Massage & Bodywork

March/April 2012

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education PATHOLOGY PERSPECTIVES | BODY AWARENESS | FUNCTIONAL ANATOMY | SOMATIC RESEARCH Pes Anserine Group By Christy Cael Three large thigh muscles converge medially just below the knee and form the pes anserine group. The sartorius muscle descends from the front, the gracilis from the middle, and the semitendinosus from the back of the thigh. Pes anserine means "goose foot," and is named for its three-pronged shape where the muscles join and form a single attachment near the medial condyle of the tibia. The three muscles form a tripod of dynamic stabilizers for the medial knee. This group mirrors the laterally located iliotibial band in form and function. The muscles of the pes anserine group are superficial and easily palpated. The sartorius is the most anterior, beginning at the anterior superior iliac spine and crossing from lateral to medial as it descends the anterior thigh. This long, slender muscle forms the lateral border of the femoral triangle and acts on both the hip and knee. The gracilis is a superficial hip adductor that runs straight down the inner thigh from pubis to tibia. It forms the middle prong, or center, of the tripod of the pes anserine group. Like all of the pes anserine muscles, the gracilis crosses both the hip and the knee, offering movement and stability at both joints. The semitendinosus is one of three muscles that form the hamstring group on the posterior thigh and the only one that inserts at the pes anserine tendon. It begins at the ischial tuberosity of the pelvis, descends the posterior medial thigh, and wraps around the medial knee. The position and orientation of this muscle give it excellent leverage to medially rotate the hip and knee. The pes anserine group helps stabilize the lower extremity as the body turns over a planted foot. This motion is essential when changing direction when walking, running, or performing any activity where the foot is in contact with the ground or other fixed object. Activation of these muscles assists the medial collateral ligament in preventing separation between the medial condyles of the femur and tibia (valgus stress). Injuries to the underlying medial collateral ligament and attached medial meniscus are very common, particularly when the pes anserine muscles are inhibited, weak, or imbalanced. Adhesions and poor circulation are common where the muscles converge at the knee and can limit function. Excessive tension in the iliotibial band and vastus lateralis may also inhibit the pes anserine muscles and create valgus stress on the knee. A well-functioning pes anserine group may prevent or minimize damage to the ligament, meniscus, and articular cartilage of the knee by balancing stress and controlling movement at this joint. Attachments • Origin: Anterior superior iliac spine (sartorius), inferior ramus of pubis (gracilis), and ischial tuberosity (semitendinosus) • Insertion: Medial shaft of tibia via the pes anserine tendon Actions • Flexes, abducts, and externally rotates the hip—sartorius • Adducts the hip—gracilis • Extends and internally rotates the hip—semitendinosus • Flexes and internally rotates the knee—all Innervation • Femoral nerve, L3–4: sartorius • Obturator nerve, L2–4: gracilis • Sciatic nerve, L4–S2: semitendinosus Semitendinosus Adductor magnus Gracilis Semimembranosus Sartorius Gluteus medius Gluteus maximus Iliotibial band Biceps femoris (long head) Biceps femoris (short head) Popliteus PES ANSERINE GROUP Celebrate ABMP's 25th anniversary and you may win a refund on your membership. ABMP.com. 47

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