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Minnesota State University, Mankato
Minnesota State University, Mankato

Manual Muscle Testing

Page address: http://ahn.mnsu.edu/athletictraining/spata/kneemodule/manualmuscle.html/

Gastrocnemius

Origin of Medial Head
Proximal & posterior part of the medial epicondye and adjacent part of the femur, capsule of knee joint
Origin of Lateral Head
Lateral condyle and posterior surface of femur, capsule of knee joint
Insertion
Into the middle part of the posteior surface of the calcaneus
Action
Plantarflexion of the ankle
Nerve
Tibial, & S1–2

Gastrocnemius

Patient
Standing on two feet
Fixation
None
Test
Plantarflexion of the ankle bilaterally
Pressure
Body weight and gravity
See Test

Gastrocnemius 2

Patient
Standing on two feet
Fixation
None
Test
Plantarflexion of the ankle bilaterally
Pressure
Against shoulders bilaterally in the direction of dorsiflexion, body weight and gravity
See Test

Gastrocnemius 3

Patient
Single leg stance
Fixation
None
Test
Plantarflexion of the ankle
Pressure
Body weight and gravity
See Test

Popliteus

Origin
Anterior part of the groove on the lateral condyle of the femur and oblique popliteal ligament of the knee
Insertion
Triangular area proximal to the soleal line on the posterior surface of the tibia and fascia cocering the muscle
Action NWB (origin fixed)
Medial rotation of tibia on femur and knee flexion
Action WB (insertion fixed)
Laterally rotates femur on tibia and flexes knee joint, also helps reinforce posterior knee joint ligaments
Nerve
Tibial, L4–5& S1
Patient
Sitting with knee flexed to 90° and with leg in lateral rotation of tibia on femur
Fixation
None
Test
Medial rotation of tibia on femur
Pressure
None, just testing muscle activity
See Test

Biceps Femoris

Origin of Long Head
Distal part of sacrotuberous ligament, and posterior part of tuberosity of ischium
Origin of Short Head
Lateral lip of linea aspera, proximal two thirds of upracondylar line, and lateral intermuscular septum
Insertion
Lateral side of head of fibula, lateral condyle of tibia, deep fascia on lateral side of leg
Action
The long and short heads of the Biceps femoris flex and laterally rotate the knee joint
In addition, the long head extends and assists in lateral rotation of the hip joint
Nerve to Long Head
Sciatic (tibial branch) L5, S1–3
Nerve to Short Head
Sciatic (peroneal branch) L5, S1–2
Patient
Prone
Fixation
The examiner should hold the thigh firmly down on the table
Test
Flexion of the knee between 50° and 70° with the thigh in slight lateral rotation, and the leg in slight lateral rotation on the thigh
Pressure
Against the leg proximal to the ankle in the direction of knee extension. Do not apply pressure against the rotation component
See Test

Semitendinosus

Origin
Tuberosity of ischium by tendon common with long head of Biceps femoris
Insertion
Proximal part of medial surface of body of tibia, and deep fascia of leg
Action
Flexes and medially rotates the knee joint. Extends and assists in medial rotation of the hip joint
Nerve
Sciatic (tibial branch) L4–5, S1–2
Patient
Prone
Fixation
The examiner should hold the thigh firmly on the table
Test
Flexion of the knee between 50° and 70° with the thigh in medial rotation, and the leg medially rotated on the thigh
Pressure
Against the leg proximal to the ankle in the direction of knee extension. Do not apply pressure against the rotation component
See Test

Semimembranosus

Origin
Tuberosity of ischium, proximal and lateral to Biceps femoris and Semitendinosus
Insertion
Posteromedial aspect of medial condyle of tibia
Action
Flexes and medially rotates the knee joint. Extends and assists in medial rotation of the hip joint
Nerve
Sciatic (tibial branch) L4–5, S1–2
Patient
Prone
Fixation
The examiner should hold the thigh firmly on the table
Test
Flexion of the knee between 50° and 70° with the thigh in medial rotation, and the leg medially rotated on the thigh
Pressure
Against the leg proximal to the ankle in the direction of knee extension. Do not apply pressure against the rotation component
See Test

Quadriceps Femoris

Origin of Rectus Femoris
Straight head from anterior inferior iliac spine. Reflected head from groove above rim of acetabulum
Origin of Vastus Lateralis
Proximal part of intertrochanteric line, anterior and inferior borders of greater trochanter, lateral lip of gluteal tuberosity, proximal one half of lateral lip of linea aspera, and lateral intermuscular septum
Origin of Vastus Intermedius
Anterior and lateral surfaces of proximal two thirds of body of femur, distal one half of linea aspera, and lateral intermuscular septum
Origin of Vastus Medialis
Distal one half of intertrochanteric line, medial lip of linea aspera, proximal part of medial supracondylar line, tendons of Adductor Longus and Adductor Magnus, and Medial Intermuscular Septum
Insertion
Proximal border of patella and through patellar ligament to tuberosity of tibia
Nerve
Femoral L2–4
Patient
Sitting with knees over side of table, holding on to table
Fixation
The examiner may hold the thigh firmly down on the table, or, because the weight of the trunk is usually sufficient to stabilize the patient during this test, the examiner may put a hand under the distal end of the thigh to cushion that part against table pressure
Test
Extension of the knee joint without rotation of the thigh
Pressure
Against the leg above the ankle, in the direction of flexion
See Test

Sartorius

Origin
Anterior superior iliac spine and superior half of notch just distal to spine
Insertion
Proximal part of medial surface of tibia near anterior border
Action
Flexes, laterally rotates, and abducts the hip joint
Flexes and assists in medial rotation of the knee joint
Nerve
Femoral L2–3
Patient
Supine
Fixation
None necessary on the part of the examiner
The patient may hold on to the table
Test
Lateral rotation, abduction, and flexion of the thigh, with flexion of the knee
Pressure
Against the anterolateral surface of the lower thigh, in the direction of hip extension, adduction and medial rotation, and against the leg in the direction of knee extension
The examiner must resist the multiple action test movement by a combined resistance movement
See Test

Gracilis

Origin
Inferior half of symphysis pubis and medial margin of inferior ramus of pubic bone
Insertion
Medial surface of the body of tibia, distal to condyle, proximal to insertion of Semitendinosus, and lateral to insertion of Sartorious
Actions
Hip adduction and knee flexion
Nerve
Obturator, L2–L4
Patient
(find)
Fixation
(find)
Test
(find)
Pressure
(find)
See Test

Tensor Fascia Latae

Origin
Anterior part of external lip of iliac crest, outer surface of anterior superior iliac spine, and deep surface of fascia lata
Insertion
Into ilitotibial tract of fascia lata at junction of proximal and middle thirds of thigh
Actions
Flexes, medially rotates, and abducts the hip joint; tenses the fascia lata; and may assist in knee extension
Nerve
Superior gluteal L4–5, S1
Patient
Supine
Fixation
The patient may hold on to the table
Quadriceps action is necessary to hold the knee extended
Usually no fixation is necessary by the examiner, but if there is instability and the patient has difficulty in maintaining the pelvis firmly on the table, then one hand of the examiner should support the pelvis anteriorly on the opposite side
Test
Abduction, flexion and medial rotation of the hip with the knee extended
Pressure
Against the leg in the direction of extension and adduction
Do not apply pressure against the rotation component
See Test