The Gracilis: pain generator in knee

The gracilis is one of the contributor to the pes anserine when we consider to knee pain. It helps to add stability to the medial stabilizing complex of the knee. During a gait cycle, the gracilis contracts throughout stance phase with bursts from terminal swing through initial contact and again from pre swing to initial swing.

The gracilis is a superficial muscle on the medial thigh, running from the the pubic symphisis and upper pubic arch to the pes. The muscle adducts, medially rotates (with hip flexion), laterally rotates, and flexes the hip joint and also help in flexion of the knee.

It can be called upon as a thigh flexor (as can the sartorius), When The TFL, rectus femoris and iliopsoas groups are dysfunctional and obliques fails to initiate hip flexion. Gracilis dysfunction may contribute to medial knee pain when the hip flexion is required. When your patients have excessive mid foot pronation. During prolong standing and sudden start of walking that erthe foot requires on the ground too long and need some “help” or a “jump start” to initiate thigh flexion.
Think about this “unsung hero” next time you have a recalcitrant medial knee pain patient.

• Reference:
• Gray H: Anatomy of the Human Body Lea and Febiger, Phildelphia and New York 1918
• Michaud T: in Human Locomotion: The Conservative Management of Gait-Related Disorders 2011

• Gupta, Aman & Saraf, Abhinesh & Yadav, Chandrajeet. (2013). ISSN 2347-954X (Print) High-Resolution Ultrasonography in PesAnserinus Bursitis: Case Report and Literature Review. 1. 753-757.
• image courtesy : getbodysmart.com