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Electromyography of iliopsoas.

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ELECTBOMYOGRA P€IY O F ILIOI’SOAS
SOHX
17.
BASMAJIAN
I)cytr~?mwit o f -4 n u t o m y , Qiiccn ’s Uniz.ersztj1,
Kingston, Ontario, Canada
T \ V O E’IGURES
Rcccnt advances in thc surgery of tlic hip joint have focussed attention on the niuacles ol’ the region. Interest in the
functions of iliopsoas in particular has been renewed by the
novel surgical procedure inti.odnccd by Alustarcl ( 5 2 ) in
wliicli the insertion of iliopsoas is transplanted to the greater
trochanter to substitute for paralyzed abductor muscles. Nust a d fiiids that the resulting restoration of stability to the pelvis greatly outweighs the reduction of flexor power. The remaining flcxor muscles are quitc capable of providing any
needed fleyion f o r ordinary functions (ilfustarcl, ’,5S).
When one begins to search the usual source-books f o r
precise infomiation about the actioiis and functions of
iliopsoas, the only point that is agreed upon by all is that the
muscle is obviously a flexor of the hip and probably has some
influence on the lumbar vertebrae. There is a confusing clisagreenicnt about the other influcnces produced by the muscle.
Last (’5.2)ascribes medial rotation of the hip mainly to the
“ponrerful pull of ilia-psoas." ’I’he iimerican Grct?j’sAnntonz,?j
edited by Goss (’48) states that it rotates the hip mediallp
while the British GTCL~J’S
edited by Johnston and TVhillis (’54)
is more cautious with “it produces a slight degree of medial
rotation. . . .” Lockhart ( ’,5l) in Cul.zninghnin’s T c z f b o o k
agrees with this and Grant ( ’52)’ although he sounds a note of
skepticism, holds out f o r medial rotation too. Woodburne
1 Supported iii p a r t by a grant from the Biekell Foundation aiid the Bniiting
Research Foundation.
127
( ' 3 7 ) agrees with Steciictiqjli ( '4s) that iliopsoas rotates
nicclialiy \vIieii tlic liilll) is extended an d laterally -\vheii it is
flesctl. To coiiil)lete the spcctriun of opinion, a t least a tlozcil
major reference \vorl;s (see Stce11dijli, '45) state t h at iliopsoas is a lateral rotator.
In this running coiitroversy that is iioiv iiiore tllaii a century
old aliiiost evei*yoiic has lost sight of the priiiei1)le that a
riiusclc so close to ;I joint must have a n iiiil)ortaiit posturd
o r st;il)iliziiig funct ioii.
Because tlic coiijectuid iiicttliods of the past liavc not
produced a cl ca ia-cut ail STVCr, a precise clec t roniy oglapiii c
study \\'as u1ltlertal;eli.
1\1>4TEJZl41, ASL) 31ETIIOI)S
Records were iiiaclc of tlic activity of iiio1)soas iii 4
young men using concentric iicecllc eicctrocles thrust into
iliacus f o r a depth of tn o iii~'li(>s
froin tlic skin suifaw just
niec1i;il to tlie anterior superior iliac bpiiie. ,\ltliougii tlic
i
of iliacns, 0111'
actioiis of psoas iiiny possibly rliflcr f i ~ ) ntliose
espei*ience with other two-licacletl muscles (Basiiiajian anll
Latif, ' 3 7 ) snggrsts tha t this is iiiilikely insofar a s actions
of i1iol)soas a t tlic hip are eoiicrrnt~rl. Tlici appai*atiisiisetl is
a special multi-channel elect ix)niyogray)li l n i l t by Stan1c;v Cox
Ltcl. It and the details of technique a i descrilietl
~
eist1\\ liere
(Basiriajian, '57, '53). The u D c of yliotogrw1diic recordings
from tlie faces of cathode-ray oscilloscopes coni1,iiietl ivith
clcetimlcs pi.o\-itlcs
liigii-gain arnp1ifici.s and conecnt~*ic-accdlc
a liigliip ix~lialdeiii(1ex of cveii the slightest activity. IUtliougli
iiiaiip aiitl vai-ietl tests were c a r r i d out olily the p'c.i*tiiicnt
oiieb \vill be coiisitlcred.
