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Hip Anatomy and Function Guide

Learn about hip region anatomical characteristics, pathomechanics, gait impact, and hip disorders management, including joint hypomobility. Complete guide on hip surgeries and rehabilitation.

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Hip Anatomy and Function Guide

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  1. The Hip Chapter 20

  2. Structure and Function of the Hip

  3. Anatomical Characteristics of the Hip Region • Bony Structures • The pelvis • The femur • Hip Joint Characteristics • Characteristics • Articular surfaces • Ligaments

  4. Anatomical Characteristics of the Hip Region (cont'd) • Hip Joint Arthrokinematics • Motions of the femur • Motions of the pelvis • Influence of the Hip Joint on Balance and Posture Control

  5. Functional Relationships of the Hips and Pelvis • Motions of the Femur and Muscle Function • Motions of the Pelvis and Muscle Function • Anterior pelvic tilt • Posterior pelvic tilt • Pelvic shifting • Lateral pelvic tilt • Pelvic rotation • Pelvifemoral motion (lumbo-pelvic rhythm)

  6. Pathomechanics in the Hip Region • Decreased Flexibility • Muscle Weakness • Patellofemoral impairment • Anterior cruciate ligament strain • Piriformis syndrome

  7. Pathomechanics in the Hip Region (cont'd) • Hip Muscle Imbalances and Their Effects • Shortened tensor fasciae latae and/or gluteus maximus • Dominance of the TFL over the gluteus medius • Dominance of the two-joint hip flexor muscles over the iliopsoas • Dominance of hamstring muscles over the gluteus maximus • Use of lateral trunk muscles for hip abductors

  8. Pathomechanics in the Hip Region (cont'd) • Asymmetrical Leg Length • Unilateral short leg • Coxa valga and coxa vara • Anteversion and retroversion

  9. The Hip and Gait • Hip Muscle Function and Gait • Hip flexors • Hip extensors • Hip abductors • Effect of Musculoskeletal Impairments on Gait

  10. Referred Pain and Nerve Injury • Major Nerves Subject to Injury or Entrapment • Sciatic nerve • Obturator nerve • Femoral nerve • Common Sources of Referred Pain in the Hip and Buttock Region

  11. management of hip disorders and surgeries

  12. Joint Hypomobility: Nonoperative Management • Related Pathologies and Etiology of Symptoms • Osteoarthritis (degenerative joint disease) • Post immobilization hypomobility • Common Structural and Functional Impairments • Common Activity Limitations and Participation Restrictions • Early stages • Progressive degeneration

  13. Joint Hypomobility: Nonoperative Management (cont'd) • Management: Protection Phase • Provide patient education • Decrease pain at rest • Decrease pain during weight-bearing activities • Decrease effects of stiffness and maintain available motion

  14. Joint Hypomobility: Nonoperative Management (cont'd) • Management: Controlled Motion and Return to Function Phases • Progressively increase joint play and soft tissue mobility • Improve joint tracking and pain-free motion • Improve muscle performance in supporting muscles, balance and aerobic capacity • Patient education

  15. Total Hip Arthroplasty • Indications for Surgery • Preoperative Management • Procedures • Background • Prosthetic designs and materials • Cemented versus cementless fixation

  16. Total Hip Arthroplasty (cont'd) • Overview of Operative Procedures • Standard surgical approaches • Minimally invasive approaches • Implantation of components and closure

  17. Total Hip Arthroplasty (cont'd) • Complications • Intraoperative complications • Early postoperative complications • Late complications • Dislocation: a closer look • Leg length inequality: a closer look

  18. Total Hip Arthroplasty (cont'd) • Postoperative Management • Immobilization • Weight-bearing considerations • Exercise progression and functional training • Accelerated rehabilitation

  19. Total Hip Arthroplasty (cont'd) • Postoperative Management • Exercise • Maximum protection phase after traditional THA • Moderate protection phase after traditional THA • Minimum protection phase and resumption of full activity • Extended rehabilitation and modification of activities • Return to sport activities

  20. Total Hip Arthroplasty (cont'd) • Outcomes • Pain relief, patient satisfaction, and quality of life • Physical functioning • Implant design, fixation, and surgical approach • Impact of rehabilitation

  21. Hemiarthroplasty of the Hip • Indications for Surgery • Procedures • Background • Operative procedure • Postoperative Management • Outcomes

  22. Hip Fracture • Incidence, Risk Factors and Impact on Function • Sites and Types of Hip Fracture

  23. Open Reduction and Internal Fixation of Hip Fracture • Indications for Surgery • Procedures • Types of fixation and surgical approach

  24. Open Reduction and Internal Fixation of Hip Fracture (cont'd) • Postoperative Management • Weight-bearing considerations • Exercise and functional training • Exercise • Maximum protection phase • Moderate and minimum protection phases • Extended exercise programs after surgery for hip fracture

  25. Open Reduction and Internal Fixation of Hip Fracture (cont'd) • Outcomes • General outcomes • Impact of rehabilitation

  26. Painful Hip Syndromes: Nonoperative Management • Related Pathologies and Etiology of Symptoms • Musculotendinous impairments • Tendinopathies and muscle strains • Repetitive trauma • Bursitis • Trochanteric bursitis • Psoas bursitis • Ischiogluteal bursitis (Tailor’s or Weaver’s bottom)

  27. Painful Hip Syndromes: Nonoperative Management (cont'd) • Femoroacetabular Impingement (FAI) • Common Structural and Functional Impairments, Activity Limitations, and Participation Restrictions • Pain • Gait deviations • Imbalance in muscle flexibility and neuromuscular control • Decreased muscular endurance

  28. Painful Hip Syndromes: Nonoperative Management (cont'd) • Management: Protection Phase • Control inflammation and promote healing • Develop support in related areas

  29. Painful Hip Syndromes: Nonoperative Management (cont'd) • Management: Controlled Motion Phase • Develop a strong mobile scar and regain flexibility • Develop a balance in length and strength of the hip muscles • Develop muscle and cardiopulmonary endurance • Patient education • Management: Return to Function Phase

  30. Exercise interventions for the hip region

  31. Exercise Techniques to Increase Flexibility and Range of Motion (ROM) • Techniques to Stretch Range-Limiting Hip Structures • To increase hip extension • To increase hip flexion • To increase hip abduction • To increase hip abduction and external rotation simultaneously • To increase hip internal rotation

  32. Exercise Techniques to Increase Flexibility and ROM (cont'd) • Techniques to Stretch Range-Limiting Two-Joint Muscles • Rectus femoris stretches • Hamstring stretches • Tensor fasciae latae and iliotibial band stretches

  33. Exercises to Develop and Improve Muscle Performance and Functional Control • Open-Chain (Non-Weight-Bearing) Exercises • To develop control and strength of hip abduction (gluteus medius, gluteus minimus, and TFL) • To develop control and strength of hip extension (gluteus maximus) • To develop control and strength of hip external rotation • To develop control and strength of hip adduction

  34. Exercises to Develop and Improve Muscle Performance and Functional Control (cont'd) • Closed-Chain (Weight-Bearing) Exercises • Closed-chain isometric exercises • Closed-chain dynamic exercises • Functional Progression for the Hip

  35. Independent Learning Activities • Critical Thinking and Discussion • Laboratory Practice • Case Studies

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