🔹Hip flexion (anterior thigh muscles) :

🔸Psoas major
Nerve supply : lumbar plexus,
Problem in this nerve causes compression or external trauma leading to weakness or paralysis.

🔸Iliacus
Nerve supply : femoral nerve.

🔹Acessory hip flexors :
- Rectus femoris
- Sartorius
- Tensor fasciae latae
- Pectineus

🔸ROM : from Zero to 115 or 125

🔹Limitations :
1- contact of thigh on abdomen with knee flexed.
2- tension of hamstring with knee extended.

🔸Notice that
1- Knee flexed or extended to prevent the substitution.
2- Hamstring is a two jointed muscle which has a passive insufficiency.
3- To get the exercise more difficult increase the lever arm.

🔹Palpation of
1- Psoas major : distal to inguinal ligament.
2 - Iliacus : slide in iliac crest.

🔸Notice that inguinal ligament presents in the medial side of sartorius.

🔹Substitution by 2 muscles :
1- Sartorius in hip flexion causes lateral rotation and abduction of thigh.
2- Tensor fasciae latae in hip flexion causes medial rotation and abduction of thigh.

🔸To avoid the substitution, we should keep the thigh toward the med line (other leg)

🔹Weakness of hip flexors :
1- Disability in climbing stair, walking, bringing the trunk forward in sitting position.
2- Marked weakness in walking because the patient should do propulsion of hip (bringing the leg forward by pelvic motion) which comes from anterior and lateral abdominal muscles action rather than hip flexion.

🔸Notice that :
1- In propulsion of hip there is :
🔹Anterior pelvic tilt
🔹Hyper lordosis (extension in lumber)

2- Also weakness in hamstring causes inability to stand up strightly
و دا يحصل اما اجيب حاجه من ع الأرض، وعندي ضعف في ال hamstring، فـ هطلع بال trunk extensors و مش هكمل الحركه هفضل معوج كدا لان اللي مفروض تكمل الحركه فيها weakness و هي ال hamstring.

🔹Contracture of hip flexors:
1- Unilateral causes flexion, abduction, external rotation.
2- Bilateral causes lower cross syndrome which is :
🔹Anterior pelvic tilt (hip flexion deformity)
🔹Lumber hyper lordosis