Chapter 13 Hip, Pelvis, and Thigh Injuries

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Chapter 13 Hip, Pelvis, and Thigh Injuries. The 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. Anatomy of the Hip and Pelvis. - PowerPoint PPT Presentation

Text of Chapter 13 Hip, Pelvis, and Thigh Injuries

  • Chapter 13Hip, Pelvis, and Thigh Injuries

  • The Hip, Pelvis, and ThighIncludes 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

  • Anatomy of the Hip and PelvisThe 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.

  • Anatomy of the ThighBonesThe femurDesigned to permit maximum mobility and support during movementLongest and strongest bone in the bodyExtends from the hip to the kneeThe head of femur articulates with the pelvis to form the hip joint

  • Anatomy of the ThighPelvisIliumIschiumPubis

  • Muscles of the HipMost powerful in the bodyHip FlexorsRectus femorisSartoriusIliopsoasPsoas majorPsoas minoriliacus

  • Muscles of the HipHip ExtensorsHamstringsBiceps femorisVastus lateralisVastus medialisGluteus maximus

  • Muscles of the HipAbductorsGluteus mediusGluteus minimusTensor fascia latae

  • Muscles of the Hip/ThighMedial Thigh Muscles (Groin)Primary function: adductionGracilisAdductor magnusAdductor brevisAdductor longusPectineus

  • Thigh InjuriesVery few sprained ligaments or dislocations in this areaProper flexibility and strength prevents most hip injuriesProper equipment also important

  • Thigh InjuriesQuadriceps ContusionSymptoms & SignsCaused by sharp blow to thighSevere impact from relaxed thigh (muscle to femur)Extent of force and degree of thigh relaxation determines depth of injuryFeels like a muscle bruiseProduces intense pain and weaknessGrades 1 - 4 depending on severity of injury

  • Thigh InjuriesManagementRICEUse elastic bandage for pressure and support in the quadriceps areaConstant stretching of quadriceps muscleDo not exercise if pain is still occurringBegin slowly with swimming, jogging, etc...

  • Thigh InjuriesMyositis Ossificans (bone growth in muscle) Symptoms & SignsPain, muscle weakness, soreness, swelling, decreased muscle function, ROMCaused by multiple blows to the muscle areaA single severe blowImproper care of a contusionManagementPRICEDo not ignore quadriceps contusionsRemove surgically after one year

  • Thigh InjuriesQuadriceps & Hamstring StrainsSymptoms & SignsPain, discomfort, point tenderness, spasms, sorenessGrade 1 = mostly spasms, grade 3 = rupture of tendon/muscle tissuesStrains tend to reoccur because of scar tissue that forms during the healing processManagementPRICE, NSAIDS, analgesicsCryotherapyPreventative stretch, warm up, use proper form

  • Thigh InjuriesStress Fractures and Femur FracturesSymptoms & SignsStress 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:RestAn alternative activity-Management for femur fracture:Immobilization, once at hospital traction splint may be used to pull femur and reduce pain

  • Femur Fractures

  • Anatomy of the Hip and PelvisBonesIliumBroad, flaring portion of hip boneCrest of the pelvisPubisLower, posterior part of hip boneIschium Helps to form the hip

  • Hip injuriesHip PointerInjury to the iliac crestCan be as minimal as contusion or as major as an avulsion fractureCan be very painful and debilitating

  • Hip Injuries/ConditionsLegg-Calve-Perthes DiseaseA disruption of blood flow to the head of the femurThe 'ball' of the 'ball and socket' joint diesUsually is seen in children 2 to12 years of age, five times more common in boys than girlsCharacterized by extreme pain in groin and knee area, or walking with limp

  • Hip InjuriesDislocation of hip Femur pops out of the socket (acetabulum)CausesAthletic injuriesCar accidentsSevere fallsSigns & SymptomsExtreme painLeg is often internally rotatedPossible loss of feeling in foot or leg due to nerve damageX-Ray or position of leg usually determines this injury

  • Hip Injuries - DislocationManagementCall ambulance immediately, hospital will relocate hipMonths of rehab needed very long process Begin with normal ROM and strengthMay need to learn how to walk again

  • Hip injuries - Snapping HipThe snapping hip The IT band snaps over the greater trochanter hip stability becomes lessened and ligaments and adductor muscles become less stable.- CausesHabitual movements that predispose muscles around the hip to become imbalancedGreater range of motion of hip abductionDancers, gymnasts, hurdlers structurally narrow pelvic widthSigns & SymptomsSnapping occurs when balancing on one legPain and inflammation with the snapping

  • Hip snapping

  • Hip injuries Hip snappingManagementCryotherapyUltrasound to stretch tight muscles and strengthen weak muscles in the hip regionResume activity when the pain subsides

  • Slipped Capital Femoral EpiphysisThe head of the femur slips off of the neck or shifts positionFound mostly in boys between 10 -17 who are tall & thin or obeseMay be related to the effects of a growth hormoneSigns & SymptomsPain in the groin, limpingHip and knee pain during passive and active motion

  • Avascular NecrosisTemporary or permanent loss of the blood supply to the proximal femur.- CausesWithout blood, the bone tissue dies and causes a collapse of the joint surface.Use of steroids can cause AVN- Signs and SymptomsNo symptoms in the early stagesJoint pain, at first during activity, then during restOsteoarthritis may develop after a period of time

  • Avascular NecrosisManagementSee physician for an MRI, X-ray, or CT scanElectrical stimulation, ROM exercises, reduce weight bearing activitySurgery will eventually be required to repair the joint

  • Groin Strains and Avulsions

  • Groin Strains

    Groin strains usually involve the adductor group (especially adductor longus)CausesRunning, jumping, or twisting with external rotationSports that require stretching of the hipRapid changes in speed or direction (soccer)Signs & SymptomsComplete rupture of the muscles that attach the pelvis bone to the femur bone. Pain, weakness, and internal hemorrhageA sudden twinge or feeling of tearing

  • Groin StrainsManagementRICE, NSAIDs, anagelsics for 48 72 hours after injury occursRestDaily whirlpool therapy or cryotherapyUltrasoundGradual stretching to restore ROMProtective spica bandages can be worn or Sawa groin & thigh braces

  • Hip, Thigh, and Groin Stretches

  • Hip, Thigh, and Groin Stretches