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The upper fibers act as abductors of the hip joints. The gluteus maximus is a tensor of the fascia lata , and by its connection with the iliotibial band steadies the femur on the articular surfaces of the tibia during standing, when the extensor muscles are relaxed.
Stretching the hip into extension and limiting excessive knee flexion avoids placing the rectus femoris in a position of passive insufficiency, thereby maximizing the stretch to the iliopsoas tendon. Strengthening exercises for the hip flexors may also be an appropriate component of the program.
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However, in the patient with a normal hip joint, a positive test is a good indicator of psoas hypertonicity. [2] Other signs from the Thomas test: opposite/ contralateral hip flexes without knee extension- tight iliopsoas; hip abducts during the test- tight tensor fasciae latae; knee extension occurs- tight rectus femoris
The lateral rotator group is a group of six small muscles of the hip which all externally (laterally) rotate the femur in the hip joint.It consists of the following muscles: piriformis, gemellus superior, obturator internus, gemellus inferior, quadratus femoris and the obturator externus.
Gandbhir and Rayi point out that the biomechanical action involved comprises a class 3 lever, where the lower limb's weight is the load, the hip joint is the fulcrum, and the lateral glutei, which attach to the antero-lateral surface of the greater trochanter of the femur, provide the effort.
Involuntary extension of the "normal" leg occurs when flexing the contralateral leg against resistance. To perform the test, the examiner should hold one hand under the heel of the "normal" limb and ask the patient to flex the contralateral hip against resistance (while the patient is supine), asking the patient to keep the weak leg straight while raising it.