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The muscles in the medial compartment of the thigh are collectively known as the hip adductors. There are four primary muscles in this group: adductor longus, adductor brevis, adductor magnus, and gracilis. These muscles are responsible for moving the thigh or lower extremity closer to the body's central axis. They also play a role in hip flexion and rotation. The adductor magnus, in particular, is the largest muscle in the medial compartment and is considered by some to be the most powerful and complex muscle of the adductor group.
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What You'll Learn
Adductor longus
The adductor longus is a large, flat, fan-shaped muscle located in the medial compartment of the thigh. It is one of the hip adductors, along with the adductor brevis, adductor magnus, gracilis, and obturator externus. The obturator nerve, arising from the lumbar plexus, innervates the adductor longus. The obturator nerve's anterior branch runs behind the adductor longus and supplies it. The adductor longus is also supplied by the deep femoral artery, a branch of the femoral artery, and the obturator artery, a branch of the internal iliac artery.
The adductor longus originates from the pubis bone of the pelvis and expands into a fan shape, with a broad distal attachment along the linea aspera of the femur. It forms the medial border of the femoral triangle and is located in front of the adductor magnus and adductor brevis muscles. The pectineus muscle is found to its lateral side, while the gracilis muscle is found medially. The adductor longus also has anterior relations to its upper part, including the spermatic cord and fascia lata, and the femoral artery and vein are present anteriorly in its lower part near its attachment.
The adductor longus muscle's primary function is to adduct the thigh at the hip joint. It also provides some medial or lateral rotation and flexion of the thigh. Along with the other hip adductors, it helps to stabilise the pelvis when standing and aids in balancing the body on the lower limb during walking. Adductor tendinopathy, a common injury in sports such as soccer and ice skating, can cause medial leg and groin pain. It is caused by a disproportionate strain on the muscles, often combined with inadequate warm-up and stretching.
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Adductor brevis
The adductor brevis is a flat, triangular muscle found in the inner thigh. It is one of the shortest muscles in the adductors group, which also includes the adductor longus, adductor magnus, gracilis, and pectineus muscles. These inner thigh muscles are responsible for producing movements of the hip joint, primarily thigh adduction, but they also assist with flexion, internal and external rotation, and stabilization of the pelvis during standing or walking.
The adductor brevis muscle has a narrow origin on the anterior surface of the body of the pubis, with some fibres arising from the lateral surface of the inferior pubic ramus. From there, it widens into a triangular shape as it extends towards its insertion on the femur. Specifically, it attaches to the superior half of the medial lip of the linea aspera, located on the upper third of the femur, medial to the insertion of the adductor magnus, and lateral to the insertion of the pectineus muscle.
The adductor brevis is innervated by the obturator nerve, with both its anterior and posterior branches crossing the muscle. The obturator nerve arises from the lumbar plexus (L2-L4). The blood supply for the adductor brevis typically comes from the deep femoral artery (profunda femoris) and its branch, the artery for the adductors. Additional blood supply can come from the medial circumflex femoral and obturator arteries.
The adductor brevis is a weak adductor of the thigh, and its main function is indeed the adduction of the thigh. This action is particularly active when the thigh is flexed and during the gait cycle. The adductor brevis also plays a role in external rotation and flexion of the hip. All the adductors of the thigh pull the leg medially when walking, helping to maintain balance and shift the centre of gravity to the supporting foot.
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Adductor magnus
The adductor magnus performs adduction at the hip joint. It also contributes to the flexion and medial rotation of the thigh, especially the superior horizontal portion of the adductor part. The hamstring part also assists in the extension of the thigh. The adductor magnus is most active during the adduction of the flexed thigh when standing, such as when kicking with the medial side of the foot. It is believed that, together with the adductor longus, this muscle also acts as a medial rotator of the thigh, although this depends on the position of the thigh and the mechanical axis of the femur.
The adductor magnus is the most commonly injured muscle in the medial compartment. Tight adductors can cause knee pain, especially in runners. Adductor canal syndrome is an unusual cause of acute arterial occlusion in younger men, resulting from arterial compression by an abnormal musculotendinous band arising from the adductor magnus muscle.
