Hip, Pelvis, and Thigh

1. Hip, Pelvis, and Thigh

2. Femoral-Acetabular Joint • This area contains some of the strongest muscles in the body. • Tremendous demands on those muscles. • Vulnerable to injuries that can sideline athletes for long periods of time.

3. Anatomy of the Hip, Pelvis, & Thigh • Ball & socket joint • Acetabulum- hip socket • Very deep • Covered by very thick, strong ligaments

4. Bones of the Hip, Pelvis, & Thigh • Femur • Greater Trochanter • Femoral Neck • Femoral Head • Ilium • Ischium • Ischial Tuberosity • Pubis

6. Ligaments of the Femoral-Acetabular Joint • Iliofemoral Ligament • Ischiofemoral Ligament

8. Anterior Thigh Rectus Femoris Vastus Lateralis Vastus Medialis Vastus Intermedius Sartorius Anterior Hip Iliacus Psoas Posterior Thigh Biceps Femoris Semimembranosus Semitendinosus Posterior Hip Gluteus Maximus Gluteus Minimus External Rotators Muscles of the Hip Region

11. Medial Thigh Gracilis Pectineus Adductor Brevis Adductor Longus Adductor Magnus Lateral Gluteus Medius Tensor Fascia Latae IT band Greater Trochanteric Bursa Muscles of the Hip Region

13. Movements of theFemoral-Acetabular Joint • Flexion • Extension • Abduction • Adduction • Internal Rotation • External Rotation • Circumduction

14. Preventing Hip Injuries • Proper flexibility training • Appropriate equipment (football, hockey, etc.) • Proper strength training

15. Thigh Injuries • Contusion • Mechanism: direct blow • Signs & Symptoms: pain, swelling, bleeding, loss of function • 3 grades - determined by severity of symptoms • Treatment: PRICE, stretching, ultrasound, padding

17. Thigh Injuries • Myositis Ossificans • Mechanism: result of quad contusion • Bone forms within muscle due to calcium build-up at injury site. • Signs & Symptoms: pain, weakness, loss of function • Rx: RICE, padding, NO ULTRASOUND

19. Thigh Injuries • Strain • Quadriceps - sudden contraction, stretching • Hamstrings - excessive force due to muscle imbalance. • Re-injury very common • Groin - stretching • involves adductors and hip flexors • Signs & Symptoms: pain, loss of function, deformity • 3 grades • Rx: RICE

20. Thigh Injuries • Acute Femoral Fracture • Mechanism: direct blow, fall from height • Signs & Symptoms: pain, deformity, unable to bear weight • Treatment: splint, 911 • risk damage to soft tissue, arteries, and nerves

21. Femoral Fracture

22. Thigh Injuries • Femoral Stress Fx (occurs at femoral neck) • Mechanism: overuse • usually associated with poor eating, menstrual irregularities • Signs & Symptoms: similar to strain or tendinitis but does not resolve • Treatment: rest, Non-Weight Bearing

23. Femoral Neck Stress Fracture

24. Hip Injuries • Iliac Spine Contusion (Hip Pointer) • Mechanism: direct blow • Signs & Symptoms: pain, swelling, ecchymosis • abdominal and hip muscles attach on the iliac crest • Rx: RICE

26. Hip Injuries • Greater Trochanteric Bursitis • Mechanism: direct blow, repetitive hip flexion, extension, & abduction • Signs & Symptoms: pain at lateral hip, occasionally ‘snapping’ sensation • Treatment: rest, corticosteroids

28. Hip Injuries • Hip Subluxation/Dislocation • Mechanism: extreme force, usually posterior dislocations or severe internal rotation accompanied with a posterior blow to the femur. • More common in car accidents than sports • Signs & Symptoms: hip internally rotated and slightly flexed, extreme pain • Call Ambulance immediately

30. Hip Dislocation

31. Hip Injuries • Legg-Calve-Perthes Disease • Decrease in circulation in femoral head; avascular necrosis of articular cartilage • More common in children & teens who are still growing • Signs & Symptoms: persistent pain in knee & groin, walking with limp with all other injuries ruled out

32. Legg-Calve-Perthes Disease

33. Bo Jackson