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Anatomy & Injuries to the Thigh, Hip and Pelvis. SP Sports Medicine John Hardin Instructor. General Information about the pelvis. This area of body is strong and stable Great demand placed on this part of body—”core” Functions: support the spine & trunk
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Anatomy & Injuries to the Thigh, Hip and Pelvis SP Sports Medicine John Hardin Instructor
General Information about the pelvis • This area of body is strong and stable • Great demand placed on this part of body—”core” • Functions: • support the spine & trunk • Transfer weight to lower extremities • Place for muscle attachment of thigh and trunk • Protect organs of pelvic region
Anatomy • Bones • Muscles • Ligaments
Bones • Femur • Head, neck, greater trochanter, lesser trochanter, shaft, medial & lateral condyle and epicondyles • Pelvis • Ilium: iliac crest, ASIS, AIIS, PSIS • Ishcium: ischial tuberosity • Pubis: Pubic symphysis • Acetabulum
Muscles • Hip Flexors: • Iliacus & psoas major= Iliopsoas • Rectus femoris • Sartorius • Hip Extensors: • Hamstrings-biceps femoris, semitendinosus, semimembranosus • Gluteus maximus
Muscles • Knee flexors: • Hamstrings, gastrocnemius • Knee extensors: • Quadriceps—rectus femoris, vastuslateralis, vastusmedialis, vastusintermedius
Muscles • Hip Adductors: • Adductor magnus, adductor longus, adductor brevis, gracilis, pectineus • Hip Abductors: • Gluteus medius, tensor fascia latae
Muscles • Hip Internal rotators: • Tensor fascia latae, gluteus minimus • Hip External rotators: • Gluteus maximus, gluteus medius, piriformis
Ligaments • Thickening of joint capsule allows for very stable joint • Iliofemoral • Ischiofemoral • pubofemoral • LigamentumTeres • Also called the round ligament • Attaches head of femur into acetabulum allowing blood supply to that area
Preventing injuries to thigh/hip • Flexibility training and stretching • Strength training • Proper protective equipment
Common Injuries • Strains • Sprains • Contusions • Fractures • Dislocations
Strains • Quads • Hamstrings • Groin (adductors) • Hip flexors • Gluteals
Strains • Mxn: • sudden strong contraction of muscle(s) • overstretching of muscle(s) • Muscle strength imbalance
Strains • S/S: pain/discomfort • POT • Bleeding causing discoloration (after 1-2 days) • Loss of function • Muscle spasm • deformity
Strains • TX: RICE • modify/restrict activity • crutches if necessary • Medical referral if necessary • Restore normal ROM flexibility and strength using various modalities as needed
Strains • Complications: • recurrent strains due to “inelasticity of scar tissue” especially at that same site • Excess buildup of scar tissue
Contusions • Quadriceps • Hip pointer
Quadriceps Contusion • Mxn: • direct blow to relaxed thigh compressing the musculature again the femur
Quadriceps Contusion • S/S: • Pain • POT • Bleeding into the muscle • Swelling • Temporary loss of function
Quad contusion • Tx: RICE w/ knee flexed • Crutches if necessary • Restore normal ROM, flexibility & strength • Ultrasound • Heat • Medical referral if needed
Quad contusion • Complication: • Myositisossificans—formation of bony tissue within the muscle • Very painful • Greatly restricts ROM mainly flexion • Caused by: • severe blow that is not properly cares for • Repeated blows to same area
Hip Pointer • Mxn: • direct blow to the iliac crest and/or ASIS
S/S: • Pain • Spasm • Bleeding in the area—discloration • Temporary loss of motion • Unable to rotate trunk or flex hip without pain
Hip Pointer • Tx: • RICE • Bed rest if necessary • Medical referral if necessary • Return to activity when pain if gone and motion is restored
Fractures-Avulsion • Most common at ASIS or IschialTuberosity • Mxn: forceful contraction of muscle
Avulsion Fractures • S/S: • Extreme pain with movement & weight bearing • POT (either over the ASIS or Ischial tub.) • Bleeding/discoloration
Avulsion • TX: • Ice • crutches • Medical referral for x-ray
Fractures- femur • Occurs most often in the shaft of the femur • Mxn: • great force-direct or indirect- placed on the femur
Femur Fractures • S/S: • Pain • POT • Deformity w/ thigh externally rotated, shortened • Loss of motion/function • Swelling due to internal bleeding • Muscle spasms • Muscle lacerations
Femur fractures • Can be life threatening—fatty tissue and bone marrow can get into the blood stream and cause a blood clot
Femur Fracture • Tx: • Call 911 • Don’t move the athlete • Hare traction splint • Check for distal pulse • Control any external bleeding • Treat for shock