The hip flexors help balance the posterior pelvic muscles. Three key muscles often become tight and shortened as a result of activities of daily living. These are the iliacus, psoas major, and the rectus femoris. The iliacus and the psoas major are often referred to as the iliopsoas because they share the same insertion at the lesser trochanter of the femur. The psoas minor inserts on the superior ramus of the pubis bone and mainly supports the natural lordotic curvature of the spine, but is only found in about 40% of the population. The psoas major originates on the anterior surface of the lumbar vertebrae and runs over the pubis bone and inserts into the lesser trochanter of the femur. This muscle not only helps to flex the hip, but also has an effect on the lordotic curvature of the lumbar vertebrae. The rectus femoris has a proximal attachment at the acetabulum and inserts into the tibial tuberosity. This long muscle plays a role in both hip flexion and leg extension (Figure 9-4).
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