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Gracilis
The gracilis muscle is a spiral unipennate muscle in the medial thigh compartment. It is the most superficial and medial of the hip adductor muscles. It crosses both the hip and knee joints, adducting the thigh at the hip and flexing the leg at the knee. The gracilis muscle descends almost vertically down the leg and attaches to the medial tibia at the Pes anserinus, where it joins with the sartorius and semitendinosus muscle tendons.
The gracilis muscle is innervated by the obturator nerve, which arises from the lumbar plexus. The obturator nerve innervates the gracilis muscle via the lumbar spinal vertebrae. The nerve branches into anterior and posterior branches, with the anterior branch innervating the gracilis muscle. The obturator nerve also innervates the adductor longus and, sometimes, the adductor brevis.
The gracilis muscle is prone to strain injuries, particularly in high-impact sports that involve ballistic movements or stretching, such as soccer, hockey, baseball, basketball, and football. These injuries can result in adductor tendinopathy and groin strain. Tearing of the gracilis muscle usually occurs near its bony attachments at the pelvis. The gracilis tendon may be used in reconstruction surgery of the ACL, particularly in women, who have a smaller volume of the gracilis muscle than men.
The gracilis muscle is also used in microsurgery and reconstructive surgery, either as a pedicled flap or as a free microsurgical flap. As a pedicled flap, the gracilis muscle can be used in perineal and vaginal reconstruction, as well as in the treatment of anal incontinence. As a free microsurgical flap, it is used in the reconstruction of upper and lower limbs, breast reconstruction, and the restoration of forearm function or dynamic reconstruction of facial paralysis.
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Pectineus
The pectineus muscle is a flat, quadrangular muscle found in the superomedial part of the anterior thigh. It is one of the muscles located on the medial thigh, alongside a group of four primary large muscles: the adductor longus, adductor brevis, adductor magnus, and gracilis muscles. These muscles primarily function in hip adduction.
The pectineus muscle arises from the pectineal line of the pubis and, to a lesser extent, from the surface of the bone in front of it, between the iliopectineal eminence and pubic tubercle. The fibres pass downward, backward, and lateral, to be inserted into the pectineal line of the femur, which leads from the lesser trochanter to the linea aspera. The muscle then slides over the superior margin of the superior pubic ramus and courses posterolaterally down the thigh, sometimes being partially divided into a larger anterior (superficial) layer and a smaller posterior (deep) layer.
The pectineus is considered a transitional muscle between the anterior thigh and medial thigh due to its innervation, which primarily comes from the femoral nerve (L2 and L3) and, in some cases, from the obturator nerve. The obturator nerve is always present in over 90% of cases and is the greater nerve to the muscle. The muscle is also innervated by the accessory obturator nerve in 8.7% of cases.
The pectineus muscle assists in hip adduction and flexion, and its functions include the additional movements of thigh flexion, external (lateral) rotation, and internal (medial) rotation. It is a postural muscle as it stabilizes the pelvis and balances the trunk on the lower extremity during walking. Activities that use this muscle include running, skating, kicking a soccer ball, and playing basketball.
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Frequently asked questions
The hip adductors are a group of five muscles located in the medial compartment of the thigh. These muscles are the adductor longus, adductor brevis, adductor magnus, gracilis, and pectineus.
The main function of the hip adductors is to produce adduction of the thigh at the hip joint, pulling the thigh towards or past the median plane. They also help to stabilize the pelvis and maintain its balance during walking.
The adductor magnus is the largest and most posterior muscle in the hip adductor group. It has two parts: the adductor component and the hamstring component.
The adductor magnus contributes to the flexion (adductor part) and extension (hamstring part) of the thigh. It also helps to control the pelvis for posture.
The gracilis muscle is the most medial and superficial muscle of the hip adductors. It crosses both the hip and knee joints and is responsible for adduction of the thigh at the hip and flexion of the leg at the knee.
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