Learning Modules - Medical Gross Anatomy
Movements of the Lower Limb - Page 1 of 12
Movements of the Lower Limb - Introduction
This module presents the nomenclature of movement at the joints of the lower
limb. When you first approach your study of the lower limb, concentrate on the
motions and less on the names of muscles producing those motions. After you have
studied the lower limb, use this module to review and summarize muscle actions at
the joints of the lower limb.
The lower limb is our primary tool for locomotion, and therefore it is adapted
to provide a stable yet mobile structure. There is a great number of joints within the
entire lower limb, allowing for locomotion over uneven ground at varying velocities
and with rapidly changing directions.
In comparing the upper and lower limbs, it is evident that the upper limb is
specialized as the organ of manipulation, and the lower limb serves for locomotion.
To serve these purposes, the upper limb emphasizes mobility and sacrifices stability,
while the lower limb emphasizes stability and sacrifices mobility. The contrast is
perhaps most striking when comparing the mobile pectoral girdle (clavicles and
scapulae) to the rigid pelvic girdle (os coxae and sacrum).
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Movements of the Lower Limb - Page 2 of 12
Thigh Flexion and Extension
Flexion of the thigh is also called flexion
of the hip.
Muscles: iliopsoas (psoas major and
iliacus) is the most powerful flexor, assisted
by sartorius, rectus femoris, and pectineus.
Extension of the thigh is also called hip
extension. Any movement away from flexion
is extension.
Muscles: gluteus maximus is the most
powerful hip extensor, assisted by the
hamstring muscles (semitendinosus,
semimembranosus, biceps femoris).
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Thigh Abduction and Adduction
Abduction of the thigh is also called hip
abduction. The thigh is pulled laterally away
from the midline.
Muscles: gluteus medius and minimus are
the most powerful hip abductors, assisted by
piriformis and tensor fasciae latae.
The hip abductors are active in
stabilizing the contralateral hip when the foot
is lifted off the ground during walking, i.e.
when the right foot is off the ground and
moving forward, the hip abductors on the left
are contracting. This keeps the pelvis from
falling toward the unsupported right side.
Adduction of the thigh is also called hip
adduction. The thigh moves medially toward
the midline.
Muscles: adductor longus, adductor
brevis, adductor magnus, and gracilis are the
powerful hip adductors, assisted by pectineus.
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Thigh Medial and Lateral Rotation
Medial rotation of the thigh or hip brings
the knee and foot medially.
Muscles: gluteus medius and minimus,
and the adductors (longus, brevis, magnus).
With the contralateral foot elevated,
contraction of the gluteus medius and
minimus during walking swings the pelvis
anteriorly (by trying to medially rotate the
fixed thigh, and thereby rotating the pelvis
forward). These muscles do this while
stabilizing the hip with their abduction force.
Lateral rotation of the thigh or hip
moves the knee and foot laterally.
Muscles: gluteus maximus is most
powerful, assisted by piriformis, obturator
internus and externus, the gemelli, and
quadratus femoris.
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Movements of the Lower Limb - Page 5 of 12
Thigh Circumduction
Circumduction at a joint is a motion that
circumscribes a cone. The hip, although designed for
stabile mobility, can still circumscribe a cone.
Muscles: all those that move the thigh.
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Leg Flexion and Extension
Flexion of the leg is flexion at the knee.
Only slight rotation can occur at the knee
joint.
Muscles: sartorius, gracilis, hamstrings
(semitendinosus, semimembranosus, biceps
femoris), gastrocnemius, plantaris
Extension of the leg is extension at the
knee. Only slight rotation can occur at the
knee joint.
Muscles: quadriceps (rectus femoris, and
vastus lateralis, medialis, and intermedius)
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Valgus and varus movements
Genu valgum is the clinical term for
"knock-knee". The medial collateral ligament
limits this movement, so a valgus stress is
placed on the knee to test the integrity of this
ligament.
Genu varus is the clinical term for "bowleg". The lateral collateral ligament limits this
movement, so a varus stress is placed on the
knee to test the integrity of this ligament
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Dorsiflexion and Plantarflexion
Dorsiflexion moves the top (dorsum) of the foot up toward the
anterior surface of the leg. It could be considered "true" extension at the
ankle.
Muscles: tibialis anterior, extensor digitorum longus, extensor
hallucis longus, fibularis tertius.
Plantarflexion moves the foot in line with the leg to point the toes.
It could be considered "true" flexion at the ankle.
Muscles: gastrocnemius, soleus, plantaris, tibialis posterior, flexor
digitorum longus, flexor hallucis longus, fibularis longus and brevis.
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Inversion and Eversion
Inversion is a movement at the ankle and foot that is similar to
supination. The sole of the foot moves to face the midline. However,
while supination occurs by rotation of the radius, the leg bones do not
move relative to each other. Rather, inversion takes place primarily
through the transverse tarsal joint. This joint is actually two joints in a
line: talonavicular and calcaneocuboid.
Muscles: tibialis anterior primarily, assisted by tibialis posterior.
Eversion of the ankle could be considered somewhat similar to
pronation, except for the fact that its completely different. The sole of
the foot is moved to face away from the midline, through the transverse
tarsal joint primarily.
Muscles: fibularis longus, brevis, and tertius.
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Toe Flexion and Extension
Flexion of the toes, except the hallux or great toe, occurs at three joints: metatarsophalangeal, proximal
interphalangeal, and distal interphalangeal.
Muscles: flexor digitorum longus flexes all 3 joints, flexor digitorum brevis flexes MP and PIP only;
lumbricals and interossei flex MP and extend the PIP and DIP.
Extension of the toes, except the hallux or great toe, occurs at three joints: metatarsophalangeal, proximal
interphalangeal, and distal interphalangeal.
Muscles: extensor digitorum longus and brevis extend all 3 joints; lumbricals and interossei extend the
PIP and DIP while flexing the MP.
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Hallux Flexion and Extension
The hallux or great toe has only 2 phalanges, and therefore it has only two joints: metatarsophalangeal
and interphalangeal. Flexion of the hallux is important in pushing off during walking or running.
Muscles: flexor hallucis longus and brevis.
Extension of the hallux happens at the MP and IP joints.
Muscles: extensor hallucis longus and brevis.
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Toe Abduction and Adduction
The toes have limited mobility, but some degree of abduction and adduction of the toes helps to
accommodate to uneven ground during gait.
Abduction of the toes takes place in reference to the second toe. In the hand, abduction moves the digits
away from the third digit.
Muscles: dorsal interossei, abductor hallucis, and abductor digiti minimi.
Adduction moves the toes toward the second toe.
Muscles: plantar interossei and adductor hallucis.
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