Title: Chapter 13 Hip, Pelvis, and Thigh Injuries
1Chapter 13Hip, Pelvis, and Thigh Injuries
2The Hip, Pelvis, and Thigh
- Includes some of the strongest muscles in the
body. - Subjected to tremendous demands.
- Extremely vulnerable to injuries that can
sideline a player for an extensive period of time
3Anatomy of the Hip and Pelvis
- The hip joint is a ball-and-socket joint that
allows motion and provides stability needed to
bear body weight - The socket area, which is inside the pelvis, is
called the acetabulum. The ball part of this
joint is the top of the leg bone (head). It joins
with the acetabulum to form the hip joint.
4Anatomy of the Thigh
- Bones
- The femur
- Designed to permit maximum mobility and support
during movement - Longest and strongest bone in the body
- Extends from the hip to the knee
- The head of femur articulates with the pelvis to
form the hip joint
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6Anatomy of the Thigh
- Pelvis
- Ilium
- Ischium
- Pubis
7Muscles of the Hip
- Most powerful in the body
- Hip Flexors
- Rectus femoris
- Sartorius
- Iliopsoas
- Psoas major
- Psoas minor
- iliacus
8Muscles of the Hip
- Hip Extensors
- Hamstrings
- Biceps femoris
- Vastus lateralis
- Vastus medialis
- Gluteus maximus
9Muscles of the Hip
- Abductors
- Gluteus medius
- Gluteus minimus
- Tensor fascia latae
10Muscles of the Hip/Thigh
- Medial Thigh Muscles (Groin)
- Primary function adduction
- Gracilis
- Adductor magnus
- Adductor brevis
- Adductor longus
- Pectineus
11Thigh Injuries
- Very few sprained ligaments or dislocations in
this area - Proper flexibility and strength prevents most hip
injuries - Proper equipment also important
12Thigh Injuries
- Quadriceps Contusion
- Symptoms Signs
- Caused by sharp blow to thigh
- Severe impact from relaxed thigh (muscle to
femur) - Extent of force and degree of thigh relaxation
determines depth of injury - Feels like a muscle bruise
- Produces intense pain and weakness
- Grades 1 - 4 depending on severity of injury
13Thigh Injuries
- Management
- RICE
- Use elastic bandage for pressure and support in
the quadriceps area - Constant stretching of quadriceps muscle
- Do not exercise if pain is still occurring
- Begin slowly with swimming, jogging, etc...
14Thigh Injuries
- Myositis Ossificans (bone growth in muscle)
- Symptoms Signs
- Pain, muscle weakness, soreness, swelling,
decreased muscle function, ROM - Caused by multiple blows to the muscle area
- A single severe blow
- Improper care of a contusion
- Management
- PRICE
- Do not ignore quadriceps contusions
- Remove surgically after one year
15Thigh Injuries
- Quadriceps Hamstring Strains
- Symptoms Signs
- Pain, discomfort, point tenderness, spasms,
soreness - Grade 1 mostly spasms, grade 3 rupture of
tendon/muscle tissues - Strains tend to reoccur because of scar tissue
that forms during the healing process - Management
- PRICE, NSAIDS, analgesics
- Cryotherapy
- Preventative stretch, warm up, use proper form
16Thigh Injuries
- Stress Fractures and Femur Fractures
- Symptoms Signs
- Stress fracture femur bends slightly, pain and
discomfort from pounding of lower extremity
(running) - Femur Fracture severe pain, loss of function,
internal bleeding, swelling - Management for stress fracture
- Rest
- An alternative activity
- -Management for femur fracture
- Immobilization, once at hospital traction splint
may be used to pull femur and reduce pain
17Femur Fractures
18Anatomy of the Hip and Pelvis
- Bones
- Ilium
- Broad, flaring portion of hip bone
- Crest of the pelvis
- Pubis
- Lower, posterior part of hip bone
- Ischium
- Helps to form the hip
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20Hip injuries
- Hip Pointer
- Injury to the iliac crest
- Can be as minimal as contusion or as major as an
avulsion fracture - Can be very painful and debilitating
21Hip Injuries/Conditions
- Legg-Calve-Perthes Disease
- A disruption of blood flow to the head of the
femur - The 'ball' of the 'ball and socket' joint dies
- Usually is seen in children 2 to12 years of age,
five times more common in boys than girls - Characterized by extreme pain in groin and knee
area, or walking with limp
22Hip Injuries
- Dislocation of hip Femur pops out of the socket
(acetabulum) - Causes
- Athletic injuries
- Car accidents
- Severe falls
- Signs Symptoms
- Extreme pain
- Leg is often internally rotated
- Possible loss of feeling in foot or leg due to
nerve damage - X-Ray or position of leg usually determines this
injury
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25Hip Injuries - Dislocation
- Management
- Call ambulance immediately, hospital will
relocate hip - Months of rehab needed very long process
- Begin with normal ROM and strength
- May need to learn how to walk again
26Hip injuries - Snapping Hip
- The snapping hip The IT band snaps over the
greater trochanter hip stability becomes lessened
and ligaments and adductor muscles become less
stable. - - Causes
- Habitual movements that predispose muscles around
the hip to become imbalanced - Greater range of motion of hip abduction
- Dancers, gymnasts, hurdlers structurally narrow
pelvic width - Signs Symptoms
- Snapping occurs when balancing on one leg
- Pain and inflammation with the snapping
27Hip snapping
28Hip injuries Hip snapping
- Management
- Cryotherapy
- Ultrasound to stretch tight muscles and
strengthen weak muscles in the hip region - Resume activity when the pain subsides
29 Slipped Capital Femoral Epiphysis
- The head of the femur slips off of the neck or
shifts position - Found mostly in boys between 10 -17 who are tall
thin or obese - May be related to the effects of a growth hormone
- Signs Symptoms
- Pain in the groin, limping
- Hip and knee pain during passive and active
motion
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31Avascular Necrosis
- Temporary or permanent loss of the blood supply
to the proximal femur. - - Causes
- Without blood, the bone tissue dies and causes a
collapse of the joint surface. - Use of steroids can cause AVN
- - Signs and Symptoms
- No symptoms in the early stages
- Joint pain, at first during activity, then during
rest - Osteoarthritis may develop after a period of time
32Avascular Necrosis
- Management
- See physician for an MRI, X-ray, or CT scan
- Electrical stimulation, ROM exercises, reduce
weight bearing activity - Surgery will eventually be required to repair the
joint
33Groin Strains and Avulsions
34 Groin Strains
- Groin strains usually involve the adductor group
(especially adductor longus) - Causes
- Running, jumping, or twisting with external
rotation - Sports that require stretching of the hip
- Rapid changes in speed or direction (soccer)
- Signs Symptoms
- Complete rupture of the muscles that attach the
pelvis bone to the femur bone. - Pain, weakness, and internal hemorrhage
- A sudden twinge or feeling of tearing
35Groin Strains
- Management
- RICE, NSAIDs, anagelsics for 48 72 hours after
injury occurs - Rest
- Daily whirlpool therapy or cryotherapy
- Ultrasound
- Gradual stretching to restore ROM
- Protective spica bandages can be worn or Sawa
groin thigh braces
36Hip, Thigh, and Groin Stretches
37Hip, Thigh, and Groin Stretches