Transcript The Hip and Pelvis

The Hip and Pelvis
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Hip is one of the most stable joints in the
body.
It is the strongest joint in the body.
What kind of joint is the hip?
The Hip and Pelvis
The muscles of the
back, abdomen,
hamstrings,
quadriceps, adductors
and gluteals all attach
here.
Muscle Groups
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Gluteal Muscles are the largest.
Hip Flexors
Hip Adductors
Quads and Hamstrings
The Hip and Pelvis
Gluteal MusclesGluteus mediuship abduction, hip internal rotation
Gluteus maximuship extension
The Hip and Pelvis
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Adductor Muscles
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Adductor magnus
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Adduct/extend
Adductor Brevis
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adductor
The Hip and Pelvis
The pelvis is made up of flat
bones that support the skeleton.
It has 3 function:
 Attachment for muscles that
control the lower limbs
 House parts of digestive and
urinary tract
 House reproductive systems
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Skeletal structure
There are 5 main parts of the pelvis:
 Ilium
 Ischium
 Pubis
 Coccyx
 Sacrum
Skeletal Structure
Ilium-flared bone that is
the lateral and upper
part of the pelvis
 Iliac Crest-upper ridge
 Greater sciatic notchallows sciatic nerve to
pass to legs
 Iliac Fossa-inner
surface of ilium.
Skeletal Structure
Ischium-bears the
weight when
sitting.
Ischial tuberosityboney point of
your butt.
Skeletal Structure
Pubis-front of the pelvis,
in front of the
bladder.
Pubis symphysis-where
the two pubis are
fused.
Skeletal Structure
Sacrum-5 vertebrae
fused together to
form a single bone.
It is between lumbar
and coccyx.
Skeletal Structure
Coccyx- contains 3-5
rudimentary
vertebrae.
Susceptible to shock
from a fall and
damage can effect
the nerves of the
lower body.
Muscles of the Pelvis Hip Thigh
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The head of the femur is covered with
cartilage which helps absorb shock and fits
into the acetabulum.
The synovial fluid further cushion the
joint.
Several Ligaments to support the joint.
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Injuries to the Hip and Thigh
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Greater Trochanteric Bursitisinflammation of the greater trochanteric
bursa.
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Cause- to little stretch/warm up
Pain over lateral hip, gets worse with walking,
running, twisting
Limit activity, stretch, ice massage and NSAID
Injuries to the Hip and Thigh
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Fracture to the
Femur- mostly in the
elderly due to a fall.
Treatment- surgery to
pin or replace hip.
Injuries to the Hip and Thigh
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Hip Dislocation- not
very common, usually
rather traumatic.
If you do not get it
back quickly the
muscles will prevent it
from going in without
sedation.
Sacroiliac Injuries
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They may be acute or chronic.
Pain is less in the morning and gets worse
as the day goes on.
Warm up will help with pain
during activity, but it will
return after cooled down.
Sacroiliac Joint
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The joint where the
sacram meets the
Illium on either side is
the sacroiliac joint.
Sacroiliac Special Test
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Patrick/Fabere TestPatient is supine and
in figure 4 position.
Pain in hip with
position indicates
iliopsoas, or hip joint
abnormalities with
pressure indicates SI
problem.
Sacroiliac Special Tests
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Compression Testwith patient in supine
compress the hips at
ASIS.
Distraction Test- with
patient in supine push
apart the hips at the
ASIS.
Injuries to the Hip and Thigh
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Strains
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Quadriceps
Hip Flexor
Hamstring
Adductor-Groin
Injuries to the Hip and Thigh
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Quadriceps Contusion
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Blow to the Quad
region of the thigh
Treatment should
include ice in a flexed
knee position to
facilitate healing, and
crutches.
Thigh Injuries
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Myositis Ossificans-ossifying
mass (calcium deposit) forms
within a muscle due to recurrent
trauma or improper injury care.
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After a contusion never heat,
stretch excessively, or continue
play that is highly painful.
May show up in xray/MRI 4-6
weeks after injury.
Hip Injuries
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Iliac Crest Contusion (Hip
Pointer)- Extreme pain,
swelling at iliac crest
caused by a direct blow.
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Treatment is ice and
padding around contusion.