A tutorial to

EMG placement on the lower

extremity muscles
Moein Nazifi

1. Introduction
In this article, a basic method for EMG placement will be provided. Since our targets in the synergy
studies are the lower extremity muscles which play a major role in gait, this article only aimed a
limited number of leg muscles. These muscles are the tibialis anterior (TA), soleus (SL), medial
gastrocnemius (MG), vastus medialis (VM), rectus femoris (RF), medial hamstrings (MH), lateral
hamstrings (LH) and gluteus medius (GM).
Along the same line, a brief introduction to each muscle will be provided and then the
recommendations for EMG electrode placement and the necessary landmarks on the body will be
provided. At last, a clinical test will be introduced. This test is of importance since it mainly
activates the target muscle and one can easily check the EMG activation levels to double check
the correctness of the EMG placement.

Figure 1 Target muscles in this study with their approximate place

2. EMG placement
2.1. Tibialis anterior
This muscle is responsible for dorsiflexion of the ankle joint and assistance in inversion of the foot. Fig.2
shows its location within the body.

Figure 2 Location of tibialis anterior

Recommended sensor placement procedure

Starting
posture

Supine or sitting.

Electrode size

Maximum size in the direction of the muscle fibers: 10 mm.

Electrode
distance

20 mm.

- location

The electrodes need to be placed at 1/3 on the line between the tip of the
fibula and the tip of the medial malleolus.

- orientation

In the direction of the line between the tip of the fibula* and the tip of the
medial malleolus**.

- fixation on
the skin

(Double sided) tape / rings or elastic band.

- reference
electrode

On / around the ankle or the proc. spin. of C7.

Clinical test

Support the leg just above the ankle joint with the ankle joint in dorsiflexion
and the foot in inversion without extension of the great toe. Apply pressure
against the medial side, dorsal surface of the foot in the direction of plantar
flexion of the ankle joint and eversion of the foot.

Figure 3 Location of EMG electrode (yellow cross) and the tip of the fibula (blue circle)

*The fibula or calf bone is a leg bone located on the lateral side of the tibia, with which it is connected above and
below. It is the smaller of the two bones in the shank.

Figure 4 Fibula bone

** Malleolus is the bony prominence on each side of the ankle. The medial malleolus is the prominence on the inner
side of the ankle.

2.2. Soleus
The action of the calf muscles, including the soleus, is plantar flexion of the foot. They are
powerful muscles and are vital in walking, running, and dancing. The soleus specifically plays an
important role in maintaining standing posture; if not for its constant pull, the body would fall
forward. Fig. 5 show its place in the body.

Figure 5 Soleus muscle.

Recommended sensor placement procedure

Starting
posture

Sitting with the knee approximately 90 degrees flexed and the heel / foot of
the investigated leg on the floor.

Electrode size

Maximum size in the direction of muscle fibers: 10 mm.

Electrode
distance

20 mm.

- location

The electrodes need to be placed at 2/3 of the line between the medial condyle
of the femur* to the medial malleolus.

- orientation

In the direction of the line between the medial condyle to the medial
malleolus.

- fixation on
the skin

(Double sided) tape / rings or elastic band.

- reference
electrode

On / around the ankle or the proc. spin. of C7.

Clinical test

Put a hand on the knee and keep / push the knee downward while asking the
subject / patient to lift the heel from the floor.

Figure 6 Location of medial malleolus (lower blue circle), medial

condyle of the femur (upper blue circle), and EMG location (yellow
cross)

* The medial condyle is one of the two projections on the lower extremity of femur (the bone in the thigh), the other
being the lateral condyle.

Figure 7 Position of the condyle in the knee

2.3. Medial gastrocnemius

Gastrocnemius is a very powerful superficial muscle that is in the back part of the lower leg. It
runs from its two heads just above the knee to the heel. The gastrocnemius is primarily involved
in running, jumping and other "fast" movements of leg. Its function is plantar flexing the foot at
the ankle joint and flexing the leg at the knee joint.

Figure 8 Gastrocnemius muscle

Recommended sensor placement procedure

Starting
posture

Lying on the belly with the face down, the knee extended and the foot
projecting over the end of the table.

Electrode size

Maximum size in the direction of the muscle fibers: 10 mm.

Electrode
distance

20 mm.

- location

Electrodes need to be placed on the most prominent bulge of the muscle.

- orientation

In the direction of the leg (see picture).

- fixation on
the skin

(Double sided) tape / rings or elastic band.

- reference
electrode

On / around the ankle or the proc. spin. of C7.

Clinical test

Plantar flexion of the foot with emphasis on pulling the heel upward more
than pushing the forefoot downward. For maximum pressure in this position it
is necessary to apply pressure against the forefoot as well as against the
calcaneus.

Figure 9 EMG location for the medial

gastrocnemius

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2.4. Vastus medialis

The vastus medialis is a muscle located medially in the thigh that extends the knee. The vastus
medialis is part of the quadriceps muscle.

Recommended sensor placement procedure

Starting
posture

Sitting on a table with the knees in slight flexion and the upper body slightly
bend backward.

Electrode size

Maximum size in the direction of the muscle fibers: 10 mm.

Electrode
distance

20 mm.

- location

Electrodes need to be placed at 80% on the line between the anterior superior
iliac spine and the joint space in front of the anterior border of the medial
ligament.

- orientation

Almost perpendicular to the line between the anterior superior iliac spine*
and the joint space in front of the anterior border of the medial ligament**.

- fixation on
the skin

(Double sided) tape / rings or elastic band.

