Transcript Chapter 14
Chapter 14 Injuries to the Hip and Pelvis In Your Notebooks: • How many joints does the hip have? Anatomy Review Primary hip structures • Innominate bones • Ilium • Ischium • Pubis Anatomy Review (cont.) Functions of the pelvis include: • • • • Attachment of lower extremities. Protection of internal organs. Muscle attachments. Birth process, in females. Joints (other than hip) • Sacroiliac • Pubic symphysis Nervous System Major Nerves • Femoral • Sciatic • Obturator (not shown) • Saphenous • Tibial • Peroneal • Plantar nerves (not shown) • Digital nerves Circulatory System Major Blood Vessels • External iliac • Femoral • Deep profunda femoral (not shown) • Saphenous vein • Popliteal • Anterior tibial • Posterior tibial • Dorsalis pedis • Plantar Hip Muscles Actions: • Hip Flexion- Rectus Femoris, Iliopsoas group, Tensor Fascia Lata, Sartorius • Hip Extension: Gluteals & Hamstrings • Hip Adduction: Adductors, Pectineus and Gracillis • Hip Abduction: Gluteals & Tensor Fascia Lata Musculature (cont.) Anterior Muscles • Psoas major & minor • Iliacus • Pectineus • Adductors – magnus, longus, brevis Musculature (cont.) Anterior Muscles (continued) • Gracilis • Tensor fascia latae • Quadriceps – vastus muscles, rectus femoris Musculature Posterior Muscles • Gluteals – maximus, medius, minimus • Deep external rotators – piriformis, gemelli, obturators, quadratus femoris • Hamstrings – biceps femoris, semitendinosus, semimembranosus 3 Hip Flexors 3 3 2 1 4 Hip Extensors 2 2 1 Hip Adductors 1 2 3 Hip Abductors 1 1 2. Tensor Fascia Lata In Your Notebooks: • List a function of the pelvis. Hip Anatomy Questions 1. Name the 3 main bones of the hip. 2. What are the 3 joints that make up the hip? 3. What are the 4 main functions of the hip? 4. List: - the 4 motions of the hip - the muscles that perform each motion - where those muscles are located 1. Name the 3 main bones of the hip. 2. What are the 3 joints that make up the hip? 3. What are the 4 main functions of the hip? 4. What are the 4 motions of the hip? 5. List the muscles that perform each motion 6. Where are each of these muscle groups located? In Your Notebooks: • List an injury of the hip region. In Your Notebooks: • List the Signs and Symptoms of a Pelvic Fracture. What Injury do you think this is?? Common Sports Injuries: Skeletal Injuries Fractures of the Pelvis • Pelvic fractures are devastating injuries. • Pelvic fractures are not common in sports, because it typically takes a great deal of force to fracture the pelvis. • This injury may occur in sports such as hockey, pole-vault, or football. • Pelvic fractures in the adolescent can be serious. Fractures of the Pelvis (cont.) Signs and symptoms include: • Abnormal pain in pelvic region. • Swelling at the injury site, usually accompanied with visual or palpable deformity. • Pain elicited when iliac crests are pressed together. • Injury to internal organ(s) may be associated with this injury. Fractures of the Pelvis (cont.) First Aid • Treat for shock and internal bleeding. • Monitor vital signs. • Arrange for transportation to a medical facility on a spine board, elevated at the feet. An athlete with suspected pelvic fracture should not be allowed to return to participation before obtaining a physician’s approval. Adolescent Pelvic Fractures Femoral Neck Stress Fracture • Commonly occurs in amenorrheic athletes involved in endurance sports. • Result of a loss in shock-absorbing capacity of fatigued hip muscle • Or poor footwear,hard running surface or hip deformities • Athlete complains of severe anterior thigh or groin pain and experiences pain when walking. Slipped Capital Femoral Epiphysis • Commonly occurs in prepubescent boys, particularly tall boys who experienced recent growth spurts, overweight boys, and late-maturing boys. • Exhibits flexed hip,lack of hip motion,pain in ant. Groin,hip/knee What about this one?? Hip Pointer Hip Pointer is a common injury, involving a contusion to the anterior/superior portion of the iliac crest. • Although extremely painful and debilitating, it does not require immediate medical attention. • Signs and symptoms include swelling, pain, and discoloration at injury site. • Athlete may walk with slight limp. Hip Pointer (cont.) First Aid • Apply ice immediately. • Athlete should rest and avoid activities involving lower extremities. • In