Hip

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.

Hip Pelvis Bones – Ilium – Ischium – Pubis Hip Joint – Head of femur – Neck of femur – Acetabulum – Greater Trochanter

Ligaments of the Hip

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.

Anterior Compartment Muscles Rectus Femoris (quadricep muscle) Vastus Medialis (quadricep muscle) Vastus Intermedialis (quadricep muscle) Vastus Lateralis (quadricep muscle) Gracilis Sartorius

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

Lateral Compartment Muscles Hip Abduction and External Rotation – Gluteus Medius – Gluteus Maximus – Tensor fascia lata

External Rotation Piriformis Superior Gemellus Interior Gemellus Obturator Externus Obturator Internus Quadratus femoris

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

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

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

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

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.

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

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

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

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

HOPS Review History: questions to determine nature location of injury Observation: V isual examination of injury P alpation: A hands-on exam S tress tests: Tests to check range of motion and degree or injury

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

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

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

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

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

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

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

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

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