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The gracilis muscle is a long strap muscle with a long distal tendon, that starts at the lower part of the pelvis and runs down the inner thigh, connecting with the upper part of the tibia. It is the only adductor of the thigh that crosses and acts on two joints: the hip and knee. The gracilis muscle helps with hip adduction, medial rotation, and knee flexion, and is also involved in walking and running, helping to stabilize the inner hip and thigh.
| Characteristics | Values |
|---|---|
| Definition | Superficial bands of muscle that start at the lower part of the pelvis (pubic ramus) and run down the inner thigh and past the inner knee, connecting with the upper part of the shin bone (tibia). |
| Location | Medial (adductor) compartment of the thigh. |
| Innervation | Anterior branch of the obturator nerve. |
| Neurovascular Supply | One major and one minor vascular pedicle. |
| Major Pedicles | One artery (major artery), two veins (venae comitantes), and the anterior branch of the obturator nerve enter the muscle. |
| Minor Pedicles | One artery and two vena comitantes enter the muscle. |
| Function | Helps with hip adduction, medial rotation, lateral rotation, and flexion of the hip, and flexion of the knee. |
| Additional Functions | Helps stabilize the inner hip and thigh during walking or running, and aids the hamstring muscles during the initial swing phase of walking or boat rowing. |
| Number of Muscles | Two, one on each side of the body. |
| Muscle Type | Type 2, unipennate, with an excursion of approximately 10 cm. |
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What You'll Learn
The gracilis muscle is a superficial muscle of the inner thigh
The gracilis muscle is supplied by the obturator nerve, which enters the muscle obliquely at a distance of 6 to 12 cm from its origin. The obturator nerve forms two divisions, one of which is superficial to the pedicle and the other deep to the pedicle. The vascular supply to the gracilis muscle comes from a branch of the profunda femoris artery, which is located 8 to 12 cm from the muscle's origin.
The gracilis muscle has a type II blood supply, with one major and one minor vascular pedicle. The major pedicle is the medial femoral circumflex artery, which enters the muscle about 10 cm from the pubic symphysis. The minor pedicle artery can be the superior femoral artery, deep femoral artery, or descending genicular artery. The obturator nerve, which innervates the gracilis muscle, enters the muscle at the same point as the major pedicle artery or slightly proximal to it.
The gracilis muscle is commonly used in reconstructive surgery, either as a pedicled flap or as a free microsurgical flap. It can be used for perineal and vaginal reconstruction, as well as in the treatment of anal incontinence, a technique called graciloplasty. The gracilis muscle is also used in the reconstruction of upper and lower limbs, breast reconstruction, and to restore forearm function or in dynamic reconstruction of facial paralysis.
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It helps with hip adduction and internal rotation
The gracilis muscle is a superficial muscle in the medial (adductor) compartment of the thigh. It is one of seven hip adductor muscles that help draw the thighs together. The gracilis muscle is the only adductor of the thigh that crosses and acts on two joints: the hip and knee.
The gracilis muscle helps with hip adduction, which is the action of pulling the legs together. It also helps with internal rotation, allowing you to rotate your thighs inward. During walking, the gracilis muscle helps with medial (internal) rotation around the knee joint when the knee is in a semiflexed position. This is evident when the foot is planted on the ground.
The gracilis muscle is involved in knee flexion, or the bending of the knee. It works with the hamstrings, sartorius, gastrocnemius, plantaris, and popliteus muscles to bend the knee. Together, these muscles are known as knee flexors. The overuse of the gracilis muscle from activities such as cycling or running can cause the muscle to stiffen and "pull" at the lower attachment point just below the knee, resulting in pain, redness, and swelling.
The gracilis muscle is vulnerable to various injuries, including groin strains, muscle spasms, and pinched nerves. These injuries may be treated with pain medications, physical therapy, and gentle exercises and stretches. One recommended stretch for the gracilis muscle is the butterfly stretch, which is performed in a seated position with the soles of the feet placed together and knees lowered toward the floor.
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It aids in knee flexion
The gracilis muscle is a long, slender muscle that runs from the inner groin, along the inner thigh, to the bottom of the inner knee. It is the only adductor of the thigh that crosses and acts on two joints: the hip and the knee.
The gracilis muscle plays a crucial role in knee flexion, which is the bending of the knee. It works in conjunction with other muscles, such as the hamstrings, sartorius, gastrocnemius, plantaris, and popliteus, to facilitate this movement. This group of muscles is collectively known as knee flexors.
During activities such as walking or running, the gracilis muscle aids in knee flexion by helping to stabilize the knee when it is bent. This stabilization is achieved through slight contractions with each step, ensuring the knee remains in a stable position.
