Transcript Thigh and Hip

Every Athlete’s Injury
• The one area of the body that all athlete’s need
to pay greatest attention to is the leg
- more importantly the thigh
- video
- this is especially true for sprinters
• We are going to look at three injuries that are the result of speed/velocity
• “I pulled my GROIN!”
• “That’s a hammy!”
• “I got a charley horse”
• The thigh is the area of the body spanning distally from the knee and proximally
to the hip
• It is composed of a single bone, the FEMUR and many muscles
-largest, longest and second strongest bone in the
human body
- can withstand 30 times an adult’s weight!
Head
Greater Trochanter
Lesser Trochanter
Shaft (Linea aspera)
Patellar surface
Lateral condyle
Medial condyle
Trochanter: Bony prominences at the proximal end of the femur; muscle
attachment for hip and thigh muscles
Condyle: A rounded prominence at the end of a bone, most often for
articulation with another bone
The Pelvis
Sacrum
Iliac crest
Ilium
Anterior Superior
iliac crest
Anterior Inferior
iliac crest
Coccyx
Pubis
Ischium
Acetabulum
Ischial tuberosity
The Hip Joint
• the hip joint is the articulation of the proximal end of the femur (head) and the
acetabulum of the pelvis
What type of joint? Ball and socket
• is the primary connection between the appendicular skeleton of the lower body
and the axial skeleton
• to understand the musculature of the hip and thigh we will look at it
from 4 different areas: flexor/extensors, adductor, anterior and posterior
Hip Flexors and Extensors
The Glutes
Gluteus maximus
Gluteus medius
Gluteus minimus
Gluteus maximus
O: crest of ilium, sacrum and coccyx
I: greater trochanter of femur and iliotibial
Gluteus medius
tract
O: lateral surface of ilium
F: hip extension and external rotation
I: posterior surface of greater
trochanter
F: abduction and internal rotation
of the hip
Gluteus minimus
O: lateral surface of ilium
I: anterior surface of greater
trochanter
F: abduction and internal rotation of
the hip
Tensor fasciae latae
O: anterior iliac crest
I: iliotibial tract
F: flex, abduct and
medially rotate thigh
Sartorius
O: anterior superior iliac spin
I: medial surface of tibia
F: (crosses 2 joints) flexion and
lateral rotation of hip and helps
flex knee
Gluteal muscles: http://www.youtube.com/watch?v=DdGD1dGOEAw&feature=related
Adductors: http://www.youtube.com/watch?v=1loym2KxcfQ&feature=related
Anterior: http://www.youtube.com/watch?v=xFmIK0rtw98&feature=related
Posterior: http://www.youtube.com/watch?v=4FdWHFl8jo4&feature=related
Psoas minor
-present in less than 50%
of the population
-evolutionary remnant
Iliacus
Iliopsoas
O: inner surface of ilium
major of femur
I:Psoas
less trochanter
F:
flexion
O:hip
first
5 lumbar vertebrae
I: lesser trochanter of femur
F: hip and trunk flexion
Hip Adductors
Pectineus
O: supeior pubis
I: lesser trochanter to linea
aspera
F: hip adduction and flexion
Adductor longus
Adductor brevis
O: body of pubis
I: linea aspera
F: hip adduction
O: inferior of pubis
I: linea aspera
F: hip adduction and flexion
Adductor magnus
O: inferior pubis and
ischial tuberosity
I: linea aspera
F: hip adduction and
extension
Gracilis
O: inferior pubis
I: below medial tibial
condyle
F: adducts hip and flexes
knee
Gluteal muscles: http://www.youtube.com/watch?v=DdGD1dGOEAw&feature=related
Adductors: http://www.youtube.com/watch?v=1loym2KxcfQ&feature=related
Anterior: http://www.youtube.com/watch?v=xFmIK0rtw98&feature=related
Posterior: http://www.youtube.com/watch?v=4FdWHFl8jo4&feature=related
Anterior Thigh (Quadriceps) –4 muscles
Vastus lateralis
O: lateral side of
linea aspera and
greater trochanter
Vastus intermedius
F: knee extension
O: anterior shaft of
and hip flexion
femur
medialis
F:Vastus
knee extension
O: medial aspect of
linea aspera
F: knee extension
Rectus femoris
O: anterior inferior iliac
spine
F: knee extension and
hip flexion
All quad muscles join into
patellar tendon, wrap
around the patella and insert
on the tibial tuberosity of
tiba
Rectus femoris
Gluteal muscles: http://www.youtube.com/watch?v=DdGD1dGOEAw&feature=related
Adductors: http://www.youtube.com/watch?v=1loym2KxcfQ&feature=related
Anterior: http://www.youtube.com/watch?v=xFmIK0rtw98&feature=related
Posterior: http://www.youtube.com/watch?v=4FdWHFl8jo4&feature=related
Posterior Thigh -Hamstrings
Semitendinosus
O: ischial tuberosity
I: tendon inserts on
proximal tibia below
medial condyle
Semimembranosus
flexestuberosity
and
O:F:ischial
internally rotates
I:knee
posterior
aspect of
and extends
hip
medial tibial condyle
F: flexes and medially
rotates knee; extends
hip
Biceps femoris
O: 2 heads – 1 off ischial
tuberosity and 1 off linea aspera
I: heads join into head of fibula
F: extensor of hip and flexor of
knee; rotates flexed knee
Gluteal muscles: http://www.youtube.com/watch?v=DdGD1dGOEAw&feature=related
Adductors: http://www.youtube.com/watch?v=1loym2KxcfQ&feature=related
Anterior: http://www.youtube.com/watch?v=xFmIK0rtw98&feature=related
Posterior: http://www.youtube.com/watch?v=4FdWHFl8jo4&feature=related
“I pulled my GROIN!” (GROIN strain) Adductor
longus
** Remember, ligaments sprain and MUSCLES STRAIN**
• An injury to the one or more of the thigh adductor (groin) muscles
Caused by quick acceleration or a sudden change in direction
• 3 Grades of strains
Grade I: mild discomfort; no limit to activity
Grade II: moderate discomfort; limited running/jumping; some swelling
and bruising
Grade III: PAIN when walking; swelling and bruising
Treatment = R.I.C.E
-may have to limit physical activity depending on severity
-gradual introduction back to sports
“That’s a hammy!” (Strained hamstring)
• An injury to the posterior muscles of the thigh
(hamstrings)
Caused by overextension of leg during high velocity activities
• 3 Grades of strains
Grade I: minor tears; tightness in knee flexion, discomfort when
walking, minor swelling
Grade II: partial tear; limp; pain in knee flexion and palpation;
swelling
Grade III: complete tear; crutches?, PAIN, swelling immediate
Treatment = R.I.C.E
- limit physical activity depending on severity
-Anti inflammatory drugs
-stretching
- video
“I got a charley horse” (Quadriceps contusion)
• An injury often to the anterior muscles of thigh (quads)
Often caused by a rapid impact to the muscle
-muscle compressed against a bone (femur)
• Also called “dead leg”
• 2 types:
Intramuscular: tearing of muscle within sheath; limited
visible bleeding, but loss of function; days or weeks to
recover
Intermuscular: tearing of muscle and part of sheath;
visible bleeding, visible bruising, recovery quicker
• 3 Grades:
Grade I: tightness in thigh; little swelling and some trouble walking
Grade II: swelling, pain upon palpation, unable to full flex at knee, pain during
activity; limp
Grade III: immediate swelling, severe pain, crutches; out 3-12 weeks