LOWER LIMB

GENERAL INFORMATION

The lower limb consists of the hip, thigh, knee, leg, ankle and foot. It plays a crucial role in movement, weight-bearing and balance, making it essential for walking, running and jumping. This region’s muscles, bones, joints and nerves work together to facilitate locomotion and support body posture.

ORIGIN

The muscles of the lower limb originate from various bones in the pelvis and femur:

• Gluteus Maximus: Originates from the ilium, sacrum and coccyx, forming the most significant muscle in the lower limb.
• Rectus Femoris: One of the quadriceps muscles originating from the anterior inferior iliac spine.
• Hamstrings: Originates from the ischial tuberosity of the pelvis.
• Tibialis Anterior: Originates from the upper two-thirds of the lateral surface of the tibia.

INSERTION POINT

The muscles of the lower limb insert into different bones, facilitating joint movements:

• Gluteus Maximus: Inserts into the femur’s iliotibial tract and gluteal tuberosity.
• Rectus Femoris: Inserts into the patella via the quadriceps tendon.
• Hamstrings: Inserts into the tibia and fibula, controlling knee flexion and hip extension.
• Tibialis Anterior: Inserts into the medial cuneiform and base of the first metatarsal bone of the foot.

MAJOR ARTERIES

The lower limb receives its blood supply from major arteries, including:

• Femoral artery: The main artery that supplies oxygenated blood to the muscles and tissues of the lower limb.
• Popliteal artery: Supplies blood to the knee joint and surrounding muscles.
• Anterior tibial artery: Supplies blood to the front part of the leg and foot.

NEURAL INNERVATION

The nerves of the lower limb include:

• Sciatic nerve: The largest nerve in the body, responsible for motor and sensory functions in the leg, running from the lower back to the foot.
• Femoral nerve: Innervates the quadriceps muscles and provides sensation to the anterior thigh.
• Tibial nerve: A branch of the sciatic nerve that innervates the calf and foot muscles.

TRIGGER POINT

The lower limb can develop trigger points, particularly in the muscles, causing pain and restricted movement. Trigger points often arise in the hamstrings, calf muscles and quadriceps, leading to discomfort during movement.

CONCENTRIC FUNCTION

Concentric contraction in the lower limb occurs during activities like walking and running:

• Gluteus Maximus: Contracts concentrically to extend the hip during activities like standing up from a seated position.
• Quadriceps: Contracts to extend the knee, allowing for movements such as kicking or climbing stairs.
• Hamstrings: Flex the knee and extend the hip during walking and running.
• Calf Muscles: The gastrocnemius and soleus contract to lift the heel during walking and running.

ECCENTRIC FUNCTION

Eccentric contractions control the lowering phase of movements in the lower limb:

• Quadriceps: Eccentrically controls the lowering of the body during squatting or descending stairs.
• Hamstrings: Eccentrically slow down the forward momentum of the leg during running or deceleration.
• Tibialis Anterior: Controls the lowering of the foot during the heel strike phase of walking.

ISOMETRIC FUNCTION

Isometric contractions in the lower limb stabilise the joints and muscles:

• Gluteus Medius: Contracts isometrically to stabilise the pelvis during single-leg stance or walking.
• Quadriceps: Maintains stability in the knee joint during static postures like standing.
• Calf Muscles: Engage isometrically to maintain balance when standing on the toes.

RELATED MUSCLES SCIENTIFIC NAMES

• Gluteus Maximus: The most significant muscle in the lower limb is responsible for hip extension and stabilising the pelvis.
• Rectus Femoris: Part of the quadriceps, it helps with knee extension and hip flexion.
• Hamstrings: These Include three muscles—biceps femoris, semitendinosus, and semimembranosus—that aid knee flexion and hip extension.
• Gastrocnemius: A calf muscle responsible for plantar flexion and assisting in pushing the body forward during walking and running.
• Tibialis Anterior: Responsible for dorsiflexion, helping lift the foot during walking.

ANTAGONIST

• Hip Flexors: Oppose the gluteus maximus by facilitating hip flexion and pulling the thigh forward.
• Hamstrings: Act as antagonists to the quadriceps by allowing knee flexion.
• Quadriceps: Oppose the hamstrings during hip extension and knee flexion, helping stabilise the pelvis and knee.
• Soleus: Opposes the tibialis anterior by assisting in plantar flexion and stabilising the foot during walking.
• Gluteus Minimus: It works against the adductor muscles by helping with hip abduction and stabilising the lower limb during movement.

COMMON INJURIES

• Hamstring Strain: A tear or overstretching of the hamstring muscles, often caused by sudden acceleration during running, resulting in sharp pain at the back of the thigh.
• Anterior Cruciate Ligament (ACL) Tear: An injury to the ligament in the knee, commonly occurring during pivoting movements or sudden changes in direction, leading to knee instability.
• Shin Splints: Caused by overuse of the tibialis anterior and other leg muscles, resulting in pain along the shin bone, often from running or improper footwear.
• Achilles Tendonitis: Inflammation of the Achilles tendon due to overuse, leading to pain and stiffness in the back of the ankle and lower leg.
• Patellar Tendonitis: An overuse injury that results in inflammation of the tendon connecting the kneecap to the shinbone, causing pain during jumping or running.

EXERCISES

• Squats: Strengthens the gluteus maximus, quadriceps and hamstrings by engaging the entire lower body in a compound movement that improves strength and stability.
• Lunges: Targets the quadriceps, hamstrings and gluteals by stepping forward or backward into a lunge position, enhancing lower body strength and balance.
• Calf Raises: Strengthens the gastrocnemius and soleus by lifting the heels off the ground, improving ankle stability and lower leg strength.
• Leg Press: Targets the quadriceps, hamstrings and gluteals by pushing a weighted platform away from the body, building strength in the lower limb.
• Step-Ups: Engages the quadriceps, gluteals and hamstrings by stepping onto a raised surface, improving balance and functional lower body strength.

STRETCHES

• Hamstring Stretch: Stretches the hamstrings by extending the leg and reaching for the toes, improving flexibility and preventing injury in the back of the thigh.
• Quadriceps Stretch: Performed by pulling the foot towards the buttocks while standing, this stretch targets the front of the thigh, improving flexibility in the quadriceps.
• Calf Stretch: Involves leaning forward with one leg extended behind, pressing the heel into the ground and stretching the gastrocnemius and soleus muscles.
• Hip Flexor Stretch: Targets the iliopsoas by lunging forward with one leg and pushing the hips down, improving mobility and flexibility in the front of the hips.
• IT Band Stretch: Stretches the iliotibial band by crossing one leg over the other and leaning to the side, helping relieve tension along the outer thigh.