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Injuries to the Hip and PelvisInjuries to the Hip and Pelvis

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AnatomyAnatomy

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AnatomyAnatomy

Function of the pelvisFunction of the pelvis attachment of lower extremitiesattachment of lower extremities protection of internal organsprotection of internal organs muscular attachmentmuscular attachment birth process birth process

Joints (other than hip)Joints (other than hip) sacroiliac & pubic symphysissacroiliac & pubic symphysis

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Anatomy Anatomy ReviewReview

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AnatomyAnatomy Anterior musclesAnterior muscles

psoas major & minorpsoas major & minor iliacusiliacus pectineuspectineus Adductors - magnus, Adductors - magnus,

longus, brevislongus, brevis gracilisgracilis tensor fascia lataetensor fascia latae Quadriceps - vastus Quadriceps - vastus

muscles, rectus femorismuscles, rectus femoris

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Skeletal injuriesSkeletal injuries fractures of the pelvisfractures of the pelvis

great force requiredgreat force required not common in sportsnot common in sports may occur in sports such as ice hockey, pole-vault, or may occur in sports such as ice hockey, pole-vault, or

footballfootball

in adolescent -- seriousin adolescent -- serious Signs/symptoms:Signs/symptoms:

abnormal pain in pelvic region abnormal pain in pelvic region swelling at the injury site swelling at the injury site pain elicited when iliac crests are pressed togetherpain elicited when iliac crests are pressed together injury to internal organ(s) may be associated with this injuryinjury to internal organ(s) may be associated with this injury

First Aid:First Aid: treat for shock & internal bleedingtreat for shock & internal bleeding monitor vital signsmonitor vital signs arrange for transportation to a medical facility on a spine board arrange for transportation to a medical facility on a spine board

-- elevated at the feet-- elevated at the feet

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Skeletal injuriesSkeletal injuries hip pointerhip pointer

common injury to the anterior/superior region common injury to the anterior/superior region of the pelvisof the pelvis

caused by a direct blow such as from a helmetcaused by a direct blow such as from a helmet extremely painfulextremely painful

Signs/symptoms:Signs/symptoms: swelling at the site of injuryswelling at the site of injury discoloration at site of injurydiscoloration at site of injury walk with slight limpwalk with slight limp coughing, sneezing, laughing may be coughing, sneezing, laughing may be

painfulpainful

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First Aid:First Aid: immediately apply iceimmediately apply ice rest (avoid activities rest (avoid activities

that involve the lower that involve the lower extremities)extremities)

if severe, crutches if severe, crutches may be necessarymay be necessary

Long-term careLong-term care protect the area from protect the area from

additional trauma with additional trauma with some type of padding with some type of padding with hard-shell coveringhard-shell covering

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Skeletal injuriesSkeletal injuries Osteitis PubisOsteitis Pubis

results from constant stress on the pubic symphysisresults from constant stress on the pubic symphysis long distance runners, basketball players, any athlete long distance runners, basketball players, any athlete

experiencing repetitive loading of this area is vulnerableexperiencing repetitive loading of this area is vulnerable

Signs/symptoms:Signs/symptoms: localized pain over the pubic symphysislocalized pain over the pubic symphysis vague pain in the lower abdominal regionvague pain in the lower abdominal region groin pain with no history of injury to that areagroin pain with no history of injury to that area

First Aid:First Aid: overuse injury -- as such, first aid is not a factor overuse injury -- as such, first aid is not a factor

responds well to rest, ice, and anti-inflammatory responds well to rest, ice, and anti-inflammatory med.med.

refer to a physicianrefer to a physician

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Skeletal injuriesSkeletal injuries dislocated hipdislocated hip

rare in sportsrare in sports may occur in contact/collision sportsmay occur in contact/collision sports can occur from a violent collision such as seen in tackle can occur from a violent collision such as seen in tackle

football or ice hockeyfootball or ice hockey hip is in flexion and force is applied through the femurhip is in flexion and force is applied through the femur

Signs/symptoms:Signs/symptoms: most dislocations are posterior -- pain and loss of most dislocations are posterior -- pain and loss of

movement are commonmovement are common swelling with palpable defectswelling with palpable defect knee on the involved leg is angled towards the knee on the involved leg is angled towards the

other legother leg treat for shock, immobilize the athlete and contact treat for shock, immobilize the athlete and contact

EMS, apply ice and compression, monitor distal EMS, apply ice and compression, monitor distal pulsepulse

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Skeletal injuriesSkeletal injuries avulsion fracturesavulsion fractures

bone fragment is torn away with tendon attachedbone fragment is torn away with tendon attached uncommon but can occur -- ischial tuberosity and pubis uncommon but can occur -- ischial tuberosity and pubis

are likely sites of this injuryare likely sites of this injury sports that involve sprint running, such as footballsports that involve sprint running, such as football

Signs/symptoms:Signs/symptoms: pain & swelling at site of injurypain & swelling at site of injury inability to use the muscle group involved due to inability to use the muscle group involved due to

avulsionavulsion point tenderness over injurypoint tenderness over injury snapping or popping at the time of injurysnapping or popping at the time of injury

First Aid:First Aid: immediately apply iceimmediately apply ice immobilize and use crutchesimmobilize and use crutches refer to a physicianrefer to a physician

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Soft tissue injuriesSoft tissue injuries herniashernias

protrusion of viscera through abdominal wallprotrusion of viscera through abdominal wall inguinal more common in malesinguinal more common in males femoral more common in femalesfemoral more common in females seek the advice of a physician regarding seek the advice of a physician regarding

surgical optionssurgical options nerve problemsnerve problems

most problems are related to direct contactmost problems are related to direct contact often involves the sciatic nerve with radiating painoften involves the sciatic nerve with radiating pain may be related to root impingement resulting from may be related to root impingement resulting from

lumbar strainlumbar strain

refer to a physicianrefer to a physician

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