Muscle Anatomy

[Sassy69]

This is where I have had all the problems from my rotated pelvis - my lower back gets sore and I get ridiculously tight sorta in the hams, sorta in the glutes. This in turn has impacted my ability to comfortably do squats & deads.

D_G -- the change I made in my approach to my warm ups in the gym --

- short cardio warmup
- 10 min dynamic warmup- basically running like "football drills" - back & forth in the aerobics room -- 1 cycle sprint, 1 cycle butt kick run, 1 lap high knee sprint, couple laps things like karate side kicks, front kicks, back kicks.

Then go into some static stretches, including treil's stretches above -those actually feel amazingly good on the ileo / psoas area.

 

[treilin]

SEP 26 2006

O.k. Daisy here u go:
I will list each muscle over the next few days.

Short Lateral Rotators of the Hip
(From North to South in this order stacked)

Piriformis
Gemellus Superior
Obturator internus
Gemellus Inferior
Obturator Externus
Quadratus femoris

All insert into greater trochanter of the femur. These muscles go mostly from the back of the trochanter to the back of the pelvis.

-These muscles are often over used and tightness can occur in the pelvic floor and anus as well.

-A person with no butt may have overly tight lateral rotator muscles because this will bring the coccyx in like a dog who tucks it’s tale between it’s legs.

-Antagonists = Hip Flexors : iliacus, psoas, pectineus, anterior adductors, TFL, Rectus Femoris,

-All laterally rotate hip as we step forward, change direction, and mostly to stabilize the hip joint especially when the leg is extended.

Important for posture and dynamic core support

1) Piriformis
Axial/appendicular connection from the spine to the leg. It affects the sacrum by pulling down and forward below the sacroiliac joint, and there fore it posteriorly tilts the pelvis..

-Origin: The anterior (front) part of the sacrum, the part of the spine in the gluteal region, and from the gluteal surface of the ilium (as well as the sacro-iliac joint capsule and the sacrotuberous ligament)

- Insertion: It exits the pelvis through the greater sciatic foramen to insert on the greater trochanter of the femur

-Antagonist is the posas which again pulls anteriorly on the pelvis, but like the psoas (both go to the femur) they both pull the pelvis into extension.

-Pyrimidial shaped muscle

-Name Meaning- Latin for Pear shaped

-Nerve to Piriformis innervates the piriformis muscle

-Stretch 1:
Sit with one leg straight out in front. Hold onto the ankle of your other leg and pull it directly towards your chest.

-Stretch 2:
Lie face down and bend one leg under your stomach, then lean towards the ground.

Medical Issues:

Piriformis syndrome is a rare neuromuscular disorder that occurs when the piriformis muscle compresses or irritates the sciatic nerve-the largest nerve in the body. The piriformis muscle is a narrow muscle located in the buttocks. Compression of the sciatic nerve causes pain-frequently described as tingling or numbness-in the buttocks and along the nerve, often down to the leg. Pain (or a dull ache) is the most common and obvious symptom associated with piriformis syndrome. This is most often experienced deep within the hip and buttocks region, but can also be experienced anywhere from the lower back to the lower leg.
Weakness, stiffness and a general restriction of movement are also quite common in sufferers of piriformis syndrome. Even tingling and numbness in the legs can be experienced.


Treatment :
Generally, treatment for the disorder begins with stretching exercises and massage. Anti-inflammatory drugs may be prescribed. Cessation of running, bicycling, or similar activities may be advised. A corticosteroid injection near where the piriformis muscle and the sciatic nerve meet may provide temporary relief. In some cases, surgery is recommended

Overload (or training errors): Piriformis syndrome is commonly associated with sports that require a lot of running, change of direction or weight bearing activity. However, piriformis syndrome is not only found in athletes. In fact, a large proportion of reported cases occur in people who lead a sedentary lifestyle. Other overload causes include:
• Exercising on hard surfaces, like concrete;
• Exercising on uneven ground;
• Beginning an exercise program after a long lay-off period;
• Increasing exercise intensity or duration too quickly;
• Exercising in worn out or ill fitting shoes; and
• Sitting for long periods of time.

 

[treilin]

Sep 27 2006

Second Deep lateral Rotator covered

Superior Gemellus

ORIGIN: Spine of ischium

INSERTION: Middle part of medial aspect of greater trochanter of femur

ACTION: Externally rotates thigh, Abducts thigh when flexed, Stabilize the hip joint

FUNCTION: The lateral rotators of the hips main function is to rotate your hips from side to side. This occurs during movements such as swinging a baseball bat, swinging a golf club, swinging a tennis racket, throwing punches while boxing and throwing a shot put and discus.

