Clinical Anatomy 31:535–543 (2018)

ORIGINAL COMMUNICATION

Adductor Magnus: An EMG Investigation into Proximal

and Distal Portions and Direction Specific Action
MATTHEW L. BENN,1 TANIA PIZZARI,2 LEANNE RATH,1 KYLIE TUCKER,3 AND
ADAM I. SEMCIW 1,2,4*
1
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
2
La Trobe University Sports and Exercise Medicine Research Centre, Bundoora, Victoria, Australia
3
School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia
4
Department of Physiotherapy, Princess Alexandra Hospital, Wooloongabba, Brisbane, Queensland, Australia

Cadaveric studies indicate that adductor magnus is structurally partitioned into

at least two regions. The aim of this study was to investigate the direction-
specific actions of proximal and distal portions of adductor magnus, and in
doing so determine if these segments have distinct functional roles. Fine-wire
EMG electrodes were inserted into two portions of adductor magnus of 12
healthy young adults. Muscle activity was recorded during maximum voluntary
isometric contractions (MVICs) across eight tests (hip flexion/extension, inter-
nal/external rotation, abduction, and adduction at 08, 458, and 908 hip flexion).
Median activity within each action (normalized to peak) was compared between
segments using repeated measures nonparametric tests (a 5 0.05). An effect
size (ES 5 z-score/冑sample size) was calculated to determine the magnitude of
difference between muscle segments. The relative contribution of each muscle
segment differed significantly during internal rotation (P < 0.001; ES 5 0.88)
and external rotation (P 5 0.003, ES 5 0.79). The distal portion was most active
during extension [median (interquartile range); 100(0)% MVIC)] and internal
rotation [58(34)% MVIC]. The proximal portion was most active during exten-
sion [100(49)% MVIC] and adduction [59(64)%MVIC], with low level activity
during external rotation [15(41)%MVIC]. This study suggests that adductor
magnus has at least two functionally unique regions. Differences were most
evident during rotation. The different direction-specific actions may imply that
each segment performs separate roles in hip stability and movement. These
findings may have implications on injury prevention and rehabilitation for
adductor-related groin injuries, hamstring strain injury, and hip pathology.
Clin. Anat. 31:535–543, 2018. VC 2018 Wiley Periodicals, Inc.

Key words: hip; adductor; electromyography; fine-wire; buttocks

Additional Supporting Information may be found in the online

INTRODUCTION
Injuries to the groin and/or hip adductor muscles
are common in both recreational and elite athletes
(Nicholas and Tyler, 2002; Robinson et al. 2004). Defi-
cits in hip adduction strength or function are a signifi-
cant risk factor for groin injuries (Tyler et al. 2001;
Crow et al. 2010; Engebretsen et al. 2010; Morrissey
et al. 2012), with a high risk of re-injury (Emery and
Meeuwisse, 2001; Tyler et al. 2001; Hagglund et al.
2006; Werner et al. 2009; Engebretsen et al. 2010).
version of this article.
Contract grant sponsor: UQ Early Career Research Grant (Sem-
ciw 2016).
*Correspondence to: Adam Semciw; School of Health and
Rehabilitation Sciences, The University of Queensland, Bris-
bane, 4072, QLD, Australia. Email: adam.semciw@gmail.com
Received 24 August 2017; Revised 25 February 2018; Accepted
2 March 2018
Published online 23 March 2018 in Wiley Online Library
(wileyonlinelibrary.com). DOI: 10.1002/ca.23068

