Hip adductors

Author: Achudhan Karunaharamoorthy • Reviewer: Dimitrios Mytilinaios MD, PhD • Last reviewed: March 27, 2020

The adductors of the hip are part of the inner hip musculature and range from the lower pelvic bone to the femur and knee region. Thereby it lies in between the extensor and flexor group of the thigh muscles.

The hip adductors shape the surface anatomy of the medial thigh. This group of muscles is very important for the adduction of the thigh and other movements of the lower limb.

With the term hip adductors, we mean the muscles that are shown in the following table.

Key facts about the hip adductors
Members	Adductor magnus Adductor minimus Adductor longus Adductor brevis Pectineus Gracilis Mnemonic: AAAA, Pretty Good!
Innervation	All muscles are innervated by the obturator nerve or its direct branches, except the pectineus that is innervated by the femoral nerve and the hamstring part of the adductor magnus that is innervated by the tibial nerve .
Overall function	Adduction of the hip joint

This article will give you the ins and outs of every muscle, including its origins, insertions, innervation, and functions, together with some clinical notes.

Contents

Anatomy and key facts
Function
Mnemonic
Clinical notes
Related diagrams and images

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Anatomy and key facts

The innervation is mainly supplied by the obturator nerve which arises from the lumbar plexus and reaches the adductors through the obturator canal; two muscles have a double innervation.

The hip adductors are as follows:

Pectineus muscle

Pectineus muscle has it's origin or proximal attachment point on the anterior surface of the superior pubic ramus, specifically at landmark known as the pectineal line (pectin ossis pubis). It inserts onto the posterior aspect of the proximal femur, at a line known as the pectineal line, extending from the base of the lesser trochanter to the linea aspera. It is additionally innervated by the femoral nerve.

Key facts about the pectineus muscle
Origins	Pectineal line on the superior ramus of the pubis
Insertions	Pectineal line of the femur, linea aspera of femur
Innervation	Femoral nerve
Function	Hip joint: Thigh flexion, Thigh adduction, (Thigh intenral & external rotation); Pelvis stabilization

Adductor magnus muscle

Adductor magnus is one of the biggest muscles of the human body and consists of two parts: the adductor and ischiocondylar (hamstring) parts. The adductor part originates from the inferior pubic ramus and the ischial ramus and inserts at the gluteal tuberosity, the medial lip of the linea aspera and the medial supracondylar line of the femur ('flesh insertion'). The ischiocondylar part originates from the ischial tuberosity and inserts into the adductor tubercle on the medial epicondyle ('tendinous insertion'). In terms of innervation, the adductor part is supplied by the obturator nerve, while the hamstring part is supplied by the tibial division of the sciatic nerve.

Key facts about the adductor magnus muscle
Origins	Adductor part: Inferior pubic ramus, Ischial ramus Ischiocondylar part: Ischial tuberosity
Insertions	Adductor part: Gluteal tuberosity, Linea aspera (medial lip), Medial supracondylar line Ischiocondylar part: Adductor tubercle of femur
Innervation	Adductor part: Obturator nerve (L2-L4) Ischiocondylar part: Tibial division of sciatic nerve (L4) Mnemonic: African Mouse Sneaks Out (refers to Adductor Magnus Sciatic Obturator)
Function	Hip joint: Thigh flexion, Thigh adduction, Thigh external rotation (adductor part), Thigh extension, Thigh internal rotation (ischiocondylar part); Pelvis stabilization

Adductor minimus muscle

This describes the inconstant superior separation of the adductor magnus which is found in many people. It extends from the inferior pubic ramus to the gluteal tuberosity of the femur.

Key facts about the adductor minimus muscle
Origins	Inferior pubic ramus
Insertions	Gluteal tuberosity of femur
Innervation	Obturator nerve (L2-L3)
Function	Hip joint: Thigh adduction, Thigh external rotation

Adductor longus muscle

This muscle has its origin at the external surface of the body of the pubic bone, inferior to the pubic crest and lateral to the pubic symphysis. It inserts at the medial lip of the linea aspera that belongs to the middle one-third of the femoral shaft. Distally it forms an aponeurosis extending to the vastus medialis muscle (vastoadductorial membrane).