NERVE: Nerve to obturator internus (L5, S1, 2) (nerve to obturator internus originates in the sacral plexus. It arises from the ventral divisions of the fifth lumbar and first and second sacral nerves)
Artery: Inferior gluteal artery

Notes:
Smaller then Gemellus Inferior

The Gemellus Superior, May cause symptoms of sciatica because of the compression of the tibial nerve between the gemellus superior and obturator internus muscles. Eventually, because of this pathology, there may be a new found syndrome called the Gemellus Superior syndrome, similar to the Piriformis syndrome. Severe pain may be felt upon hip abduction and internal rotation.

Variations of this muscle are a rare abnormality. This muscle has been found to be absent in 8% of white people, and 6% of black people.

It is anterior to the obturator internus, posterior to the gluteus medius, and deep to the gluteus maximus. It is approximately the same size and shape as the obturator internus.

 

[treilin]

SEP 28 2006
Third of the deep lateral rotators from superior to inferior:

Obturator Internus

Origin : Internal surface of obturator membrane and posterior bony margins of obturator foramen

Insertion : Medial surface of greater trochanter of femur, in common with superior and inferior gemelli

Action : Rotates the thigh laterally; also helps abduct the thigh when it is flexed (Horizontal flexion)

Nerve : Nerve to the obturator internus and superior gemellus -- a branch of the sacral plexus (L5, S1)

Artery: Internal pudendal and superior and inferior gluteal arteries

Notes:
-The Obturator internus is situated partly within the lesser pelvis, and partly at the back of the hip-joint.

-Fibers converge rapidly toward the lesser sciatic foramen, and end in four or five tendinous bands, which are found on the deep surface of the muscle; these bands are reflected at a right angle over the grooved surface of the ischium between its spine and tuberosity.

- A bursa, narrow and elongated in form, is usually found between the tendon and the capsule of the hip-joint; it occasionally communicates with the bursa between the tendon and the ischium.

- It is thick, fan-shaped muscle within the pelvis that covers the obturator foramen, attaching around its' perimeter, and to the thick obturator membrane.

- Both gemelli fuse with the tendon of OB. I. before its insertion.

-Obturator Internus tendonitis:

OBTURATOR INTERNUS TENDONITIS AS A SOURCE OF CHRONIC HIP PAIN: A CASE REPORT. The Pittsburgh Orthopaedic Journal, Vol 12, 2001.
Rachel S. Rohde, MD Bruce H. Ziran, MD

A 39 year old physical therapist that developed progressive right gluteal and pelvic pain insidiously two days after a ten minute rowing session. Radiographs were normal, NSAID’s and physical therapy were unsuccessful, and the pain continued to be vague. Because of a past hysterectomy, a women’s health specialist evaluated her, and MRI and CT scans were negative except for mild scarring at the site of the hysterectomy. PT included US, conditioning, and trans-vaginal pelvic musculature massage. Other conditions, such as SI dysfunction, labral pathology, spinal pathology, pelvic instability, piriformis syndrome trochanteric bursitis, and pelvic disease were all negative. Within one year, the pain was more focalized at the posterior trochanter, although not at the trochanter. Pain increased with flexion and stretching the hamstrings, along with resistance to the hamstrings, ER, and abduction. Repeat MRI showed some swelling at the right obturator internus muscle, but an injection of an anesthetic and steroid provided no relief. More than one year after onset, a CT guided anesthetic injection into the tendon sheath of the obturator provided 3 days of relief, and the diagnosis of obturator internus tendonitis was made. Continued conservative treatment failed, and almost two years after onset, a release of the tendon from the trochanter was performed. Histology of the tissue showed signs of chronic inflammation, the trochanteric bursa showed signs of inflammation, and there was scarring at the sciatic nerve. Post-op PT and stretching was utilized, and the patient had a full recovery.

 

[treilin]

SEP 29 2006

Gemellus Inferior Fourth of the deep lateral rotators from superior to Inferior

ORIGIN
Ischial tuberosity

INSERTION
Greater trochanter of hip

ACTION
stabilization
lateral rotation in a horizontal plane of hip
extension
abduction with the thigh flexed

NERVE:
innervated by the nerve to quadratus femoris (L5, S1, S2).