- reference
electrode

On / around the ankle or the proc. spin. of C7.

Clinical test

Extend the knee without rotating the thigh while applying pressure against the
leg above the ankle in the direction of flexion.

*The anterior superior iliac spine refers to the anterior extremity of the iliac crest of the pelvis.

Figure 10 Anterior superior iliac spine labeled second to bottom

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**The medial collateral ligament is one of the four major ligaments of the knee. It is on the medial (inner) side of
the knee joint.

Figure 11 Right knee, bones and ligaments

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Figure 12 EMG placement for the vastus medialis

Figure 13 the vastus medialis, rectus

femoris, and the vastus lateralis (from
right to left, respectively)

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2.5. Rectus femoris

The rectus femoris is situated in the middle of the front of the thigh. Its function is extension of
the knee joint and flexion of the hip joint. Refer to Fig.13.

Recommended sensor placement procedure

Starting
posture

Sitting on a table with the knees in slight flexion and the upper body slightly
bend backward.

Electrode size

Maximum size in the direction of the muscle fibers: 10 mm.

Electrode
distance

20 mm.

- location

The electrodes need to be placed at 50% on the line from the anterior superior
iliac spine to the superior part of the patella*

- orientation

In the direction of the line from the anterior superior iliac spine to the superior
part of the patella.

- fixation on
the skin

(Double sided) tape / rings or elastic band.

- reference
electrode

On / around the ankle or the proc. spin. of C7.

Clinical test

Extend the knee without rotating the thigh while applying pressure against the
leg above the ankle in the direction of flexion.

* The patella also known as the kneecap or kneepan, is a thick, circular-triangular bone which articulates with the
femur (thigh bone) and covers and protects the anterior articular surface of the knee joint. Refer to Fig.11.

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Figure 14 EMG placement for rectus femoris

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2.6. Medial hamstrings

This muscle is responsible for flexion and medial rotation of the knee joint. It also extends and assists
in medial rotation of the hip joint.

Recommended sensor placement procedure

Starting
posture

Lying on the belly with the face down and the thigh held down on the table, in
medial rotation, and the leg medially rotated with respect to the thigh. The
knee needs to be flexed to less than 90 degrees.

Electrode size

Maximum size in the direction of the muscle fibers: 10 mm.

Electrode
distance

20 mm.

- location

Electrodes need to be placed at 50% on the line between the tuberosity of the
ischium and the medial condyle of the tibia.

- orientation

In the direction of the line between the tuberosity of the ischium* and the
medial condyle of the tibia**.

- fixation on
the skin

(Double sided) tape / rings or elastic band.

- reference
electrode

On / around the ankle or the proc. spin. of C7.

Clinical test

Press against the leg proximal to the ankle in the direction of knee extension.

*The tuberosity of the ischium marks the lateral boundary of the pelvic outlet.
** The condyle is the portion of the upper extremity of tibia. Fig.11.

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Figure 15 The tuberosity of the ischium

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Figure 17 EMG placement for medial hamstring

Figure 16 Lateral and medial

hamstring (right to left, respectively) in
posterior view

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2.7. Lateral hamstrings

This muscle is responsible for flexion and lateral rotation of the knee joint. The long head also extends
and assists in lateral rotation of the hip joint. Refer to Fig.16.
Recommended sensor placement procedure

Starting
posture

Lying on the belly with the face down with the thigh down on the table and
the knees flexed (to less than 90 degrees) with the thigh in slight lateral
rotation and the leg in slight lateral rotation with respect to the thigh.

Electrode size

Maximum size in the direction of the muscle fibers: 10 mm.

Electrode
distance

20 mm.

Electrode
placement
- location

The electrodes need to be placed at 50% on the line between the tuberosity of
the ischium and the lateral condyle of the tibia.

- orientation

In the direction of the line between the tuberosity of the ischium and the
lateral condyle of the tibia.

- fixation on
the skin

(Double sided) tape / rings or elastic band.

- reference
electrode

On / around the ankle or the proc. spin. of C7.

Clinical test

Press against the leg proximal to the ankle in the direction of knee extension.

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Figure 18 EMG placement for lateral hamstring

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2.8. Gluteus medius

This muscle abduction of the hip joint. The anterior fibers medially rotate and may assist in flexion of
the hip joint; the posterior fibers laterally rotate and may assist in extension.

Figure 19 Gluteus medius

Recommended sensor placement procedure

Starting
posture

Lying on the side on a table.

Electrode size

Maximum size in the direction of the muscle fibers: 10 mm.

Electrode
distance

20 mm.

Electrode
placement
- location

Electrodes need to be placed at 50% on the line from the iliac crest* to the
trochanter**.

- orientation

In the direction of the line from the iliac crest to the trochanter.

- fixation on
the skin

(Double sided) tape / rings or elastic band.

- reference
electrode

On the proc. spin. of C7 or on / around the wrist or on / around the ankle.

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Clinical test

Lying on the side with the legs spread against manual resistance (holding the
ankles)

* Iliac crest is the superior border of the wing of ilium and the superolateral margin of the greater pelvis.
** The trochanter is an anatomical part of the femur connecting to the hip bone.

Figure 21 The head of trochanter shown

Figure 20 Iliac crest

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Figure 22 EMG placement for gluteus medius

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3. References
1. Neptune R., et al, Modular control of human walking: A simulation study, Journal of
biomechanics, Vol 42, 1282-1287, 2009.
2. http://seniam.org/
3. https://www.wikipedia.org/

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