ELECTROMYOGRdl'H P O F ILIOPSOAS
129
X7hile the subjects were standing at ease there was R
continuous slight to moderate level of activity (fig. 1A). I n
one of the 4 subjects there were intermittent short bursts
of marked activity at irregular hut short intervals with no
apparent change of position of either limb o r trunk and with
the subject unaware of any change (fig. 1B).
When tlie subjects were recljnii7g or sitting at ease there
was no activity (fig. 1C).
Both medial and lateral rotation of the hip joint, whether
the joint was passively or actively held in any of the extended,
semi-flexed or flexed positions produced some slight activity
in all 4 men (fig. 2). I n two there was slight but equal
activity in both directions; in the third there ~ v a sslightly
moiv activity 011 medial rotation; and in the fourth there was
slightly more on lateral rotation.
SUMMARY AND COSCLURTOSS
Iliopsoas is shown by this electrornyographic study to bcl
a n active postural or stahilizing muscle of the hip joint as
ivell as a flexor. The controversy a s to whether it H a nieclial
or a lateral rotator should be ahancloned because in fact it is
neither one nor the other.
ACKKOJiJLEDGMENTS
The author is indebted to 1\11..P. Mott and Ah-. C. Storton
f o r photographic work.
LITEKATURE CITED
Easir.i.rInN, J. V. 1957 Elcctroni?.oRI.n1)lly of two-joint I ~ I I S C ~ Anat.
.
Bc3c.
129: 371-380.
1958 A new six-cliannel electrornyograph f o r studies on muscle.
I nstitutc of Radio Eiiginwrs Transactions 011 Medical Electronics,
PGME-11: 45-47.
BASMAJIAN,
J. V., AND A. LATIF 1957 Integrated actions and functions of t h e
chief flexors of tlie elbow : LI. dcl ailed electroinyographic analysis. J .
Bone and Joint Surg., 3 9 - 8 : 1106-1118.
Cross, C. M. 1948 (editor) Gray's A!i:itomy of tlie Hulnan Body, 25th ed.
Lea and Febiger, Philaclelp11i.i.
GRANT, J. C. B. 1952 A Method of Anatomy: Dcscriptivc and Deductive.
Williams and Wilkins, Baltimore.
130
JOHN
a
V.
BASMAJIAN
ELECTKOMYOGRAPHY O F ILIOPSOAS
m
131
132
J O H N V.
I~BSMAJlAN
T. G., IXD J . HILLIS IS 1 9 . 2 (etlitors) (:ray’s ~\ii:itoiny, 1)escriptire
aild Applied, X l s t cY1. ~ ~ O l l ~ l l l : ~ i~l Sl c, e l l:llltL C‘O., ~ ~ O l l C ~ O l l .
LOCKRAKT,
R. D. 1951 h i : Chiiiiiiigliaiii’s ‘Prst-lJook of A h a t o n l y (J. c. nrnsli,
ed.) 9 t h ecl. Oxford C i i i
MUSTARD, W. T. 1952 Iliopsoas t
c)f tlic h i p abductors.
J. Boiie aiid J o i n t Surg., 3 - . ~ 1: fi47-650.
1958 Peixoiinl eoiiiiiiiiiiic:i~iori.
STEENDIJK,
R. I948 011 the lot:itiiig fiiiictioii of the ilio-lisoab niusclc. Beta
Neerl. Morpli. Xoriii. et P:itli., ti‘: 175-183.
WOODI~URNE,
R. T. 1957 Essentials of E u m a n Aii:ttoiny. Osforit University
Press, New York.
JOHNSTON,
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