BONES/JOINTS
Ischial tuberosity , greater trochanter of hip
Illiofemora, ischiofemoral, pubofemoral ligaments

EXERCISES AS PRIME MOVER (agonist)
Lunges, cable kick backs, machine and floor hip extensions,
Bridging, cable hip abductions

NOTE:
-This muscle really did not have any extra information on it...

-In most specimens, the inferior gemellus originated from the lateral surface of the ischial tuberosity and also from the medial surface (intrapelvic origin) just beneath the obturator internus and was covered by the falciform process of the sacrotuberous ligament.

-Obturator internus injury may occur and be hidden by the piriformis syndrome. Clinical symptoms may offer some clues to the clinician.

 

[treilin]

Oct 2, 2006
Quadratus Femoris,

Last of the deep lateral rotators in the upper thigh.

-Definition: flat, quadrilateral muscle, between the Gemellus inferior and the upper margin of the Adductor magnus; it is separated from the latter by the terminal branches of the medial femoral circumflex vessels.

-Name Meaning: Latin, quadratus = square

-Origin: arises from the upper part of the external border of the tuberosity of the ischium

-Insertion: into the upper part of the linea quadrata—that is, the line which extends vertically downward from the intertrochanteric crest

-Nerves: the last lumbar and first sacral nerves (L4, 5, S1)

-Artery: inferior gluteal

-Action: Laterally (external) rotates, helps adduct the hip, and stabilizes hip

-Synergists: piriformis, obturator externus, obturator internus, gemellus superior, gemellus inferior

Notes:
-Adductor magnus may be more or less segmented, the anterior and superior portion is often described as a separate muscle, the Adductor minimus. The muscle may be fused with the Quadratus femoris.

- A bursa is often found between the front of this muscle and the lesser trochanter. Sometimes absent.

- The quadratus femoris nerve originated from more cranial segments than the obturator internus nerve, however these nerves had various communication patterns inside and outside the muscles. According to the intramuscular nerve distribution, in some specimens the branches to the superior gemellus from the quadratus femoris nerve extended to the inferior gemellus, and the branches to the inferior gemellus were distributed to the obturator internus.

 

[treilin]

OCT 04 2006

HAMSTRING GROUP
Semitendinosus, Semimembranosus, Biceps Femoris

Stretches:

In this, simply kneel down on one knee and place your other leg straight out in front with your heal on the ground. Keep your back straight. Make sure your toes are pointing straight up and gently reach towards your toes with one hand. Use your other arm for balance. Hold this stretch for about 20 to 30 seconds and repeat at least 2 to 3 times.

In this stretch, stand with one foot raised onto a chair, fence railing or similar object. Keep your raised leg slightly bent, with your toes on the edge of the chair. Let your heal drop off the edge of the chair. Keep your back straight and gently move your chest towards your raised leg. As above, hold this stretch for about 20 to 30 seconds and repeat at least 2 to 3 times.

Hamstring Injury:
If you do happen to suffer from a hamstring injury, it's important that correct first aid principles are applied immediately. The RICER regime explains the correct treatment for all muscle strain injuries. RICER stand for Rest, Ice, Compression, Elevation, and then obtaining a Referral from a qualified sports doctor or physiotherapist. So, as soon as a hamstring injury occurs, rest the injured limb, apply ice to the effected area, apply a compression bandage and elevate the limb if possible. This treatment needs to continue for at least 48 to 72 hours. This is the most critical time for the injured area, correct treatment now can mean the difference between an annoying injury or a permanent, re-occurring, debilitating injury.

After the first 72 hours obtain a referral from a qualified professional and start a comprehensive rehabilitation program. This should include a great deal of strength and stretching exercises, as well as other rehabilitation activities such as massage and ultra-sound.

- Athletes particularly vulnerable are competitors involved in sports which require a high degree of speed, power and agility. Sports such as Track & Field (especially the sprinting events) and other sports such as soccer, basketball, tennis and football seem to have more than their fair share of hamstring injuries.

Source: http://www.thestretchinghandbook.com/archives/hamstring-injury-treatment.htm

Strengthening exercises:
An example of knee flexion is the leg curl exercise and an example of hip extension is the stiff-legged deadlift exercise.
One can also do squats, lunges, standing curls, to name a few.

Notes:
-The Hamstrings are primarily fast-twitch muscles, responding to low reps and powerful movements


1) Semitendinosus

Origin: Upper inner quadrant of posterior surface of ischial tuberosity with biceps femoris.

