degrees) or for any pair of hip configurations (0 and 40, 0 and 90,40 and 90 degrees), all the corresponding entries listed above that configuration or pair of configurations in the table must be added together. Thus, to determine all those muscles that function either primarily or secondarily as hip extensors in the 40-degree configuration, add together all those muscles in the extensor column that fall into this category ("all," "0 and 40 only," "40 and 90 only"). Table 2 also indicates that no hip muscles functioned primarily or secondarily as internal rotators in the zero joint configuration. The 50% criterion for the secondary muscle action would have to have been lowered below 35% of the largest component value before any hip muscle could have been classified as an internal rotator in the zero configuration. PHYSICAL THERAPY
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Fig. 2. A superior view of the lines of action of right hip musculature in a transverse plane projection relative to the hip joint center (). Lines are directed toward origin points.

Fig. 3. A lateral view of lines of action of right hip musculature in a sagittal plane projection relative to the hip joint center (). Lines are directed toward origin points.

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PRACTICE

If the cutoff level were changed to 35%, however, numerous hip muscles would have appeared in additional functional groups, and some muscles would have had two secondary actions and would have appeared in three functional groups. Table 1 data may be used to make such determinations for the zero joint configuration. The lines of action were studied extensively on graphs projected on principal anatomical planes for the zero joint configuration. Figures 2 to 4 allow easy visualization of the moment arm projection on which a muscle acted in the respective plane. Comparison of one line of action to another also was possible. We emphasize, however, that the component of a moment arm projected onto a given plane is not of the same magnitude as the component of the MAV for the moment in that plane. We also studied the lines of action for each hip muscle using an elastic string skeletal model (Fig. 5). Elastic strings and rubber bands were strung between screw eyes placed at the appropriate muscle attachment points on a dry bone specimen. The elastic string model results verified the results obtained using the MAV concept. Consequently, we have no reservations about using the MAV concept in conjunction with the straight-line muscle model to characterize hip muscle action for the zero joint configuration. As the hip moved through a simulated range of motion, the straight lines of the muscle model shifted locations and orientations relative to the joint center of rotation and relative to each other. Consequently, changes occurred both in the moment arm and in the direction of the line of action of the muscle force, resulting in MAV changes. Figure 6 shows the variations in the three MAV components with joint configuration changes for the anterior segment of the gluteus medius muscle for hip movement from a 20-degree extended to a 90-degree flexed position. The abduction component became progressively smaller while the internal rotation component increased. The flexion-extension component initially had a small extension value in the extended position but, as flexion progressed, reversed action to that of flexion. Thus, the functional group or groups into which a muscle was placed on the basis of the relative magnitudes and algebraic signs of the three MAV components depended on the joint configuration in which the classification was made. We studied graphs similar to Figure 6 for all muscles for simple rotations in the three principal anatomical planes. As previously noted, no hip muscle satisfied the criterion for inclusion in the internal rotation group for the zero joint configuration. The findings were much different, however, when hip muscles were classified for the 40- or 90-degree positions of hip flexion. In the 40-degree position (Tab. 2), the more anterior portions of the gluteus medius and gluteus minimus muscles became primary internal rotators. When the functional classification was carried out for the 90-degree flexed position (Tab. 2), all portions of both the gluteus medius and gluteus minimus became either primary or secondary internal rotators. This finding may relate to the internal rotation posture seen with spastic patients having marked hip flexion in standing. Most of the external rotators in the zero joint configuration became strong abductors in the 90degree flexed position. One may question whether an abduction force generated by this group could support the body

Fig. 4. A posterior view of lines of action of right hip musculature in a frontal plane projection relative to the hip joint center ().

Fig. 5. Elastic string model.

Fig. 6. Changes in the components of the moment arm vector of the anterior portion of the gluteus medius muscle for actions in the frontal (O), sagittal (v), and transverse () planes during hip flexion.

