Transcript Hip Injury Notes

HIP, PELVIS, AND THIGH INJURIES
SOME FYI
The hip, pelvis, and thigh contain some of the
strongest muscles in the body
 This area is also subjected to tremendous
demands
 Injuries to this area can sideline a player for
long periods of time
 Most injuries to this area are strains and
contusions
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ANATOMY OF THE HIP, PELVIS, AND THIGH
Hip joint (ball-and-socket joint) is the POC
between the femur and the pelvis
 Acetabulum-hip socket.

 Head

of femur fits here
Femur (longest bone in the body) is connected
to the pelvis by thick, strong ligaments
2
muscle groups of the femur are the quads and
hamstrings
PREVENTING HIP, PELVIS, AND THIGH
INJURIES
Since the hip is very stable, ATCs will not see a
lot of sprains or dislocations
 ATCs will see a lot of muscular strains
 Proper flexibility training and stretching will
help prevent injuries in this area
 Also wearing proper padding (ex. Football) and
strengthening the core region of the body will
help prevent injuries
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LIGAMENT INJURIES
Extremely stable joint
 Very thick ligamentous structures and strong
muscles surround the hip
 This results in very few ligament injuries
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MUSCLE AND TENDON INJURIES
Thigh strains are very common, especially to
the hip flexor, extensor, and groin muscles.
 Theories as to why this occurs:

 Many
muscles in the leg cross 2 joints
 Ex.
Hamstrings cross the back of the hip joint (extension)
and the knee joint (flexion)
 Strength
imbalance occurs
 Stronger
muscle group put excessive tension on the
opposing muscle group
MUSCLE AND TENDON INJURIES
Strains should be treated with PRICE and
wrapped with supportive elastic bandage
 Moderate and severe strains may need to be
referred to a physician
 Rehab will focus on regaining strength and
range of motion and enhancing flexibility

BONE INJURIES
Pelvic fractures are not common but can occur
if excessive stress is placed on the bone tissue
 Athletic-related fractures of this area often
occur as a result of an avulsion, disruption of
the epiphysis, stress, or trauma to femur

BONE INJURIES

Avulsions (tendon pulling away the bone)
 Occur
as a result of forceful muscle contractions
that literally pull the bone away at the site where
the tendon attaches
Ex. Football player continues to run aggressively
forward while a defender is holding his leg
**hip flexor may forcefully contract, causing a
fracture
BONE INJURIES
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Growth plate fractures
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Occur at the growth plate of the bone (the neck of the femur
joins the head)
Most commonly occurs between the ages of 10 and 15
Head of femur slips off the neck
Causes pain in the groin, hip, and knee
ATC would refer athlete to a physician b/c the treatment
involves stopping the slippage and helping to close the
growth plate through surgery
BONE INJURIES
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Stress Fractures
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Uncommon but do occur in running-oriented athletes
Caused by repetitive stress, typically from the force of
pounding of the lower extremity while running
Pounding can cause the femur to bend slightly (one side is
compressed while the other is stretched)
If this pounding continues, small hairline fractures can
develop
Rest and an alternative activity are the treatment and rehab
for this problem
BONE INJURIES

Femur Fractures
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Stress required to fracture the femur is very extreme (due to
the size of the bone)
Characterized by severe pain and loss of function, as well as
internal bleeding, swelling, or tearing of muscles, tendons,
nerves, and arteries
Often causes the leg to externally rotate
Initial treatment-immobilization and transportation to
hospital by EMS
Often use a traction splint that gently pulls the femur (helps
reduce leg pain and spasm)
BONE INJURIES
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Hip Dislocations
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Caused by extreme stress
Most occur posteriorly
Severe damage can occur because of the nerve and
vascular structures
Athlete will be in extreme pain and leg will often be internally
rotated
EMS called immediately for transportation to hospital
Rehab begins with establishing normal range of motion and
strength
Learning how to walk normally will be necessary
Long recovery process
OTHER COMMON INJURIES

Hip and Thigh Muscle Contusions
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Deep thigh contusions are common, especially in contact
sports
The more severe contusions can actually cause tissue
tearing and extensive bleeding
Myositis ossificans can occur if serious contusions are not
managed appropriately
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Bone tissue forms within the muscle
Treatment-PRICE (knee flexed during ice applications)
Moderate to severe contusions require athlete be placed on
crutches to minimize the stress to the area
OTHER COMMON INJURIES

Hip and Thigh contusions continued…
 Rehab-active
rest and gentle stretching help restore
mobility
 Ultrasound often used to help reabsorb the blood
that collects internally and to break up bony tissue
deposits
 ATC must place a protective pad over the contusion
to prevent repeated injuries to the area
OTHER COMMON INJURIES

Legg-Calve-Perthes Disease
 Disruption
of blood flow to the head of the femur
causes the tissue at head of the femur to die
 Typical signs and symptoms include groin or knee
pain and walking with a limp
 If condition is suspected, athlete should be referred
to a physician right away