The Hip http www youtube comwatch vwdx Iz
The Hip http: //www. youtube. com/watch? v=wdx. Iz 3 iqxa. Q
Bones of the Hip • Coxal Bone – hip bone composed of 3 fused bones: 1. Ilium iliac crest – serves as attachment point for abdominal muscles 2. Ischium ischial tuberosity – hamstring attachment 3. Pubis pubic symphysis The 3 bones fuse at the acetabulum – receives the head of the femur
• Coxal Bones – hip bones consists of 3 fused bones - ilium - ischium - pubis • Pelvis – 2 hip bones and the sacrum • Pelvic girdle – the paired coxal bones
• The Femur Greater Trochanter and Lesser Trochanter are sites for muscle attachments • The hip joint is a ball and socket joint that is designed for STABILITY and not for MOBILITY
Motions of the Hip Joint Hip Flexion Hip Extension Hip Abduction Hip Adduction Rotation
Muscles of the Hip Joint • Hip Flexors: 1. Iliopsoas - Iliacus - Psoas Major 2. Rectus Femoris (one of the Quad m. ) a hip flexor as well as a knee extensor
• • Exercises that work the hip flexors: - situps - leg raises - hanging leg raises
Hip Extensor Muscles • Gluteus Maximus – main hip extensor • Hamstring muscles – can not flex the knee and extend the hip fully at the same time
Hip Adductors • Adductor Longus • Adductor Brevis • Adductor Magnus • Gracilis • Pectineus
Hip Abductors • Gluteus Medius • Gluteus Minimus 2 parts of the same muscle
Tensor Fascia Lata Muscle – inserts into the Iliotibial Band. Helps to stabilize the hip joint
The Femoral Triangle • Borders: 1. Inguinal Lig 2. Sartorius 3. Adductor longus • Contents: 1. Femoral Vein 2. Femoral Artery 3. Femoral Nerve
Injuries to the Hip
Sacral Fractures - MOI: fall in a sitting position or direct contact - Displacement can injure nerves and the urinary bladder - Bed rest, only surgery for severe displacement
Coccyx Fractures • • • MOI – fall in a sitting position Sitting is almost impossible Treatment aimed at pain relief, sitting “forward” on the ischial tuberosities • Return to athletics as soon as comfortable
Acetabular Fractures • Rare, results from severe trauma • MOI – direct, violent force that passes through femoral neck into the acetabulum • Immediate pain, inability to walk on leg • Shortening of extremity • Bed rest, possible surgery, followed by ROM exercises • Best treatment may still result in osteoarthritis of the hip
Acetabular Fractures
Dislocations of the Hip • Posterior dislocations most common - 95% of all hip dislocations - Why? Anterior hip capsule is strong, and MOI occurs more commonly in athletics - MOI: hip and knee flexed at 900 , force exerted through shaft of femur, driving it posteriorly “dashboard injury” - S & S: severe pain, inability to move, hip flexed and internally rotated, shortened extremity - Complications: fractures, sciatic nerve problems, avascular necrosis, arthritis
Dislocations of the Hip • Anterior Hip Dislocation - less than 5% of hip dislocations - MOI: forceful ABDuction and external roation - S & S: immediate pain, limb is ABDucted and externally rotated, palpable mass in groin - Complications: avascular necrosis, compression of femoral vein which can lead to a thrombus
Fractures of the Femur • Strength of femur is very good in young athletes • Severe trauma causes the injury
Femoral Fractures
Femoral Neck Fractures
Slipped Capital Femoral Epiphysis • Occurs in growing athlete • More common in boys, usually between ages of 11 – 15, short, heavy boys more common • MOI: not always identifiable • S & S: pain, may be referred to knee, common to have coach “run it out” Common to see glutues medius limp Treament depends on degree of slippage
Hip Pointer
Avulsion of Lesser Trochanter of Femur • Forceful Strain of Ilioposas muscle
Avulsion of Ischial Tuberosity • Forceful stretch of Hamstring muscles
Avulsion of Anterior Superior Iliac Spine (ASIS) • Origin of the Sartorius muscle
Avulsion of Crest of Ilium • Forceful contraction of the abdominal muscle
Osteitis Pubis
Snapping Hip Syndrome
Legg-Calve-Perthes Disease
Slipped Capital Femoral Epiphysis
Quadriceps Contusion
Myositis Ossificans
Iliotibial Band Syndrome
Piriformis Syndrome
The Abdominal Muscles 1. Rectus Abdominus trunk flexion 2. Internal Oblique rotates trunk to same side 3. External oblique rotates trunk to opposite side
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