Hip

1. Hip

2. Vocab • Head of femur-round boney prominence at proximal end of femur • Acetabulum­-the “cup shape” socket of the hip joint that articulates with the head of the femur • Neck of femur- boney bridge between head of femur and proximal shaft of femur • Greater Trochanter-large bone prominence on lateral side of proximal femur • Lesser Trochanter-smaller boney prominence on medial aspect of proximal femur.

5. Hip • Pelvis Bones • Ilium • Ischium • Pubis • Hip Joint • Head of femur • Neck of femur • Acetabulum • Greater Trochanter

6. Ligaments of the Hip

7. Muscle Groups of the Thigh • Quadriceps • Hamstrings • Hip Abductors • Hip Adductors • Internal Rotators • External Rotators • Know the origin and insertions for the groups and the actions.

8. Anterior Compartment Muscles • Rectus Femoris (quadricep muscle) • VastusMedialis (quadricep muscle) • VastusIntermedialis (quadricep muscle) • VastusLateralis (quadricep muscle) • Gracilis • Sartorius

9. Posterior Compartment Muscles • Biceps Femoris (Hamstring) • Semimembranosus (Hamstring) • Semitendinosus (Hamstring) • Gluteus Medius • Gluteus Maximus

10. Lateral Compartment Muscles • Hip Abduction and External Rotation • Gluteus Medius • Gluteus Maximus • Tensor fascia lata

11. External Rotation • Piriformis • Superior Gemellus • Interior Gemellus • ObturatorExternus • ObturatorInternus • Quadratusfemoris

12. Quadriceps Strain • Mechanism: Forceful contraction of the hip and knee into flexion or powerful hyper extension with the knee flexed • S/S: • Acute pain (sometimes after workout is completed). • Loss of ROM (knee flexion) • Swelling, pain with palpation • A divot may be felt during palpation • Tx: RICE with Knee flexed

13. Hamstring Strain • Mechanism: Forceful contraction of the hamstrings or hyper flexion of the hip • S/S: Capillary hemorrhage • Pain, loss of function • Discoloration may occur a day or two after injury • Point tender • A severe hamstring strain includes rupturing of tendinous or muscular tissue, and hemorrhage and disability • Tx: RICE – elevation to pain tolerance

14. Groin Strain • Mechanism: Excessive abduction of the thigh and/or external rotation • S/S: Athlete may report a sudden twinge or feeling of tearing during active movement • Pain after activity • Pain with hip ABD and ER • Tx: Ice with athletes’ legs crossed with thighs abducted • Compression • Rest

15. Ruptured Rectus Femoris • Mechanism: Severe blow to the anterior thigh while the muscles are actively engaged in activity • S/S: Noticeable dip on the anterior thigh • Painful ROM • Athlete hesitates to put weight on that leg • Tx: R.I.C.E (with knee flexed) • Refer to physician

16. Quadriceps Contusion • Mechanism: Impact to the relaxed thigh. • The extent of the force and the degree of thigh relaxation determine the depth of the injury and the amount of structural and functional destruction that takes place. • S/S: Intense pain, Transitory loss of function • Immediate capillary bleeding at the time of trauma • Athlete may say he has been hit by a sharp blow to the thigh • Palpation may reveal a circumscribed swollen area that is painful to the touch • Movement to the knee can be severely restricted and athlete may have a limp.

17. Quadriceps Contusion • Tx: Rest • Ice (knee flexed) • Compression • Elevation • Protective padding when resuming activity • Light stretching

18. Hip Pointer • Mechanism: Athlete takes a direct hit to the anterior iliac spine or iliac crest • S/S: Immediate pain, spasm, and transitory paralysis of the soft structures • Unable to rotate trunk or flex the thigh without pain • Tx: Rest, Ice, Compression • Padding when resuming activity

19. Femur Fracture • Mechanism: Foot is usually planted and a severe blow impacts the femur. • S/S: Significant pain • The hip is ER and slightly ADD • Shortening of the limb may be evident • Tx: Athlete must be immediately mobilized and transported by ambulance for medical care • Refer to doctor • Athlete is put in a brace for a minimum of 4 months

20. See Other PPT for these Injuries • Quad Strain • Hamstring Strain • Groin Strain • Quad Contusion • Femur fractures • Hip Pointer • Acute Femoral Fx • Myositis Ossificans • Dislocated hip • Avascular Necrosis • Hip Labral tear • Snapping Hip • Legg Calve-Perthes

21. HOPS Review History: questions to determine nature location of injury Observation: Visual examination of injury Palpation: Ahands-on exam Stress tests: Tests to check range of motion and degree or injury

22. SOAP Review • Subjective: detailed information about patient history, complains • Objective: information that is a record of test measurements; data gained from inspection • Assessment: Identification of problem • Plan of Action: Treatment

23. Objective: Hands-On! • Perform Palpation • Check anatomical structures to determine points of pain • Check for abnormalities • Perform special test or stress test to assess severity

24. Phase I: Pain Management • Time immediately following injury or surgery which movement in affected part is limited to ease pain • Decrease swelling • Compression • ice

25. Phase II: ROM • Time when more vigorous therapeutic action initiated including joint range-of-motion, mobility and flexibility exercises • Walking (over hurdles)

26. Phase III: Proprioception • The ability to know where your body is in space • Balance exercises

27. Phase IV: Strength • Exercises using higher resistance and lower repetitions • 4 way hip • SLR (straight leg raises)

28. Phase V: Endurance • Exercise using lower resistance and higher repetitions • Both cardiovascular and strength

29. Phase VI: Sport Specific • Exercises that are specific to the sport the athlete is involved in

30. IMPORTANT! • Review the other PPT on the my teacher web page. • Chapter 21 the HIP on the Principles of Athletic Training PPT link.