severe cases, crutches may be necessary. • Permit limited participation within 1 to 2 weeks. Hip Pointer (cont.) Pad the area to avoid recurrence. Courtesy of Brent Mangus What injury could this be? Osteitis Pubis • This injury results from constant stress and possibly some degeneration in the pubic symphysis joint. • Long distance runners, basketball players, and any athlete experiencing repetitive loading of this area is vulnerable. • Male athletes may have testicular or scrotal pain, along with discomfort in the anterior pubic, suprapubic, or hip areas. Osteitis Pubis (cont.) First Aid • Refer to a physician. • Condition often responds well to rest, ice, and over-the-counter anti-inflammatory medications. • It may take 3 months to a year to recover. What Injury is this? Hip Dislocation Dislocated Hip • This serious injury is rare in athletics, but it may occur in contact/collision sports. • Injury can occur from a violent collision such as seen in tackle football or ice hockey. • The mechanism of injury: The hip is in flexion and force is applied through the femur. Hip Dislocation (cont.) Signs and symptoms include: • Generally posterior dislocation. • Pain and loss of movement in affected leg. • Swelling that is palpable. • Knee of the involved leg is angled toward the opposite leg. First Aid • Treat for shock. • Immobilize the athlete and contact EMS. • Monitor blood flow to the lower leg at all times. Any Guesses?? Avulsion Fractures of the Hip In an avulsion fracture, a bone fragment is torn away with tendon attached. • Avulsion fractures of the hip are uncommon but can occur—the ischial tuberosity and pubis are likely sites of this injury. • Injury likely to occur while sprinting or jumping. • More common in Adolescents Avulsion Fractures of the Hip (cont.) Signs and symptoms include: • Pain and swelling at site of injury. • Inability to use the muscle group involved due to avulsion. • Point tenderness over injury. • Snapping or popping sensation at the time of injury. Avulsion Fractures of the Hip (cont.) First Aid • Immediately apply ice. • Have athlete rest. • Limit athlete’s movements. Crutches may be necessary for walking. • Refer to a physician for evaluation. In Your Notebooks: • What is a Hip Pointer? • What is an Avulsion Fracture? • What position would an athlete be in if they dislocated their hip? • What joint does Osteititis Pubis affect? • Who is most likely to get a Femoral Neck Stress Fracture? • Who is most likely to get a slipped capital femoral epiphysis? Injuries to Male Genitalia These injuries are usually transient (short) in nature. • Scrotal trauma can cause testicular contusion. • Severe trauma can rupture testicle. Wearing a protective cup is advised in collision/contact sports. Testicular or Scrotal Contusions Signs and symptoms include: • Extreme pain & point tenderness. • Assuming fetal position and grasping testicles. • Athlete’s report of a blow to the testicles. First Aid • Apply ice, and allow athlete to rest lying down. • In cases of swelling or pain lasting longer than a few minutes, refer to a physician. • Testicular torsion (twisting) can occur and results in considerable discomfort. Transport to medical care facility. Nerve Problems A common complaint is burning or tingling sensation radiating from the hip to buttocks area and going down the leg. • This discomfort often results from sciatic nerve irritation. • Continuing to participate in the activity aggravates the irritation. • Refer athlete to a physician. • Rest, stretching, and strengthening exercises may be helpful. Hernias A hernia is a protrusion of viscera through abdominal wall. • Inguinal hernia is more common in males • Femoral hernia is more common in females. • Athlete should seek the advice of a physician regarding surgical options. • In a sports hernia, the posterior inguinal wall is weakened without protrusion of abdominal contents. No palpable hernia is detected, but athlete complains of pain in groin and lower abdominal areas. • http://www.youtube.com/watch?v=JXn4NggR z4k Prevention • Many hip injuries can be prevented through proper conditioning and strengthening of the associated musculature. • Rest is also important for the body to repair micro damages incurred by the stresses of training. • Protective equipment and proper footwear may also help to prevent injuries from occurring.