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during the stance phase of gait for a person with marked hip flexion. In addition, Table 2 shows that the primary or secondary actions of muscles causing flexion, extension, and adduction are fairly stable throughout the range of hipflexionfrom 0 to 90 degrees, a range common to many functional activities. This is not the case for the actions of muscles causing abduction and rotation. The gluteus medius muscle is in the best position for abduction in the 0- to 40-degree range. As hip flexion progresses, its anterior, middle, and posterior portions

Fig. 7. Changes in sagittal plane components of selected adductors during hip flexion. TABLE 3 Number of Action Changes for Three Simple Hip Movements

lose their efficacy for abduction, leaving the small external rotators to abduct. Only the tensor fasciae latae and the piriformis muscles maintain a fairly stable abduction action throughout the range offlexionconsidered in this study. The hip must flex to about 40 degrees or beyond before muscles are configured in an advantageous position for internal rotation. These muscles include the portions of the gluteus medius that have, by then, lost their efficacy for abduction. External rotators, like abductors, also are in their most advantageous position for performing their action in the 0- to 40-degree range of hipflexion,before becoming abductors. The actions of the hip muscles in the 40- and 90-degree flexed positions were consistent with our results using the elastic string skeletal model. The only exception was the gluteus maximus muscle, where the straight-line representation was not valid when flexion exceeded approximately 5 degrees because of impingement on underlying bone and muscle. In a previous study of gait that included the gluteus maximus, the extension value of the MAV for this muscle was never allowed to fall below that for the 5-degree flexed configuration.5 The three perpendicular components (actions) of the MAV for each hip muscle changed in magnitude and occasionally in algebraic sign (reversed action) for each of the three simple hip movements studied. Therefore, we studied a total of nine changes (three actions multiplied by three movements) for any given muscle or group of muscles. Figure 7 shows changes

Movements Action Changes 20 Abduction 15 Adduction 20 Extension 40 Flexion 15 External Rotation 15 Internal Rotation

Frontal plane Adduction

cc
Abduction

14
6(2 b )

16
8(4 b )

11
5(0 b )

8 0 13
12 (2b)

6 2 11
5(0 b )

2 4 16
8(4 b )

Sagittal plane Extension

c c

1 0 15
2(0 b )

5 1 15
6(4 b )

6 2 18
11(4 b )

3 10 12
2(0 b )

8 1 12
7(3 b )

2 5 9
5(0 b )

Flexion

c
Transverse plane Internal rotation

5 5 10
3(1 b )

5 0 11
5(3 b )

3 1 12
6(3 b )

External rotation

0 7 17
6(0 b )

3 3 16
9(7 b )

3 3 15
11(3 b )

c
a b

2 9

4 3

1 3

Component of MAV increased or decreased during movement. Action reversed. c C Component of MAV varied by less than 0.2 cm. 356
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PRACTICE

