1. Hip, Thigh & Pelvis Injuries
Mechanisms, Signs & Symptoms and Treatment of Strains, Sprains and Contusions

2. Hip, Thigh & Pelvis Injuries - Introduction
What is a strain?
What is a sprain?
Do you know the difference between the two?
What is a contusion?

3. Hip, Thigh & Pelvis Injuries - Objectives
Students will be able to:
Identify the signs & symptoms of injuries to the hip, thigh & pelvis
Identify the mechanism of injury for hip, thigh & pelvis injuries
Identify the proper treatment for hip, thigh & pelvis injuries

4. Hip, Thigh & Pelvis Injuries - Terminology
Strain-
A stretching or tearing of a muscle or tendon. Results in a 1st, 2nd, or 3rd degree injury. An injury to a muscle or tendon.

5. Hip, Thigh & Pelvis Injuries - Terminology
Sprain-
A stretching or tearing of the joint capsule or ligament. Results in a 1st, 2nd or 3rd degree injury. An injury to ligament.

6. Hip, Thigh & Pelvis Injuries - Terminology
Muscle contusion-
an injury caused by an impact to the muscle which results in discoloration due to a disruption of circulation in the area

7. Hip, Thigh & Pelvis Injuries - Terminology
Sign-
observable evidence of an injury

8. Hip, Thigh & Pelvis Injuries - Terminology
Symptom-
what the athlete tells you they feel

9. Hip, Thigh & Pelvis Injuries - Terminology
Mechanism-
a description of how the injury occurred

10. Hip, Thigh, and Pelvis Injuries Terminology
Fracture-
An injury to a bone in which the tissue is broken or disrupted. A break in a bone.

11. Hip, Thigh, and Pelvis Injuries Terminology
Dislocation-
A complete disunion of the bones in a joint
Subluxation-
A partial disunion of the bones in a joint

12. Hip, Thigh, and Pelvis Injuries Terminology
Bursitis-
Irritation and inflammation of a bursa

13. Hip, Thigh, and Pelvis Injuries Terminology
Myositis Ossificans - A very painful condition in which an ossifying mass (calcium deposit) forms within the muscle. Resulting from trauma to the quadriceps muscle that was not properly protected after an initial injury.

14. Hip, Thigh & Pelvis Injuries
Quad Contusions
Mechanism
A direct blow to your quad which causes the blood vessels to burst which forms a hematoma

15. Hip, Thigh & Pelvis Injuries
Quad Contusion
Signs & Symptoms
Tenderness, swelling, limping
Some loss of Range of Motion (ROM)

16. Hip, Thigh & Pelvis Injuries
Quad Contusion
Treatment
RICE-
Rest
Ice
Compression
Elevation
Possible use of crutches
Place affected leg on stretch
Additional padding when returning to play

17. Hip, Thigh & Pelvis Injuries
Iliac Crest Contusion (Hip Pointer)
Mechanism
Direct trauma to the iliac crest

18. Hip, Thigh & Pelvis Injuries
Iliac Crest Contusion (Hip Pointer)
Signs and Symptoms
Extreme tenderness, swelling, ecchymosis, limping

19. Hip, Thigh, & Pelvis Injuries
Iliac Crest Contusion (Hip Pointer)
Treatment
Ice, compression
Additional padding when returning to play

20. Hip, Thigh & Pelvis Injuries
Adductor (Groin) Strain
Mechanism
Too much stress
Forceful contraction
Over stretching
Due to sudden sideways changes in direction

21. Hip, Thigh & Pelvis Injuries
Adductor Strain
S & S
Pain/ Tenderness in the adductor
Pain on hip adduction
Popping/ snapping during injury

22. Hip, Thigh & Pelvis Injuries
Adductor Strain
Treatment (TX)
Ice
Compress thigh
Anti-inflammatory meds
Stretching & strengthening exercises

