The Hip Joint

1. The Hip Joint Exercises and Injuries

2. Exercises for the Hip Joint • Good • ExRx • Qustionable • Bodybuilding

3. Terminology • Compound • An exercise that involves two or more joint movements. • Isolated • An exercise that involves just one discernible joint movement.

4. Terminology • Closed Chain • An exercise in which the end segment of the exercised limb is fixed, or the end is supporting the weight. Most compound exercises are closed chain movements. • Open Chain • An exercise in which the end segment of the exercised limb is not fixed, or the end is not supporting the weight. Most isolated exercise are open chain movements.

5. Gluteus Maximus

6. Gluteus Maximus – Squats

7. Gluteus Maximus – Dead Lift

8. Gluteus Maximus – Lunge

9. Gluteus Maximus – Step Up

10. Gluteus Maximus – Leg Press

11. Hip Abductors/Adductors

12. Hip Abductors – Cable

13. Hip Abductors – Seated

14. Hip Abductors – Lever

15. Hip Adductors – Seated

16. Hip Adductors – Lever

17. Hip Flexors

18. Hip Flexors – Leg Raise

19. Hip Flexors – Lever

20. Stretching • Opposite action of the muscle • For example, to stretch a hip extensor muscle, perform hip flexion.

21. Gluteus Maximus - Stretching

22. Abductors - Stretching

23. Abductors (IT Band) - Stretching

24. Hip Flexors - Stretching

25. HIP INJURIES

26. GROIN INJURIES

27. Pathology • Twisting, running, jumping • Muscles most often involved: • Adductor longus • Iliopsoas • Gracilis • Sartorius

28. Pathology • Strain – pulled muscle • Tendinitis – inflammation of a tendon • Avulsion fractures • Stress fracture near the pubic crest or femoral neck

29. Causes • Sudden change in direction • Kicking across your body (What action of the hip does this require?) • Slipping while changing directions • Overuse

30. Treatment • Ice for 20 to 30 minutes every 3 to 4 hours • NSAID • Supportive bandage • Stretching e.g. butterfly stretch • Patience. Wait until… • full range of motion • full strength • run with no pain • change direction with no pain

31. HIP POINTER • A hip pointer is a contusion to the iliac crest, the surrounding soft tissue structures, or the greater trochanter of the femur. • Typically, the injury is caused by a direct blow or fall. • Hip pointer injuries occur most commonly in contact sports (eg, football, hockey), but they can also occur in noncontact sports (eg, volleyball) as a result of a fall onto the hip or side. • Pain and tenderness in this region can limit an athlete's participation in sports.

32. Hip Pointer

33. Hip Pointer • Initial treatment consists of icing, compression and rest. • Anti-inflammatory medication and gentle stretching should begin at about 48 hours after the injury. • A personalized program of strengthening, flexibility and coordination exercises is then designed for the patient. • If the bruising of the muscle and bone from the injury is severe, however, return to full activity may take several weeks.

34. OSTEOARTHRITIS

35. Osteoarthritis • It is a chronic disease in which the cartilage in a joint deteriorates or breaks down. • There are two categories of osteoarthritis, primary and secondary. • Primary osteoarthritis appears without any apparent cause, usually as a result of aging. • Secondary osteoarthritis occurs in joints that have sustained injuries, experienced infections or fractures. • Obesity can also cause secondary osteoarthritis due to the added pressure on weight bearing joints.

36. Osteoarthritis • Depending on the joints involved, swimming, walking, and cycling (perhaps on a stationary exercise bicycle) are often the best exercises for people with osteoarthritis. • Why these exercises? • Common sense safety precautions : • Warm up • Medication? • Ice arthritic joint for 15 to 20 minutes after a workout • If the joints are more painful that night or the next few days, suspend the workouts

37. HIP DISLOCATION

38. Dislocation • Any traumatic hip dislocation requires immediate treatment, ideally within six hours or less. • This is because a traumatic hip dislocation interrupts the normal blood circulation to the top of the femur, depriving the bone of its vital oxygen supply. • Unless the dislocated hip is reduced (replaced in its socket) promptly, and normal circulation is restored within the hip joint, there can be permanent damage to the head of the femur. This permanent damage is called avascular necrosis.

39. Dislocation • January 13, 1991, Bo Jackson partially dislocated his hip, tearing the blood vessels to the neck and head of the femur. • X-rays revealed a small fracture to the posterior of the hip socket. • Four weeks later, scans of the joint showed the beginning of vascular necrosis, in which the bone cells die because of deficient blood supply, and chondrolysis, in which cartilage degenerates. • Eventually Jackson would require a total hip replacement which relieves him of pain and allows him full range of motion.

40. HIP REPLACEMENT SURGERY

41. Causes 1. Osteoarthritis is perhaps the most common cause for hip replacement surgery. 2. Avascular necrosis is another cause of degeneration of the hip joint.

42. Causes 3. Abnormalities of hip joint function resulting from fractures of the hip and some types of hip conditions that appear in childhood can also lead to degeneration many years after an injury.

43. Surgery

44. Parts • Acetabular component – metal shell with plastic inner socket • Femoral component – metal stem with a metal or ceramic head

45. Types • Cemented – epoxy cement holds metal to bone

46. Types • Uncemented – mesh allows bone to grow into the prothesis

47. Operation

48. Removing the femoral head • Dislocate the hip joint • Cut femoral neck with power saw

49. Reaming the Acetabulum • Power drill and special reamer remove the cartilage • Bone is formed to fit the metal shell

50. Inserting the Acetabular Component • Cemented • Uncemented