C
V 2018 Wiley Periodicals, Inc.
536 Benn et al.
Lower hip adduction strength is also reported in peo-
ple with hip osteoarthritis (Arokoski et al. 2002), fem-
oroacetabular impingement (Freke et al. 2016) and
knee osteoarthritis (Deasy et al. 2016) compared to
matched peers. While there is a clear association
between hip adduction strength and lower limb injury,
the generic reference to adductor muscles in injury
epidemiology has made it difficult to attribute a spe-
cific adductor muscle or region to an injury subgroup
or clinical pain condition.
Adductor magnus is the largest of the hip adductor
muscle group, occupying 63% of their combined vol-
ume (Takizawa et al. 2014b), and has the second
largest cross-sectional area of all muscles in the lower
limb (Ito et al. 2003). It is understood to play an
important role in stabilizing the hip joint (Green and
Morris, 1970; Takizawa et al. 2014b), as well as con-
tributing to the hip joint’s tri-planar range of motion
during functional tasks such as walking (Green and
Morris, 1970; Gazendam and Hof, 2007; Kolk et al.
2015) and running (Gazendam and Hof, 2007;
Hamner et al. 2010).
In spite of the size and theoretical importance of
adductor magnus, there are inconsistencies in the lit-
erature regarding its function (Green and Morris,
1970; Dostal et al. 1986; Arnold and Delp, 2001). A
possible explanation for these inconsistencies is that
this large muscle acts with functionally distinct seg-
ments, much like other large muscles with distinct
functional portions, such as pectoralis major and del-
toid muscles (Wickham et al. 2004), gluteus medius
(Semciw et al. 2013), gluteus minimus (Semciw et al.
2014a), and semitendinosus (Hegyi et al. 2018;
Woodley and Mercer, 2005).
In support of distinct functional portions, recent
cadaveric studies demonstrate that adductor magnus
consists of between two and four structurally unique
segments from proximal to distal (Tubbs et al. 2011;
Takizawa et al. 2014b). Distally, adductor magnus is
predominantly innervated by the tibial nerve (Taki-
zawa et al. 2014a), has longer fascicle lengths (Taki-
zawa et al. 2014b) and is larger in volume (Takizawa
et al. 2014b). The proximal fibers are predominantly
innervated by the obturator nerve (Takizawa et al.
2014a), are smaller in volume and shorter in length
(Takizawa et al. 2014b). The long, large distal fibers
(segment) are theoretically able to generate large tor-
ques through greater range of movement, while the
small, short proximal fibers are less likely to drive
movement through range, but perhaps contribute
more to stabilizing the femur within the acetabulum
(Takizawa et al. 2014b).
Biomechanical modelling studies provide further
evidence of functional differentiation of adductor mag-
nus, based on location. By estimating moment arms
(in the anatomical position), the potential contribution
of proximal and distal adductor magnus to the three
planes of motion can be imputed. Dostal et al. (1986)
proposed that the proximal portion of adductor mag-
nus (described as adductor minimus) had moment
arms that favored hip adduction and flexion, while its
moment arm in the transverse plane was neutral. The
distal portion [described as posterior in Dostal et al.