23. Hip, Thigh & Pelvis Injuries
Hamstring Strain
Mechanism:
Not warming up properly
Incomplete rehab
Inappropriate training
Lack of flexibility

24. Hip, Thigh & Pelvis Injuries
Hamstring Strain
S & S
Sudden severe pain during exercise
Snapping or popping
Pain in back of thigh & lower buttock when walking
Bruising, swelling & decreased strength

25. Hip, Thigh & Pelvis Injuries
Hamstring Strain
Treatment (TX)
RICE
Some stretching and strength
Compression wrap when return-to-play

26. Hip, Thigh & Pelvis Injuries
Quad Strain
Mechanism
Stretching quadriceps beyond normal ROM
Sudden forceful stress from jumping, kicking, sprinting

27. Hip, Thigh & Pelvis Injuries
Quad Strains
S & S
Possible bruising
Pain
Decreased ROM & Strength
Limping

28. Hip, Thigh & Pelvis Injuries
Quad Strains
Treatment (TX)
RICE
Compression wrap when return-to-play
Strengthening & stretching

29. Hip, Thigh & Pelvis Injuries
Hip Flexor Strain
Mechanism
Sudden forceful stress from jumping, kicking, sprinting
Tight muscles & poor flexibility

30. Hip, Thigh & Pelvis Injuries
Hip Flexor
S & S
Pain
Swelling
Loss of function
Decreased ROM & strength
Pain increased with flexion

31. Hip, Thigh & Pelvis Injuries
Hip Flexor
Treatment (TX)
RICE
After couple of rest days start gentle stretching
Compression wrap when return-to-play

32. Hip, Thigh, and Pelvis Injuries
Femur Fracture
Mechanism
Foot is usually planted and a severe blow impacts the femur.

33. Hip, Thigh, and Pelvis Injuries
Femur Fracture
S&S
Significant pain
The hip is externally rotated
Shortening of the limb may be evident
Possible soft tissue damage
Loss of function

34. Hip, Thigh, and Pelvis Injuries
Femur Fracture 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

35. Hip, Thigh, and Pelvis Injuries
Hip Fracture
Mechanism
Fall from a height
Or by someone elderly
Vehicle accident
High energy
impact

36. Hip, Thigh, and Pelvis Injuries
Hip Fracture
S&S
Severe pain
Inability to bare weight
Shortening of the limb may be evident
The hip is externally rotated

37. Hip, Thigh, and Pelvis Injuries
Hip Fracture TX
Immobilization
Transported by ambulance for medical care
Usually requires surgery

38. Hip, Thigh, and Pelvis Injuries
Hip Dislocation
Mechanism
High energy impact
Limb is usually planted then hit
Falling from a height

39. Hip, Thigh, and Pelvis Injuries
Hip Dislocation
S&S
Severe pain
Inability to move
Hip is internally rotated

40. Hip, Thigh, and Pelvis Injuries
Hip Dislocation TX
Transported by ambulance for medical care
Reduced by MD

41. Hip, Thigh, and Pelvis Injuries
Bursitis
Mechanism
Repetitive motions
New exercise
Working
Possibly acute due to impact

42. Hip, Thigh, and Pelvis Injuries
Bursitis
S&S
Pain
Point tenderness over lateral hip
Increased pain on hip motion
Structural tests all negative

43. Hip, Thigh, and Pelvis Injuries
Bursitis TX
RICE
Limiting activity or resting
Anti-imflamitory drugs (NSAIDs)

44. Hip, Thigh, and Pelvis Injuries
Myositis Ossificans
Mechanism
Deep quad contusion
**Not properly healed

45. Hip, Thigh, and Pelvis Injuries
Myositis Ossificans
S&S
Hard painful mass
Swelling
Tenderness
Loss of function
Restricted ROM

46. Hip, Thigh, and Pelvis Injuries
Myositis Ossificans TX
RICE
Crutches
Limit ROM
Do NOT exercise or stretch - may cause more bleeding
Calcium mass usually reabsorbed (3-6 months)
Surgery