Thigh Hip Groin and Pelvis Injuries Basic Anatomy

Thigh, Hip, Groin and Pelvis Injuries

Basic Anatomy

Injuries to the thigh • Quadriceps contusion Cause: direct blow to thigh S&S: instant pain; immediate capillary effusion; swelling; point tenderness; ROM; limp Care: leg in flexion with ice (helps to lengthen muscle fibers); RICE; protective thigh padding

• Myositis Ossificans Traumatica – Irritated tissue produces calcified formation that resemble cartilage or bone Cause: severe or repeated blow to thigh; leads to ectopic bone production; improper care of contusion; too-vigorous treatment – Improper care = “running off” an injury too soon, too vigorous treatment S&S: pain; weakness; swelling; ROM; palpable defect Care: xray 2 -6 wks after injury; conservative treatment; possible surgery (too early removal may cause return)

• Quadriceps muscle strain Cause: sudden stretch or contraction; can be associated with muscle weakness or overly constricted S&S: pain, point tenderness; spasm; loss of function; (Grades of strain) Care: RICE; NSAIDs; begin with isometric exercise; neoprene sleeve/ace wrap; gradual stretching

• Hamstring Strain Cause: highest incidence of strains; exact cause is unknown; possibly quick change of muscle firing; muscle fatigue; faulty posture; leg-length discrepancy; improper form; tight hamstrings; muscle imbalance S&S: internal bleeding; pain and immediate loss of function depend on degree; (grades) Care: RICE with rest being most important; gradual stretching and strengthening; massage after swelling subsides; protective = neoprene sleeve/ace wrap

• Hamstring Strains – Strains are always a problem to the athlete because they tend to recur as a result of the inelastic, fibrous scar tissue that sometimes forms during the healing process – The higher the incidence of strains at a particular site, the greater amount of scar tissue and the greater the likelihood of further injury – Sometimes, the fear of another pulled muscle becomes almost a neurotic obsession which can be more handicapping than the injury itself – D. Arnheim, “Principles of Athletic Training”

• Femoral fractures Cause: great force such as falling from height or direct impact; occurs most often in shaft S&S: shock; deformity; muscle spasms; pain and point tenderness over fracture; loss of function; swelling Care: 9 -1 -1; treat for shock; splinting;

Injuries to Pelvis and Hip • Groin strain Cause: overextension of groin musculature, running, jumping, and twisting with external rotation S&S: sudden twinge or feeling tearing during a movement; may not be noticed until post activity; pain; weakness; internal bleeding Care: rest 48 -72 hrs; hip spica; gradual stretching; rehab; rest has been the best treatment; exercise should be delayed until the groin is pain free

• Dislocated hip Cause: traumatic force along axis of femur when the knee is bent or by falling on side S&S: flexed, adducted, and IR thigh; femur posterior in acetabulum; serious pathology of tearing of capsular and ligamentous tissue; possible sciatic nerve damage Care: Call 9 -1 -1; reduction; immobilization consists of 2 wks bed rest and use of crutches for month or longer

• Iliac crest contusion (hip pointer) Cause: direct blow to iliac crest causing severe pinching action to soft tissue region S&S: immediate pain; spasm; and transitory paralysis of soft structures; athlete is unable to rotate trunk or to flex thigh without pain Care: RICE; referral for xray; recovery ranges from 1 -3 wks; padding