The pectineus is a flat, quadrangular muscle forming the medial wall of the femoral triangle, running from the superior pubic ramus to the femoral shaft just below the lesser trochanter. It is the most anterior and superior of the medial thigh muscles and the only hip adductor primarily innervated by the femoral nerve rather than the obturator nerve. Its position in the femoral triangle adjacent to the femoral vessels makes it an important surgical landmark.
| Origin | Pecten pubis (superior pubic ramus) |
|---|---|
| Insertion | Pectineal line of the femur, between the lesser trochanter and the linea aspera |
| Nerve Supply | Femoral nerve (L2, L3); Occasional accessory obturator nerve branch |
| Blood Supply | Medial circumflex femoral artery |
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Its combined adduction and flexion action positions it as the adductor most effective in the flexed hip position, making it a significant contributor to the early stance phase of gait when the hip transitions from flexion to extension.
Pectineus strains produce deep groin pain that is reproduced by resisted hip adduction and flexion simultaneously, distinguishing it from pure adductor longus injuries which are more painful with adduction alone. Pectineus myalgia from overuse is common in equestrian athletes who grip with the inner thigh for prolonged periods. As part of the femoral triangle floor, it is a landmark for femoral nerve block procedures.
The pectineus is palpable in the femoral triangle just medial to the femoral pulse with the hip slightly flexed and abducted, becoming firm during resisted adduction and hip flexion simultaneously.
Muscle tear producing deep anterior groin pain reproduced by resisted combined hip adduction and flexion, common in equestrian athletes and kicking sport players.
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