Key facts about the adductor longus muscle
Origins	Body of pubis, inferior to pubic crest and lateral to the pubic symphysis
Insertions	Middle third of linea aspera of femur (medial lip)
Innervation	(Anterior division of) Obturator nerve (L2-L3)
Function	Hip joint: Thigh flexion, Thigh adduction, Thigh external rotation; Pelvis stabilization

Adductor brevis muscle

This muscle originates at the inferior pubic ramus and the external surface of the pubic body, while it inserts at the pectineal line and upper one-third of the medial lip of the linea aspera of the femur.

Key facts about the adductor brevis muscle
Origins	Body and inferior ramus of pubis
Insertions	Pectineal line and upper third of the medial lip of linea aspera of femur
Innervation	(Anterior division of) Obturator nerve (L2-L3)
Function	Hip joint: Thigh flexion, Thigh adduction, Thigh external rotation; Pelvis stabilization

Gracilis muscle

This muscle runs from the external surfaces of the pubic body, the inferior pubic ramus and the ramus of the ischium. It inserts at the medial surface of the proximal tibia , where it inserts as the superficial pes anserinus. Its tendon is easy to palpate in the inguinal region – together with the tendon of the adductor longus muscle.

Key facts about the gracilis muscle
Origins	Body and inferior ramus of the pubis, ischial ramus
Insertions	Superior part of medial surface of tibia
Innervation	Obturator nerve (L2-L3)
Function	Hip joint: Thigh flexion, Thigh adduction; Knee joint: Leg flexion, Leg internal rotation

Both the femoral artery and vein as well as the saphenous nerve proceed within a groove between the adductor magnus, adductor longus and vastus medialis muscles. This so-called adductor canal (Hunter’s canal) is anteriorly covered by the vastoadductorial membrane. Distally it ends between the “fleshy” and “tendinous” insertion of the adductor magnus and leads to the popliteal fossa.

Need a hand putting all of this into context? Our lower limb muscle anatomy reference chart will help you to quickly and effectively revise the hip adductors.

Function

As the name suggests the main function of the hip adductors is the adduction of the hip joint. Furthermore, it supports the external rotation (pectineus, adductor longus, brevis, magnus, and minimus), internal rotation (tendinous insertion of the adductor magnus), flexion (all) and extension (tendinous insertion of the adductor magnus). It should be noted that the role of the adductor muscles in rotation of the thigh is widely disputed in the literature, with many source providing conflicting descriptions of external and internal rotation. It is believed that the position of the femur plays an important role in the direction of rotation.

Being the only two joint adductor the gracilis muscle moves the knee joint as well where its contraction causes a flexion and internal rotation. The hip adductors are particularly used when crossing one’s legs. Overall they play an important role in balancing the pelvis during standing and walking.

Mnemonic

In order to remember the adductors of the hip you can use the mnemonic AAAA, Pretty Good!

Adductor magnus
Adductor minimus
Adductor longus
Adductor brevis
Pectineus
Gracilis

Clinical notes

The adductor muscle tear (groin strain) ranks among the most common sport injuries (e.g. playing soccer, doing the splits, slipping on ice etc.) and affects favorably the origin tendon at the pubic region. It is caused by a disproportional strain of the muscles, often in combination with a poor warm-up and a lack of stretching. Hereby even ruptures and hemorrhages may occur. Symptoms include pain extending to the inguinal and knee region when stretching and straining the muscles. A malposition of the sacroiliac joint can restrict the function of the hip adductors in the long run as well and should be addressed clinically.

The orthopedic pathologies mentioned above are to be distinguished from the neurogenic adductor spasm. This is a common symptom in spastic diplegia (Little’s disease). Due to the spasticity in the hip adductors the affected children walk – if at all – with adducted, flexed and internally rotated legs (scissor gait).

Hip adductors