in the flexion-extension actions of a selected group of hip adductors that occurred with sagittal plane movement (one action, one group, one movement). Portions of the adductor magnus muscle exhibited maximal extension values. Four adductors having flexion components in the 20-degree extended position showed changes in sagittal plane action (from flexion to extension) as flexion progressed. The hip extension contribution of the posterior and middlefibersof the adductor magnus may play an important role in hip deceleration and forward thrust of the body during locomotion. The extension role of hip adductors also may assist with leaping and lifting when the hip is in a flexed configuration. Table 3 summarizes all nine action changes studied for the three simple hip movements. (We disregarded the 50% criterion here to provide a more global account of action changes.) Based on the MAV component value at the starting point of each movement, each muscle was assigned an initial action for each of the frontal, sagittal, and transverse planes. Each component then was observed as the hip progressed through the simple movement to determine if the action increased, decreased, remained fairly constant, or reversed (changed algebraic sign). For example, in the 20-degree abducted position, 14 muscles had an adduction action, 13 an abduction action, and 15 an extension action. Of the 13 with an abduction action, 12 decreased in this capability (2 reversed action), 1 increased, and no muscles remained essentially constant as adduction progressed. As internal rotation progressed, 11 muscles decreased extension capability (4 reversed action), and 11 also decreased external rotation capability (3 reversed action). As flexion progressed, 9 muscles showed a decrease in external rotation capability (7 reversed action). Many patients with spastic neurological disorders show exaggerated flexion, adduction, and internal rotation at the hip in standing posture. From an analysis of the information presented in Table 3, this clearly seems to be a pathological posture in the sense that geometrical changes governing muscle action contribute to further exaggeration rather than correction or control of the posture. This occurs because, in adduction, the abductor muscles reduce their action. Similarly, in internal rotation, both the extensors and the external rotators reduce their action. Finally, in flexion, the external rotators reverse their action. A reasonable therapeutic approach in dealing with this postural problem, therefore, would appear to be an emphasis on hip extension, abduction, and external rotation, while inhibiting spasticity and facilitating normal equilibrium responses in neurodevelopmental postures such as knee-standing, half-kneeling (stance limb), and standing. Such an approach has been advocated by the Bobaths.19 Likewise, for musculoskeletal disorders of the hip, our study supports the use of extension and abduction as the positions of maximum stability. Working backward, Table 3 shows that 12 of 13 abductor muscles increased their abduction capability as abduction progressed. The fact that 6 of 15 muscles increased extension capability during hip extension, when related to concurrent stretch of the anterior capsule and iliofemoral ligament of the hip, should further reinforce the clinician's use of hip abduction and extension as the position of stability. Caution should be taken when applying the results displayed in Table 3 to general posture or gait. The MAV
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components that led to these results were generated for simple rotational movements in principal anatomical planes about mutually perpendicular joint axes. Posture and gait, however, are not restricted to such simple joint configurations, and must be analyzed, therefore, with considerable care if the results truly are to represent in vivo events. We also should point out that the straight-line model of hip musculature is a gross simplification of this complex system. The three-dimensional curvilinear contractile element connecting adjacent segments, packed between bones and subcutaneous tissue and constrained by a facial labyrinth of bindings, is reduced to a straight line, unfettered in most cases by adjacent structures. The advantage of the model is simplification of the system to a degree that allows easy analysis of mechanical action in an efficient and reasonably accurate manner. This model has been used successfully to analyze the forces and moments acting on the hip during normal and pathological gait.5 Coordinate data used in this study were far more complete than any anatomical data previously gathered for the analysis of hip muscle mechanics.3'4'9"11131416 Only three previous studies provided data for various joint configurations. Inman9 and Olson et al13 presented moment arm measurements, but only for hip abductors and only for changes with frontal plane movement. Pohtilla provided similar information about certain flexors and extensors for changes with sagittal plane movements.14 Work with the MAV and the straight-line muscle model is but one of many early steps taken by us to gain a better understanding of hip mechanics. An application of the model to the study of gait in conjunction with kinematic and kinetic analyses answered pragmatic questions asked by engineers designing hip replacements and surgeons inserting them.5 An application to functional activities in conjunction with an electromyographic analysis helped us to understand the complexity of the neurocontrol of the gluteus medius muscle.7 To date, the model has not been applied systematically in conjunction with kinematic, kinetic, or EMG analyses to the study of therapeutic exercises of the hip (including mat activities) or to specific hip configurations commonly seen during the neurodevelopmental sequence. Such applications would have to include configurations encountered with diagonal movement patterns. The anatomical model also should be expanded beyond the hip and tailored tofitindividual patients or subjects. The first effort to tailor or individualize bony landmark and muscle attachment point data of the hip was of limited success.18 Use of the MAV concept, in conjunction with the straight-line muscle model, should improve our understanding of muscle action at any joint. The computer simulations presented here to study a variety of hip configurations illustrate problems associated with the classification of hip muscles according to their action. We hope this investigation has raised significant questions about the role of hip muscles in various hip configurations and will lead to further constructive research.

SUMMARY

The MAV concept provides a convenient quantitative method for characterizing the action of a muscle with the joint in any general configuration. The MAV concept was 357