(1986)] had a moment arm that also favored
adduction, however, its sagittal and transverse plane
moment arm favored hip extension and slight inter-
nal rotation. More recent evidence by Arnold and
Delp (2001) indicates that the proximal portion of
adductor magnus has an external rotation moment
arm, while the distal portion has minimal contribution
to rotation. Together, these studies indicate that
proximal and distal portions of adductor magnus
both have a role in hip adduction, however, the con-
tribution of these muscles to actions in the sagittal
and transverse planes (in the anatomical position)
may depend on its structural delineations, and
remains unclear.
Electromyography (EMG) studies have attempted
to provide information about the functional perfor-
mance of adductor magnus in vivo. Studies by Chang
et al. (2009) and Watanabe et al. (2009) contributed
important information regarding the function of
adductor magnus during ice-skating and cycling,
respectively. However, both studies were limited by
the use of surface electrodes to record adductor mag-
nus activity, which is located deep in the thigh, and
thus may be susceptible to myoelectric cross-talk
from surrounding muscles. Green and Morris (1970)
used fine-wire EMG to provide real-time information
of the direction-specific action of adductor magnus
during multiple hip movements. In the anatomical
position, they suggested that adductor magnus was
most active in hip extension and adduction, with mod-
erate activity in hip external and internal rotation.
However, this study only placed a single fine-wire
electrode into adductor magnus, and therefore may
have only recorded activity from one segment of the
large muscle. Similarly, Greenlaw (1973) also used
fine-wire electrodes to examine adductor magnus.
Two electrodes were inserted into the muscle, specifi-
cally the proximal portion and more distal portion of
adductor magnus. Muscle activity was recorded across
a range of tasks, including walking, and controlled,
submaximal direction-specific tasks. The author con-
cluded that the proximal fibers were active as adduc-
tors, internal rotators, and flexors of the hip; while
the distal fibers differed in the sagittal plane activity,
describing them as extensors of the hip. However,
only surface landmarks were used to identify the loca-
tion of the electrode insertion site, and the electrodes
were not inserted with ultrasound guidance. Fine wire
electrode insertions are ideally performed with real-
time ultrasound guidance to ensure accurate insertion
into the correct muscle belly (Hodges et al. 1997).
Clearly, differences between proximal and distal fibers
have been described cadaverically, biomechanically,
and functionally (muscle activity), however, methodo-
logical concerns limit our confidence in these findings.
The aim of this study was to use ultrasound-guided
fine wire EMG electrodes to determine the direction-
specific action of proximal and distal portions of
adductor magnus. In addition, we aimed to determine
if each muscle segment was functionally distinct.
It was hypothesized that the proximal portion of
adductor magnus is functionally distinct from the dis-
tal portion, particularly in actions directed in the trans-
verse and sagittal planes.

