1. The Hip

2. The Pelvis

3. Anatomy of the Hip

4. Muscles of the Hip

5. Lateral Pelvic Tilt
Weak gluteus medius will not be able to control the pelvis
Hip drop occurs on the opposite side of weakness
Trendelenburg Gait

6. Coxa Vara / Valga A: Normal B: Coxa Vara C: Coxa Valga
“normal” angle at the femoral neck and shaft is 125˚
When there is Coxa Vara (less than normal angle at the neck and shaft of the femur) there is resultant genu valgum (at the knee)
When there is Coxa Valga (increased angle at the neck and femoral shaft) there is resultant genu varum
* Draw out below pictures what the genu valgum and vara would look like

7. Anteversion vs Retroversion
Version makes the leg look “twisted”
Too much Anteversion and the toes turn in
Retroversion causes toes to turn out

8. Nerves of the Lower Extremity
Main nerves surrounding the Hip:
1)Femoral N. (can be damaged during child birth, but also with a pelvic or upper femur fx)
2)Obturator (can be damaged in child birth)
3) Most common we will see as a PTA is Sciatic Nerve damage (runs through or over the Piriformis muscle, if it is tight there can be compression on the sciatic nerve causing numbness, pain down posterior thigh to the foot (weak knee flexion and loss of foot control. Specific muscles affected= hamstrings and adductor magnus

9. Piriformis syndrome affects the sciatic nerve
Piriformis syndrome affects the sciatic nerve. It can cause weak hamstrings and Adductor magnus as well as pain down the posterior thigh to the foot. It is caused by tightness of the Piriformis muscle (the muscle may become tight due to instability at the pelvis- need to encourage stabilization program). Can be treated with muscle injection in severe cases, but many cases can be treated with PT: modalities (HP,CP, US, Estim), massage techniques (including elbow compression with LE rotation prone), piriformis stretching, and then lumbar/pelvic stabilization techniques that we learned for the spine. Home techniques can include self massage with a tennis or racquet ball, icing, and stretching.

10. Total Hip Arthroplasty
(Total Hip Replacement Video)