Hip Muscle → Test → Diagnosis → Outcome Measure

Overview + individual pathways (Flexors, Extensors, Abductors, Adductors, ER, IR)

Overview (choose a pathway)

flowchart TD
  classDef group fill:#f1f5f9,stroke:#334155,color:#0b1220,rx:10,ry:10;
  A["Hip Muscle Group 
Deficit observed (MMT/gait/task)"]:::group --> B1["Flexors"]:::group
  A --> B2["Extensors"]:::group
  A --> B3["Abductors"]:::group
  A --> B4["Adductors"]:::group
  A --> B5["External Rotators"]:::group
  A --> B6["Internal Rotators"]:::group
  click B1 "#hip-flexors" "Go to Flexors"
  click B2 "#hip-extensors" "Go to Extensors"
  click B3 "#hip-abductors" "Go to Abductors"
  click B4 "#hip-adductors" "Go to Adductors"
  click B5 "#hip-er" "Go to External Rotators"
  click B6 "#hip-ir" "Go to Internal Rotators"

Tip: Use the overview first, then jump to a specific flow below.

Flexors (iliopsoas, RF, TFL, sartorius, pectineus)

flowchart TD
  classDef group fill:#f1f5f9,stroke:#334155,color:#0b1220,rx:10,ry:10;
  classDef test fill:#dbeafe,stroke:#3b82f6,color:#0b1220,rx:10,ry:10;
  classDef dx fill:#ede9fe,stroke:#8b5cf6,color:#0b1220,rx:10,ry:10;
  classDef om fill:#dcfce7,stroke:#059669,color:#0b1220,rx:10,ry:10;
  B1["Flexor deficit or tightness"]:::group --> C1["Tests:
Thomas, SLR"]:::test
  C1 --> D1["Likely Dx:
FAI, Labral tears, Anterior hip pain"]:::dx
  D1 --> E1["Outcome:
iHOT, HOS-ADL"]:::om

Load mgmt + hip-specific strengthening (iliopsoas & trunk) are core in nonarthritic hip CPGs.

Extensors (glute max, hamstrings, add. magnus—post.)

flowchart TD
  classDef group fill:#f1f5f9,stroke:#334155,color:#0b1220,rx:10,ry:10;
  classDef test fill:#dbeafe,stroke:#3b82f6,color:#0b1220,rx:10,ry:10;
  classDef dx fill:#ede9fe,stroke:#8b5cf6,color:#0b1220,rx:10,ry:10;
  classDef om fill:#dcfce7,stroke:#059669,color:#0b1220,rx:10,ry:10;
  B2["Extensor weakness"]:::group --> C2["Tests:
Bridge, Prone Hip Extension"]:::test
  C2 --> D2["Likely Dx:
Hamstring strain, Hip fracture recovery, Post-THA weakness"]:::dx
  D2 --> E2["Outcome:
Gait Speed, Cumulated Ambulation Score"]:::om

Hamstring strain rehab emphasizes eccentric loading; hip fracture CPGs stress early mobilization & gait speed.

Abductors (glute med/min, TFL)

flowchart TD
  classDef group fill:#f1f5f9,stroke:#334155,color:#0b1220,rx:10,ry:10;
  classDef test fill:#dbeafe,stroke:#3b82f6,color:#0b1220,rx:10,ry:10;
  classDef dx fill:#ede9fe,stroke:#8b5cf6,color:#0b1220,rx:10,ry:10;
  classDef om fill:#dcfce7,stroke:#059669,color:#0b1220,rx:10,ry:10;
  B3["Abductor weakness / overactive TFL"]:::group --> C3["Tests:
Trendelenburg, Single-Leg Squat"]:::test
  C3 --> D3["Likely Dx:
Patellofemoral pain, Hip OA, ITB syndrome"]:::dx
  D3 --> E3["Outcome:
LEFS, KOOS-PF"]:::om

PFP CPG favors combined hip + knee exercise; early hip-dominant work often outperforms knee-only.

Adductors (longus, brevis, magnus, gracilis, pectineus)

flowchart TD
  classDef group fill:#f1f5f9,stroke:#334155,color:#0b1220,rx:10,ry:10;
  classDef test fill:#dbeafe,stroke:#3b82f6,color:#0b1220,rx:10,ry:10;
  classDef dx fill:#ede9fe,stroke:#8b5cf6,color:#0b1220,rx:10,ry:10;
  classDef om fill:#dcfce7,stroke:#059669,color:#0b1220,rx:10,ry:10;
  B4["Adductor weakness/tightness"]:::group --> C4["Tests:
Resisted adduction, Palpation"]:::test
  C4 --> D4["Likely Dx:
Adductor strain, Athletic pubalgia, Groin pain syndrome"]:::dx
  D4 --> E4["Outcome:
HAGOS, iHOT"]:::om

HAGOS is hip/groin-specific and recommended for activity/participation tracking.

External Rotators (piriformis, obturators, gemelli, QF, obt. externus)

flowchart TD
  classDef group fill:#f1f5f9,stroke:#334155,color:#0b1220,rx:10,ry:10;
  classDef test fill:#dbeafe,stroke:#3b82f6,color:#0b1220,rx:10,ry:10;
  classDef dx fill:#ede9fe,stroke:#8b5cf6,color:#0b1220,rx:10,ry:10;
  classDef om fill:#dcfce7,stroke:#059669,color:#0b1220,rx:10,ry:10;
  B5["ER weakness or overactivity (piriformis)"]:::group --> C5["Tests:
FABER, FAIR, Resisted ER"]:::test
  C5 --> D5["Likely Dx:
Piriformis syndrome, Posterior hip impingement"]:::dx
  D5 --> E5["Outcome:
HOS-Sports, SEBT"]:::om

Consider lumbopelvic control & gait retraining when ERs are overloaded.

Internal Rotators (ant. glute med/min, TFL; adductors in flexion)

flowchart TD
  classDef group fill:#f1f5f9,stroke:#334155,color:#0b1220,rx:10,ry:10;
  classDef test fill:#dbeafe,stroke:#3b82f6,color:#0b1220,rx:10,ry:10;
  classDef dx fill:#ede9fe,stroke:#8b5cf6,color:#0b1220,rx:10,ry:10;
  classDef om fill:#dcfce7,stroke:#059669,color:#0b1220,rx:10,ry:10;
  B6["IR weakness (often subtle)"]:::group --> C6["Tests:
FADIR, Single-Leg Step-Down"]:::test
  C6 --> D6["Likely Dx:
FAI, Patellofemoral pain (dynamic valgus)"]:::dx
  D6 --> E6["Outcome:
AKPS, KOOS-PF, HAGOS"]:::om

Target IR capacity + cadence/kinematics tweaks for runners with PFP features.