Fig. 1. Schematic diagram illustrating the posterior
view of the hip joint and adductor magnus muscle bulk.
(A) Ultrasound image and schematic diagram at the level
of the lesser trochanter (LT), showing the location of glu-
teus maximus (GMax), sciatic nerve (Sci. nn.) and quad-
ratus femoris (QF). (B) Ultrasound image and schematic
diagram illustrating the insertion of the fine wire electrode
MATERIALS AND METHODS
Study Design and Participants
A convenience sample of 12 healthy young adults
(4 female) volunteered for this cross-sectional,
repeated measures study. Participants were recruited
through university noticeboards and social media. Par-
ticipants were required to be physically active and
complete at least two hours of physical activity per
week. Volunteers were excluded from participating in
the study if they had back or lower limb pathologies in
the past 3 months that required intervention or time
off work, sport or leisure activities. The study protocol
was approved by the University Human Ethics Com-
mittee (UHEC 2013001448). Informed written con-
sent was obtained from all participants prior to data
collection, and the rights of each participant were
protected.
Instrumentation and Electrode Insertion
Intramuscular electrodes, which consisted of 75 lm
R coated fine wires (A-M
bipolar stainless steel, TeflonV
Adductor Magnus 537
into proximal adductor magnus (Prox. AM) adjacent to
the proximal femur (Fem.). (C) Schematic diagram and
ultrasound image showing the insertion path of a fine wire
electrode into distal adductor magnus (Distal AM), which
was directed anterior to the semimembranosus (SM) and
deep to gracilis (Grac). [Color figure can be viewed at
wileyonlinelibrary.com]
Systems, Washington) were prepared as described in
Basmajian and Stecko (1962), leaving a 1 mm record-
ing surface for each electrode. The stance-dominant
limb was determined and used as the test limb for
each participant (Bullock-Saxton et al. 2001). The
electrodes were inserted into proximal and distal
adductor magnus under the guidance of real-time
ultrasound (Fig. 1) (LOGIQTM V2, GE Healthcare, Chi-
cago, IL).
The proximal electrode position was marked with
the participant laying prone. The midpoint of a line
between the distal point of the greater trochanter and
the ischial tuberosity was marked and used as a refer-
ence point. An ultrasound probe was placed on this
reference point and used to identify the level of the
lesser trochanter (Fig. 1A). Proximal adductor magnus
was then identified by moving the transducer head
slightly distal (3 cm) beyond the lesser trochanter,
and the fine wire electrode was then inserted into the
adductor magnus using a 9 cm spinal needle (Terumo,
Tokyo, Japan), guided by real-time ultrasound (Fig.
1B). For distal adductor magnus, the intramuscular
electrode was inserted with the participant lying on
their ipsilateral side. One-third of the distance of a line
538 Benn et al.