Insertion: Upper medial shaft of tibia below gracilis, called the Pes Anserine attachment

Action: Flexes and medially rotates the calf at the knee; extends, adducts and medially rotates the thigh at the hip

-This muscle is unique in that in can reverse Origin and insertion when this occurs:
when leg is fixed, it assists posterior stability of the pelvis and extends the pelvis
on the hip


Nerve: Tibial portion of sciatic nerve (L4, L5, S1, S2)

Synergists: semimembranosus, biceps femoris, gastrocnemius, gracilis, sartorius

Antagonists: Quadriceps Group

Notes:
-Patellar tendon and Semitendinosus are both used in anterior cruciate ligament (ACL) reconstruction

- Shares common attachment with biceps femoris muscle.

- Body is fusiform that ends at about 50% of the total length and runs on the surface of semimembranosus.

-Tendon curves around the medial tibial condyle, over the medial collateral ligament, inserts behind sartorius, and distal to gracilis.

 

[treilin]

I have been slacking on this but will add some more here in the next week!!! Maybe I will today

 

[treilin]

NOV 1 2006
O.k. the long awaited continuation:
HAMSTRING GROUP CONTINUED:

2) Semimembranosus of 3
*Pictures and stretches are located in the main log on hamstring group.


The semimembranosus, so called from its membranous tendon of origin, is situated at the back and medial side of the thigh. It arises by a thick tendon from the upper and outer impression on the tuberosity of the ischium, above and lateral to the biceps femoris and semitendinosus.

Origin: Superior lateral quadrant of posterior surface of ischial tuberosity

Insertion: Horizontal groove on the posterior Medial condyle of tibia below articular margin, fascia over popliteus and oblique popliteal ligament. The tendon of insertion gives off certain fibrous expansions: one, of considerable size, passes upward and lateralward to be inserted into the back part of the lateral condyle of the femur, forming part of the oblique popliteal ligament of the knee-joint; a second is continued downward to the fascia which covers the Popliteus muscle; while a few fibers join the tibial collateral ligament of the joint and the fascia of the leg. The muscle overlaps the upper part of the popliteal vessels

Action: Extends the thigh, flexes the knee, and also rotates the tibia medially, especially when the knee is flexed

Nerve: Tibial portion of sciatic nerve (L5, S1)

Artery: Perforating branches of profunda femoris artery, inferior gluteal artery, and the superior muscular branches of popliteal artery


Notes:

Variations: It may be reduced or absent in some people, or double, arising mainly from the sacrotuberous ligament and giving a slip to the femur or adductor magnus

Semimembranosus Tendonitis

Baker cyst is a synovial cyst located posterior to the medial femoral condyle between the tendons of the medial head of the gastrocnemius and semimembranosus muscles
**popliteal cyst, is the most common mass in the popliteal fossa and results from fluid distension of the gastrocnemio-semimembranosus bursa. A popliteal cyst may serve as a protective mechanism for the knee. Intrinsic intra-articular disorders cause joint effusion

-Strains may occur in any region of the muscle, but are most common at the musculotendinous junction. Tensile forces are particularly high at the proximal musculotendinous junction because it is the common attachment for all three major heads of the hamstrings. Consequently, strains are common here. However, strains may occur in the middle of the muscle belly as well. A strain involves muscle-fiber tearing from excessive tensile stress. However, excess stress alone does not create the injury. Instead, muscle strains occur most often when the muscle is exposed to tensile (pulling) stress while it is contracting. Tensile stress during contraction is most common during eccentric contractions. Forces on the muscle are greater in an eccentric contraction than in an isometric or concentric contraction, which is why so many strains occur from eccentric overloading.



FYI:
Knee Stabilization Notes:
Anterolateral stabilization is provided by the capsule and iliotibial tract. Posterolateral stabilization is provided by the arcuate ligament complex, which comprises the lateral collateral ligament; biceps femoris tendon; popliteus muscle and tendon; popliteal meniscal and popliteal fibular ligaments; oblique popliteal, arcuate, and fabellofibular ligaments; and lateral gastrocnemius muscle. Injuries to lateral knee structures are less common than injuries to medial knee structures but may be more disabling. Most lateral compartment injuries are associated with damage to the cruciate ligaments and medial knee structures. Moreover, such injuries are frequently overlooked at clinical examination. Structures of the anterolateral quadrant are the most frequently injured; posterolateral instability is considerably less common. Practically all tears of the lateral collateral ligament are associated with damage to posterolateral knee structures. Most injuries of the popliteus muscle and tendon are associated with damage to other knee structures.

 

[future]

This is a cool thread. Love this!