2. 1 Injuries of the Hip and Groin Your Name Here

3. 2 The Hip Strongest and best- protected joint in the body Rarely injured in sport Due to numerous supporting ligaments and muscles Any movements outside the normal ROM can be harmful

4. 3 Hip Sprain and Strain Sprain Partial or complete tearing of a ligament connects bone to bone Strain Stretch or rip in muscle fiber or its tendon

5. 4 Hip Sprain and Strain Causes Impact with another participant or a stationary object Violent twist where feet are firmly planted and trunk is forced in opposite direction

6. 5 Hip Sprain and Strain Causes Strength and flexibility imbalances Often confused with hip subluxation Often presents as a hip sprain or strain If left untreated, can result in hip dislocation Hip subluxation more serious injury Bone pops out then back in place

7. 6 Hip Sprain and Strain Signs Inability to circumduct the thigh Significant pain in the hip region Particularly during hip rotation Symptoms similar to a stress fracture Constant pain in the area

8. 7 Hip Sprain and Strain Care X-rays to rule out stress fracture Decreased ROM until hip is pain free Crutches and limited weight bearing Moderate stretching exercises for strength and flexibility

9. 8 Dislocated Hip Joint Causes A force transferred along the long axis of the femur Falling on one’s side

10. 9 Dislocated Hip Joint Causes Common in… Contact sports Athletes with cerebral palsy Skiing accidents Posterior dislocation more common than anterior dislocation

11. 10 Dislocated Hip Joint Signs In posterior dislocation thigh is Flexed, adducted, and internally rotated

12. 11 Dislocated Hip Joint Signs Anterior dislocation Abducted and externally rotated Thigh may be flexed or extended The femur head is posterior to the acetabulum

13. 12 Dislocated Hip Joint Signs May result in a lack of circulation Atrophic necrosis Death of tissue due to lack of circulation Damage to sciatic nerve may also occur A fracture is common with this injury

14. 13 Dislocated Hip Joint Care If accompanied with a fracture Surgical procedure may be needed Bed rest for two weeks following injury Without accompanied fracture Crutches and partial weight bearing for up to eight weeks Gradual ROM and strengthening following partial recovery

15. 14 Groin Strain Causes Overextension of the groin musculature Running Jumping Twisting External rotation

16. 15 Groin Strain Causes Poor strength and flexibility in groin musculature High percent of body fat

17. 16 Groin Strain Signs Feeling of tearing during movement Pain, weakness, or internal bleeding

18. 17 Groin Strain Care Ice, pressure, and rest for 2-3 days Protective spica bandage applied to area Commercial restraints to decrease ROM

19. 18 Groin Strain Study 2002 – “Adductor Muscle Strains in Sport” Musculature Adductor muscle group includes: Pectineus, adductor longus, adductor brevis, adductor magnus, gracilis, and obturator externus –Adductor longus is most commonly injured due to lack of mechanical advantage

20. 19 Groin Strain Study Incidence Many injuries go unreported because the athlete plays through the pain Most common in ice hockey and soccer players

21. 20 Groin Strain Study Prevention Therapeutic intervention to strengthen adductor muscle group Adduction strength at least 80% of abduction strength Warm-up –Bike –Adductor stretching –Sumo squats and side lunges

22. 21 Groin Strain Study Prevention Strengthening –Ball squeezes –Seated adduction machine –Unilateral lunges with reciprocal arm movements Sports-specific –On ice: kneeling adductor pulls –Standing: cable resisted stride lengths »To simulate skating –Slide skating –Cable column crossover pulls

23. 22 Groin Strain Study Rehabilitation Passive physical therapy treatment is ineffective Massage and stretching 8-12 week strengthening program is most effective Resistance training, balance training, and abdominal strengthening

24. 23 Implications Hip injuries are rare in sports Can be very serious and career threatening Understand causes, signs, and care of injuries Ensures… The safety of the athlete Promotes a quick and effective rehabilitation plan

25. 24 Sources Hip Sprain and Strain Pictures www.rad.washington.edu www.amberdragon.ca/.../0503/0301p elvis.gif northonline.sccd.ctc.edu/.../images/ex er06.gif http://www.sportsinjuryclinic.net/galler y/hip/hip_flexor_stretch.jpg http://www.sportsinjuryclinic.net/galler y/hip/hip_flexor_stretch.jpg

26. 25 Sources Dislocated Hip Joint Pictures familydoctor.org/Images/444_f1.jpg www.criduchat.co.uk/gifs/CDH.gif www.ispub.com/.../ijem/vol1n2/hip- fig1.jpg

27. 26 Sources Groin Strain Pictures www.sportsmed.buffalo.edu/info/groin.gif www.med.umich.edu/1libr/sma/groinstr.gif www.theoaklandpress.com/.../7288_512.jpg www.thinknatural.com/.../prod/800056_la.jpg http://www.seethetrainermidwest.com/stcat/image s/thumb/279900- Large.jpg http://www.newyorkrangers.com/pressbox/images/ primages/Jagr_0304PHI-LeClair-150pr.jpg http://www.sportinglife.com/pictures/general/allspo rttimcahilleverton.jpg www.bmaps.net/fixed/gstrain2.jpg