TABLE 1. Description of MVIC Actions

Action at hip Position Resistance

Internal Rotation
External Rotation
Flexion
Extension
Abduction
Adduction
Adduction Ball Squeeze
at 458 hip flexion
Adduction Ball Squeeze
at 908 hip flexion
Prone Manual resistance applied by investigator
Hip—anatomical position at lateral distal leg.
Knee—908 flexion
Prone Manual resistance applied by investigator
Hip—anatomical position at medial distal leg.
Knee—908 flexion
Side lie—stance leg Belt and manual resistance by investigator
uppermost applied at anterior distal femur.
Hip—anatomical position
Knee—908 flexion
Prone Belt secured around the plinth and the
Hip—anatomical position plantar aspect of the participant’s foot.
Knee—908 flexion
Side lie—stance leg upper- Belt secured around plinth and the lateral
most, pillow between knees aspect of the participant’s knee.
Hip—anatomical position
Knee—anatomical position
Supine Manual resistance applied by investigator
Hip—anatomical position at medial border distal leg, bilaterally.
Knee—anatomical position
Supine—feet placed flat on Ball of diameter 22 cm used for resistance.
plinth Ball positioned between medial femoral
Hips—458 flexion condyles.
Knees—908 flexion
Supine—feet placed flat on Ball of diameter 22 cm used for resistance.
wall Ball positioned between medial femoral
Hips—908 flexion condyles.
Knees—908 flexion

between the ischial tuberosity and the adductor tuber-
cle was marked, and the electrode was inserted at
this point into adductor magnus, anterior to the ham-
string muscle bulk and deep to gracilis (Fig. 1C), using
a 7 cm spinal needle (Terumo, Tokyo, Japan). The
needle was inserted under ultrasound guidance, to
ensure the electrode was placed in the belly of adduc-
tor magnus. The needles were removed immediately
after correct placement of the electrodes, and then
the electrodes were connected to a Trigno wireless
R
16-Channel EMG system (DelsysV Inc., Boston), which
was used to collect raw EMG signals.
Experimental Procedure
In addition to limb dominance, demographic data,
including sex, age, weight, and height were collected
from participants at the beginning of the trial. The
Bone-Specific Physical Activity Questionnaire (BPAQ)
was used to record physical activity levels over the
last year, and reported as average minutes per week
(Weeks and Beck, 2008).
Following insertion of each of the intramuscular
electrodes, participants completed a series of maxi-
mum voluntary isometric contractions (MVICs) in
eight directions (Table 1). Participants were instructed
to increase the force of their contraction over one sec-
ond against resistance, and maintain their maximum
effort for 3 s, before reducing the force over one sec-
ond. Each MVIC was repeated twice for each position,
with a 60-s rest between repetitions. The order of the
MVICs were randomized, and consistent verbal
encouragement was provided for all trials by the same
person, using the cues of “Ready and Push, Push,
Push, Push, Relax” for each MVIC.
MVIC EMG Data Acquisition, Processing
and Statistical Analysis
The raw EMG signal from the three-second MVIC
was recorded for analysis using a Trigno wireless EMG
system (Delsys V R Inc, Boston, USA; CMRR >80 dB
@60 Hz; gain of 1000; band pass filtered at 20–900
Hz) and sampled at 2000 Hz. Processing of the raw
R
EMG data was performed using DelsysV EMGworks
version 4.0 signal analysis software. EMG data were
adjusted for DC offset (subtraction of the signal mean
prior to wave rectification), and the intramuscular
EMG signal was then passed through a high-pass 4th
order Butterworth filter (50 Hz cut-off frequency)
(Semciw et al. 2015), in order to remove low fre-
quency artefact from the raw signal. Following this,
signals were full-wave rectified and filtered with a
low-pass 4th order Butterworth filter (6 Hz cut-off fre-
quency) to generate a linear envelope (Semciw et al.
2014b).
The mean EMG amplitude was determined from the
middle 1 s of each MVIC trial, and the higher value
(from the 2 contractions completed in each MVIC
direction) was used for further analysis (i.e., 1 value
for each of the 8 directions). This value was then nor-
malized to the highest recorded amplitude across all
eight MVIC trials. The normalized EMG amplitude is
reported throughout the manuscript. Muscle activity is
described as very high (>60% MVIC), high (41–60%