The gracilis muscle also contributes to strong leg flexion and medial (internal) rotation around the knee joint when the knee is in a semiflexed position. This means that it assists in bending the leg and rotating it inward at the knee.
The muscle receives its blood supply from the medial circumflex femoral artery, with the distal third of the gracilis supplied by a minor branch of the femoral artery. The obturator nerve innervates the gracilis muscle, providing the necessary stimulation for contraction during knee flexion.
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It is prone to injuries, including groin strains and muscle spasms
The gracilis muscle is prone to injuries, including groin strains and muscle spasms. This is due to its function as a hip adductor, allowing the leg to move towards the midline of the body, and its role in knee flexion and internal knee rotation. Groin strains can occur when the muscle is stretched or torn due to quick direction changes or kicking motions. Sports with sudden directional shifts, such as soccer, hockey, and baseball, are particularly associated with groin strains.
Groin strains involving the gracilis muscle can cause pain in the groin or inner thigh and may result in bruising and muscle weakness. Treatment for groin strains typically involves rest, ice, and compression, along with refraining from activities that put pressure on the gracilis to allow for healing. Consulting a doctor is essential for proper diagnosis and treatment.
Muscle spasms in the gracilis can be caused by various factors, including overuse, dehydration, or other underlying conditions. Identifying the cause of the muscle spasms is crucial to implementing effective corrective measures. Treatment options may include rest, ice, medication, and physical therapy, depending on the specific condition affecting the gracilis muscle.
In addition to groin strains and muscle spasms, gracilis injuries can also lead to anterior cruciate ligament (ACL) injuries, commonly seen in sports with significant lower body movement, such as skiing and basketball. Strengthening exercises, such as standing and lying thigh adduction with a resistance band, can help prevent gracilis injuries by improving the muscle's strength and protecting it from strain.
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It is used in reconstructive surgery
The gracilis muscle is the most superficial muscle of the medial (adductor) compartment of the thigh. It is also one of seven hip adductor muscles that help draw the thighs together. The gracilis muscle helps with hip adduction, hip flexion, hip internal rotation, knee flexion, and internal knee rotation.
The gracilis muscle is used in reconstructive surgery, particularly in orthopaedic and plastic surgery. In orthopaedic reconstructive procedures, the gracilis tendon autograft is considered a safe option for tendon harvesting. In plastic surgery, the gracilis muscle is used for facial reanimation in cases of facial paralysis or paresis. This procedure is known as a gracilis free muscle transfer and involves transplanting the gracilis muscle with its nerve and blood vessels from the inner thigh to the face. The nerve and blood vessels are then reconnected to those in the face and/or neck. This allows for the restoration of smile and facial tone (symmetry at rest). The gracilis free muscle transfer can also be used to treat facial paralysis, with the muscle attached under the skin to the muscles of the corner of the mouth and the tissue in the temple region.
The gracilis muscle is also used in a novel surgical technique for repairing massive rotator cuff tears. This technique involves semitendinosus and gracilis myotendinous grafting, allowing for the repair of rotator cuff tears using autologous material that is adequate and adaptable. This procedure is low-invasive and has minimal donor site morbidity.
In terms of the surgical process, the gracilis muscle is harvested with its nerve and blood vessels, and the nerve is transected to the desired length. The pedicle is identified and isolated, and the muscle is freed of all soft tissue attachments. The proximal tendon is cauterized, and the distal muscle is transected. The wound is then closed in layers, and the patient is allowed to ambulate when clinically acceptable.
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Frequently asked questions
The gracilis muscle is a superficial band of muscle that starts at the lower part of the pelvis (pubic ramus) and runs down the inner thigh and past the inner knee, connecting to the upper part of the tibia (shinbone).
The gracilis muscle helps with hip adduction (pulling the legs together), hip flexion, hip internal rotation, knee flexion, and internal knee rotation. It also helps stabilise the knee when bent and stabilise the inner hip and thigh during walking or running.
The gracilis muscle works with the hamstrings, sartorius, gastrocnemius, plantaris, and popliteus muscles to bend the knee. Together, these muscles are known as knee flexors.
The gracilis muscle is supplied by the obturator nerve, which enters the muscle obliquely at 6 to 12 cm from its origin. The vascular supply comes from a branch of the profunda femoris artery.
The gracilis muscle is commonly used in reconstructive surgery (graciloplasty) as a pedicled or free microsurgical flap. It can be used for upper and lower limb reconstruction, breast reconstruction, and restoring forearm function or facial paralysis.
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