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presented in both descriptive and geometrical terms. We used a straight-line model of muscle behavior in conjunction with the MAV concept to specify the action of 27 hip muscles for both the zero joint configuration (a neutral joint configuration corresponding to the anatomical position) and for configurations associated with simple thigh movements in the sagittal, frontal, and transverse planes. Muscles were classified according to their action for hip configurations at 0, 40, and 90 degrees of hip flexion. Changes in the functional capabilities of muscles also were described and discussed for selected groups of hip muscles, and these changes were related to clinical problems. Based on geometrical findings, a "pathological posture" of hip flexion, adduction, and internal rotation was identified. The MAV concept and the straight-line muscle model have proven to be useful and convenient in studying the kinesiology and pathokinesiology of hip function. REFERENCES
1. Degutis EW: A problem solving approach to muscle action. Kinesiology Review 2:20-31,1971 2. Morrison JB: The mechanics of muscle function in locomotion. J Biomech 3:431-451,1970 3. Paul JP: Biomechanics and related bio-engineering topics. In: Proceedings: A Symposium on Bio-Engineering Studies of the Forces Transmitted by Joints. Glasgow, Scotland, September 1964, Part II: Engineering Analysis. Oxford, England, Pergamon Press Ltd, 1965, pp 369-380 4. Jensen RH, Davy DT: An investigation of muscle lines of action about the hip: A centroid line approach vs. the straight line approach. J Biomech 8:103-110,1975 5. Crowinshield RD, Johnston RC, Andrews JG, et al: A biomechanical investigation of the human hip. J Biomech 11:75-85,1978 6. Dostal WF, Andrews JG: A three-dimensional biomechanical model of hip musculature. J Biomech 14:803-812,1981 7. Soderberg GL, Dostal WF: Electromyographic study of three parts of the gluteus medius muscle during functional activities. Phys Ther 58:691-696, 1978 8. Basmajian JV: Muscles Alive: Their Functions Revealed by Electromyog raphy, ed 3. Baltimore, MD, Williams & Wilkins, 1974 9. Inman VT: Functional aspects of the abductor muscles of the hip. J Bone Joint Surg [Am] 29:607-619,1947 10. Jensen RH: Muscles as Centroid Lines. Doctoral Dissertation. Iowa City, IA, University of Iowa, 1973 11. Jensen RH, Metcalf WK: A systematic approach to the quantitative de scription of musculoskeletal geometry. J Anat 119:209-221,1975 12. Lieb FJ, Perry J: Quadriceps function: An anatomical and mechanical study using amputated limbs. J Bone Joint Surg [Am] 5:1535-1548,1968 13. Olson VL, Smidt GL, Johnston RC: The maximum torque generated by the eccentric, isometric, and concentric contractions of the hip abductor muscles. Phys Ther 52:149-158,1972 14. Pohtilla VF: Kinesiology of hip extensors at selected angles of pelvifemoral extension. Am J Phys Med 50:241-250,1969 15. Seireg A, Arvikar RJ: The prediction of muscular load sharing and joint forces in the lower extremities during walking. J Biomech 8:89-102,1975 16. Sorbi C, Zalter R: Biomechanics and related bio-engineering topics. In: Proceedings: A Symposium on Bio-Engineering Studies of the Forces Transmitted by Joints. Glasgow, Scotland, September 1964, Part I: Engi neering Analysis. Oxford, England, Pergamon Press Ltd, 1965, pp 359367 17. Steindler A: Kinesiology: Of the Human Body Under Normal and Patholog ical Conditions. Springfield, IL, Charles C Thomas, Publisher, 1955 18. Dostal WF: The Prediction of Coordinates of Bony Landmark and Hip Muscle Attachment Points. Doctoral Dissertation. Iowa City, IA, University of Iowa, 1979 19. Bobath K, Bobath B: The facilitation of normal postural reactions in the treatment of cerebral palsy. Physiotherapy 50:246-262,1964

Fig. A 1 . Sagittal plane view through joint J in segment B showing muscle force f applied at point P with moment arm d about J. The turning effect of f is about the z-axis in the x, y plane.

Fig. A 2 . General MAV d, with x, y, z components dX, d y , d z , and x, y, z unit vectors i, j , k.