TABLE 2. Participant Demographic Data
Variable
n (female) 12 (4)
Age (range) (years) 21.4 (20–25)
Body mass (SD) (kg) 70.2 (12.3)
Height (SD) (cm) 176.6 (8.8)
BMI (SD) (kg/m2) 22.4 (2.7)
Stance limb—left 11
Physical Activity (SD) (min/wk) 426.3 (256.5)
MVIC), moderate (21–40% MVIC) or low (0–20%
MVIC) level activation (Reiman et al. 2012).
The normalized EMG amplitude data of each muscle
portion were not normally distributed across partici-
pants (indicated by box-plots and Kolmogorov Smir-
nov test), therefore non-parametric statistical
comparisons were used. Wilcoxon signed-rank tests
were used to determine if functional differences
existed between the proximal and distal portions
within each action. Differences were considered signif-
icant where P < 0.05. A standardized effect size (ES)
was used to provide an indication of the magnitude of
difference between each muscle activity within an
action. An ES was calculated by dividing the z scores
of the Wilcoxon Signed Rank Test by the square root
of the sample size (Field, 2009), and an ES of 0.2,
0.5, and 0.8 were considered small, medium and
large effect respectively (Cohen, 1988). Based on the
ES magnitude, and given the limited sample size in
this study, post-hoc sample size calculations were per-
formed to determine the minimum sample required to
detect a significant difference (P < 0.05) between
proximal and distal portions of adductor magnus
across each action, with a power of 0.80 using GPo-
wer Software (version 3.1) (Faul et al. 2007). All sta-
tistical comparisons were performed using SPSS
statistical software package (version 19, IBM SPSS
Inc., Chicago, IL).
Fig. 2. Box-plots illustrating the minimum, lower quartile, median, upper quartile
and maximum relative EMG amplitude of proximal (prox) and distal (dist) adductor
magnus during MVICs. *P < 0.05.
Adductor Magnus 539
RESULTS
Analysis was conducted on data collected from 12
participants for all actions except hip internal rotation,
for which analysis was performed on 11 participants
due to an equipment fault.
Participant demographic data including the mean
(SD) age, body mass, height, activity profiles, and
stance dominant limb are presented in Table 2.
Normalized EMG amplitudes of adductor magnus
portions for each of the eight MVIC trials are shown in
Figure 2. The distal portion was most active during hip
extension [median (interquartile range); 100(0)%
MVIC] followed by internal rotation [58(34)% MVIC],
with moderate activity levels recorded for adduction
(at 08 hip flexion) [38(46)% MVIC]. The proximal por-
tion was most active during hip extension [100(49)%
MVIC] and adduction (at 08 hip flexion) [59(64)%
MVIC]. For hip adduction, activity was highest for both
muscles with the hip in anatomical position, and
decreasing levels of activity were found when per-
forming adduction in increasing angles of hip flexion,
from 458 to 908. Low level activity was recorded for
proximal adductor magnus in external rotation, and
for both portions during flexion and abduction MVICs.
Statistical comparisons and ES for each of the iso-
metric hip actions are outlined in Appendix 1, Sup-
porting Information. The relative contribution of the
proximal portion [7(15)% MVIC] was lower than the
distal portion [59(34)% MVIC] during internal rotation
(P < 0.001; ES 5 0.88). Proximal adductor magnus
activity [15(41)% MVIC] was higher than distal
[2(1)% MVIC] during external rotation (P 5 0.003,
ES 5 0.79). No significant differences in activity
between proximal and distal portions (normalized to
their maximal contribution in any position) were
observed for other actions. Post-hoc sample size cal-
culations suggest that 27 and 28 participants may be
required to detect a moderate difference (ES > 0.57)
between muscle segments during extension and
540 Benn et al.
adduction (08) MVICs respectively. All other actions
would require large sample sizes (>100 participants)
to detect only small differences (ES < 0.25).
DISCUSSION
This study has a number of important findings.
First, both muscle segments were very highly active
during maximum resisted hip extension. Second, both
segments were moderately to highly active during
maximum resisted hip adduction (in the anatomical
position), and the activity in each segment was
reduced during maximal adduction contractions, as
the hip was positioned in more flexion. Finally, this
study found that adductor magnus consists of at least
two functionally distinct segments. The contribution of
each muscle to hip rotation differed significantly; dis-
tal adductor magnus was more active than proximal
during hip internal rotation, and proximal adductor
magnus was more active than distal in hip external
rotation.
The functional differentiation of adductor magnus
into proximal and distal portions demonstrated in this
study supports previous cadaveric and biomechanical
research. Cadaveric studies demonstrate morphologi-
cal partitioning from proximal to distal (Takizawa et al.
