Gracilis – Functional Anatomy

Overview

Gracilis is a long, thin muscle on the medial aspect of the thigh.

Origin

• medial ischiopubic ramus

Insertion

• medial tibia via pes anserine

Function

• hip adduction
• hip flexion
• assists in the internal rotation of the hip as well as flexion and internal rotation of the knee

Nerve

• obturator nerve, L2-L4

Functional Considerations

Gracilis is a weaker adductor. Consequently, sudden overload commonly injures this muscle. Typically, this involves groin pulls and adductor problems related to sports and accidental injury.

Anomalies, Etc.

Studies like this show that variations typically involve the arrangement of fascicles. Additionally, anomalies are more frequent at the pes anserine.

However, reconstructive surgery frequently harvests gracilis. Its elastic modulation provides advantages for those surgeries. It is used in many areas, some of which may be surprising. Facial, brachial, knee reconstruction, and more may use gracilis for reconstruction.

Anomalies, Etc.

Studies like this show that variations typically involve the arrangement of fascicles or the attachment at the pes anserine.

As noted previously, Its elastic modulation provides advantages for those surgeries. Consequently, reconstructive surgery often alters gracilis anatomy.

Pes Anserine

The pes anserine is the distal attachment of three iliotibial muscles on the medial tibia. They include the sartorius, gracilis and semitendinosus. Yet, this area tends to be complicated by a high degree of variability.

Typically, the sartorius attaches superiorly in a short wrapping that extends toward the tibial tuberosity. Inferiorly, the semitendinosus attaches and often extends for a short distance along the shaft of the medial tibia. Usually, gracilis attaches between those two tendons. But, again, these are generalities as the area is highly variable.

There are many studies of pes anserine. Naturally, most of them focus on the arrangement of semitendinosus, gracilis, and sartorius tendons. My illustration is based on a series of cadavers that were part of an extensive study on tendon arrangement but was modified as I explored other studies.

Variable Attachment

This study of Nigerian cadavers also found the area to be quite variable. Attachment tendons varied in number, length, and overlap. In general, the sartorius attached superiorly, and the semitendinosus attached most inferiorly. Notably, there are several helpful illustrations of variations with color coding.

Variable Bursa

Another study focused on the pes anserine bursa. Most of the time (64-67%), it was located between the tendons and the tibia. Additionally, about 20% of the time, it is located between the tendons and the medial collateral ligament. Finally, it developed among the tendons about 10% of the time. Conspicuously, there were no significant variations based on gender. However, the study has detailed charts based on gender, age, height, weight, and BMI.

Support Integrative Works to
stay independent
and produce great content.

You can subscribe to our community on Patreon. You will get links to free content and access to exclusive content not seen on this site. In addition, we will be posting anatomy illustrations, treatment notes, and sections from our manuals not found on this site. Thank you so much for being so supportive.

If you don’t care to subscribe, you can donate.

Cranio Cradle Cup

This mug has classic, colorful illustrations of the craniosacral system and vault hold #3. It makes a great gift and conversation piece.