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PRACTICE

APPENDIX Moment Arm Vector Concept

To understand the MAV concept, consider first the simple case when a muscle force (f) acts on segment B at point P in the neighborhood of joint center J and lies in a principal anatomical plane (eg, the sagittal x, y plane containing J; Fig. A1). The magnitude (M) of the moment or turning effect of f about J is defined as the product of the magnitude (f) of the force vector f and the length of the moment arm (d), or shortest (perpendicular) distance from J to the line of action of f. Thus, M = f d The turning effect of f about J also has a direction or rotational sense (clockwise or counterclockwise) that may be described con veniently using the right-hand rule. This rule states that when the right-hand fingers are curled in the direction of the turning effect about J (clockwise or counterclockwise), the direction of the extended right-hand thumb is used, for convenience, to indicate the direction or sense of the rotation. Thus, in this instance, the directed turning effect (M) of f about J can be expressed simply as M = fdk, where k is a unit vector in the positive z-direction. This method of describing the directed turning effect of a muscle force (f) about a joint (J) can be generalized easily, and_ the most general directed turning effect can be expressed as M = fd, where d is the MAV. In the previous example, d = dk. In the general case, d = du, where d is the moment arm, or shortest distance from J to the line of action of f, and u is a unit vector indicating the direction or sense of the rotational effect in accordance with the right-hand rule. We should emphasize that, although d has as its magnitude the length of the moment arm (d), the direction of d does not coincide with the orientation of the moment arm (d). Rather, the direction of d is along the axis of rotation about which the turning effect occurs. Note that this axis is perpendicular to the plane containing J and f, and its direction is established in accordance with the right-hand rule. The governing equation M = fd indicates that the direction of the directed turning effect (M) of a particular muscle and the direction of d are the same. The vector M is merely a scalar multiple of the vector d, where the scalar multiplier is the magnitude (f) of the force vector (f). The d is, in fact, equal to M when the muscle force magnitude (f) is equal to unity. This observation apparently led Jensen and Davy to describe d as the unit moment vector, or the moment vector per unit of force.4 In the general case,the direction of d, or the direction of the directed turning effect (M), will not be parallel to a principal anatomical axis (ie, the axes of flexion or extension, abduction or adduction, and internal or external rotation). Instead, d will be inclined to the three principal anatomical axes (x, y, z) at the joint, and may be decom posed readily into x, y, and z components. Thus, referring to Figure A2, d can be expressed as d = dxi + dyj + d z k, where i, j, and k are unit vectors in the positive x, y, and z directions, respectively, and d x , d y , and d z are the corresponding MAV components. The directed turning effect of f about J, at any instant, therefore, can be described by the vector M, where M = fd, and d can be decomposed and expressed in terms of three components parallel to the three principal anatomical joint axes. These three MAV compo nents, d x , d y , and d z , describe the turning effects of f about each of the three joint axes passing through J or indicate the three simulta neous turning actions of the muscle at that instant. Thus, the com ponent with the largest magnitude (dominant turning effect) repre sents the primary action of the muscle, the component of intermediate magnitude corresponds to the intermediate muscle action, and the component with the smallest magnitude is associated with the least significant action of the muscle. The algebraic sign (positive or neg ative) of the component indicates if the turning effect is directed along the positive or negative coordinate axis (in accordance with the righthand rule). To illustrate the MAV concept, consider the case when, for a specific joint configuration, the MAV for a particular muscle A in the neighborhood of joint J has the following x, y, and z components: d x = 1.5 cm, d y = - 2 . 5 cm, d z = - 1 . 0 cm. Let the positive x, y, and z axes at J correspond to adduction, extension, and internal rotation, respectively. The primary action of A in the neighborhood of J, therefore, is flexion (dy has the largest magnitude and is negative), the secondary action is adduction (d x has the second largest magni tude and is positive), and the tertiary action is external rotation (d z has the smallest magnitude and is negative). The three MAV com ponents d x , d y , and d z are in the ratio of 3 : - 5 : - 2 , so the relative turning effects of A about the three joint axes through J are also in the ratio of 3 : - 5 : - 2 .

Commentary
I commend Dostal and associates for using the moment arm vector (MAV) concept to study the actions of hip muscles. I support their efforts to demonstrate how the MAV concept and the straight-line muscle model can contribute to a thorough understanding of muscle function and movement dysfunctions encountered by physical therapists. I hope my comments further help the reader understand the model and the implications of the study and contribute to development of the model and its application to physical therapy. The authors describe the MAV concept and muscle model in clear, concise language. The Appendix and Figures contribute to understanding the concept. Several aspects of the model warrant comment. The simulated actions of manv muscles can be examined simultaneously in relation to three planes in a variety of hip positions. As a result, the relative magnitude and direction of each muscle's action in the three planes can be calculated over a wide range of hip positions. The authors demonstrated geometrical evidence that the three component actions of most hip muscles change according to various positions of the femur in relation to a fixed pelvis. Such information supports the concept that most muscles have multiple actions and, therefore, contribute to movements in spiral and diagonal patterns, a concept that has gained widespread acceptance and application in physical therapy. The method is limited, however, because the magnitude of the direction of pull caused by one muscle cannot be compared with that of another muscle. For example, the rectus femoris muscle has a component arm vector of -4.3 cm of flexion in the sagittal plane (Tab. 1). The iliopsoas muscle has a component arm vector of -1.8 cm of flexion. These numbers indicate that, within the MAV components of each muscle,flexionis the primary direction of action, not that the

Volume 66 / Number 3, March 1986 Downloaded from http://ptjournal.apta.org/ by guest on March 27, 2013

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Actions of Hip Muscles William F Dostal, Gary L Soderberg and James G Andrews PHYS THER. 1986; 66:351-359.

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