2014b), based on volume and pennation angle. Bio-
mechanical studies indicate that moment arms sur-
rounding the hip joint differ between proximal and
distal segments (although small in magnitude), partic-
ularly in the transverse plane (Dostal et al. 1986;
Arnold and Delp, 2001). Our study supplements those
above with EMG evidence to support functional differ-
entiation of adductor magnus. Contrary to our hypoth-
esis however, we did not find functional differences in
the sagittal plane, as both segments were most active
during hip extension.
According to our findings, proximal adductor mag-
nus is highly active during maximal resisted extension
and adduction (anatomical position); and is minimally
active in external rotation. One of the earliest studies
to investigate the proximal adductor magnus with
fine-wire EMG attributed “strong” levels of activity
during submaximal adduction, and “moderate” levels
during submaximal flexion and internal rotation
(Greenlaw, 1973). Despite being an innovative study
at the time, muscle activity was not quantified, and
the insertion of electrodes was not guided by real-
time ultrasound. Furthermore, electrodes were
inserted anteriorly with a short 1.5-in. needle; if the
electrode was not inserted far enough, it is likely that
recorded activity was from more anteriorly located hip
flexors and internal rotators.
Based on moment arms, biomechanical studies
attribute a primary role of adduction to proximal
adductor magnus in the anatomical position (Dostal
et al. 1986; Neumann, 2010), with minimal contribu-
tion to transverse motion (Dostal et al. 1986; no
moment arm) (Arnold and Delp, 2001; slight external
rotation moment arm), or sagittal plane motion (Dos-
tal et al. 1986; slight flexion moment arm). Human
experiments have provided some evidence that the
mechanical advantage of a muscle (related to its
moment arm) and the neural drive it receives during a
voluntary motor task is coupled (De Troyer et al.
2005; Gandevia et al. 2006; Hudson et al. 2009).
Surprisingly then, the high levels of activity recorded
for proximal adductor magnus during maximum
resisted hip extension are contradictory to the slight
flexion based moment reported by Dostal et al.
(1986). It is important to consider that the study by
Dostal et al. (1986) was based on one cadaveric
specimen, limiting overall confidence in the findings;
and neural drive recorded during extension in our
study may be influenced by more than just moment
arm; such as participant effort levels and accuracy of
direction-specific performance.
The distal portion of adductor magnus was most
active during maximal resisted extension, and moder-
ate to highly active in internal rotation and adduction,
in the anatomical position. There are two previous
fine wire studies that have attempted to examine the
direction-specific action of distal adductor magnus
(Green et al.1970; Greenlaw 1973). Both studies are
over forty years old; were qualitative in nature; and
did not confirm the location of the electrodes with
real-time ultrasound. Nevertheless, their findings
were consistent with ours, and described this portion
of adductor magnus as being active during hip exten-
sion, adduction and internal rotation, across a range
of submaximal tasks. It is also consistent with
moment arms described from the cadaveric specimen
examined by Dostal et al. (1986).
Neural drive to both portions of adductor magnus
during maximum resisted adduction decreased as the
hip was placed in a more flexed position (to 908 flex-
ion). Changes in morphological properties such as
moment arm and muscle length through the sagittal
plane are not well described in the literature, making
direct comparisons to neural drive difficult. Nonethe-
less, our results suggest that the adductor magnus is
activated to its greatest adduction capacity, when the
participant is in the anatomical position.
Clinical Implications
Given that adductor magnus was most active in
extension (both portions), it could be regarded as
more of a hip extensor than hip adductor in the ana-
tomical position. This has important clinical implica-
tions, particularly with regards to its contribution to
injuries of the hip and groin. Recent research indicates
that adductor magnus may be less involved in groin
related injuries than previously thought, and perhaps
more involved with posterior thigh pain (Serner et al.
2017). This functional relationship with posterior hip
extensors (e.g., the hamstrings) is further supported
in a biomechanical study by Chumanov et al. (2007)
who suggested that adductor magnus had the great-
est potential of all lumbo-pelvic muscles to decrease
the stretch on lateral hamstring muscles, and there-
fore may play an important role in reducing hamstring
injuries caused by muscle elongation during running.
The results of the current study also suggest that
adductor magnus may make more of a contribution to
hip and pelvic rotation than previously thought (Dostal

et al. 1986; Arnold and Delp, 2001). Proximal adduc-
tor magnus was active (although minimally) during
maximum resisted hip external rotation in the ana-
tomical position. Functionally, given its small volume
(Takizawa et al. 2014b) and minimal rotational
moment arm (Dostal et al. 1986; Arnold and Delp,
2001), it is unlikely to generate large torques in this
plane. It may however play a synergistic role with
other primary hip external rotators (e.g., gluteus max-
imus (Neumann, 2010)). Alternatively, the fibers are
oriented in a way to facilitate hip joint stability (Taki-
zawa et al. 2014b), perhaps as with other local hip
joint muscles (Gottschalk et al. 1989), by helping to
draw the head of femur into the acetabulum. On the
other hand, the distal segment recorded high ampli-
tude activity during maximum resisted hip internal
rotation in the anatomical position. Whilst there are
no primary internal rotators of the hip, this portion of
adductor magnus would likely contribute a synergistic
role to this action, along with several other hip
muscles (e.g., tensor fasciae latae and the anterior
fibers of gluteus medius) (Neumann, 2010). The
large, long fibers of the distal segment (Takizawa
et al. 2014b) may enable it to generate large torques
for moving or displacing the hip joint, or alternatively,
controlling pelvic motion on a fixed lower limb, partic-
ularly during the stance phase of the gait cycle
(Greenlaw, 1973). Being highly active during internal
rotation, as well as extension and adduction, would
enable it to contribute to complex tri-planar actions of
the hip joint during functional tasks such as the stance
phase of both walking and running (Hamner et al.
2010).
It could be recommended, based on the findings of
this study, that strengthening programs for adductor
magnus should consider the likelihood that it has at
least two functionally distinct segments. It could also
be recommended that programs should target exten-
sion and adduction for proximal adductor magnus,
such as a bilateral squat exercise with an adduction
ball squeeze; and extension, internal rotation and
adduction for distal adductor magnus, for example a
bridging exercise with a resistive theraband compo-
nent around the medial aspect of the knee, requiring
active hip adduction and internal rotation while
extending the hip into a bridge position.
Considerations for Interpretation, and
Future Research
There were some limitations to this research. This
study evaluated muscle activity during static tasks,
primarily in the anatomical position. Further research
is needed to determine if functionally distinct seg-
ments exist within the muscle during submaximal,
dynamic tasks that more closely reflect activities of
daily living, for example, walking or running. The sam-
ple size was small and it was not possible to perform
power calculations for sample size due to the explor-
atory nature of this investigation. While the sample
size was sufficient to detect differences between the
proximal and distal segments of the muscle for actions
in the transverse plane, a larger sample size of
Adductor Magnus 541
approximately 30 participants may have led to statis-
tically significant differences also being found between
the segments of adductor magnus for both hip exten-
sion and adduction in the anatomical position. In addi-
tion, the volunteers were a homogenous, convenience
sample of physically active, healthy, university-aged
students and this study did not examine other popula-
tions such as elite athletes, those with hip pathology,
adductor-related groin pain, or hamstring strain
injury. Furthermore, this study partitioned adductor
magnus into two segments in the proximal-to-distal
direction, based on cadaveric dissections of the mus-
cle (Takizawa et al. 2014b), however it is possible that
there may be further subdivisions in this direction.
Additionally, Dostal et al. (1986) and Neumann
(2010) describe adductor magnus as having separate
muscle segments in the anterior to posterior direction.
Further research is also warranted to examine the
function of these muscle segments within other popu-
lations, particularly pathological groups, to provide
further information as to their contribution to hip joint
dysfunction. Investigations in people with hip and
groin pain, or patellofemoral pain syndrome during
dynamic tasks could provide some functional rele-
vance to the hip strength deficits observed in these
populations (Rathleff et al. 2014; Freke et al. 2016).
Furthermore, differences in the rotational contribu-
tions for each muscle segment was established only
when testing the hip in the anatomical position. It has
been suggested that the action of the hip adductor
group changes with differing hip angles (Dostal et al.
1986; Arnold and Delp, 2001). This was consistent
with our study, where both portions of adductor mag-
nus made decreasing contributions to hip adduction
with increasing angles of hip flexion. Therefore, fur-
ther investigation is needed to determine the contri-
bution of adductor magnus to rotation through
different planes of movement.
CONCLUSION
Adductor magnus is composed of at least two func-
tionally unique segments. During maximum isometric
contractions in the anatomical position, proximal and
distal adductor magnus were most active in hip exten-
sion, both made contributions to adduction, with func-
tional differences most evident during rotation. The
level of adduction activity decreases as the hip is
flexed to ninety degrees. When considered together
with cadaveric and biomechanical literature, the data
supports a hip stabilizing role for proximal adductor
magnus, and a synergistic role during hip internal
rotation for distal adductor magnus, in the anatomical
position. Further work is required to clarify functional
differences between these muscle segments in clinical
populations, and in dynamic tasks such as walking.
ACKNOWLEDGMENTS
We would like to acknowledge the volunteers who
participated in this study. Conflict of interest: There
were no conflicts of interest. Author Contributions:
542 Benn et al.
Matthew Benn contributed to project design, acquisi-
tion of data, data analysis and interpretation, drafting
of the manuscript, critical revision of the manuscript
and approval of the article; Dr Tania Pizzari contributed
to conception and design of the project, data analysis
and interpretation, critical revision of the manuscript
and approval of the article; Leanne Rath contributed to
conception and design of the project, data interpreta-
tion, critical revision of the manuscript and approval of
the article; Dr Kylie Tucker contributed to project
design, acquisition of data, data interpretation, critical
revision of the manuscript and approval of the article;
Dr Adam Semciw contributed to conception and project
design, acquisition of data, data analysis and interpre-
tation, drafting of the manuscript, critical revision of
the manuscript and approval of the article.
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