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Injuries to Pelvis and Hip. Anatomy of Pelvis Bones of pelvic girdle 1. ilium 2. ischium 3. pubis 4. sacrum ** ilium, ischium, and pubis combined form

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Text of Injuries to Pelvis and Hip. Anatomy of Pelvis Bones of pelvic girdle 1. ilium 2. ischium 3. pubis 4....

  • Injuries to Pelvis and Hip

  • Anatomy of PelvisBones of pelvic girdle1. ilium2. ischium3. pubis4. sacrum** ilium, ischium, and pubis combined form the 2 pelvic bonesArticulations of pelvic girdle1. sacroiliac joint2. pubis symphysis

  • Pelvic GirdleAnatomy Of The Pelvis

  • Major Muscles of Pelvis1. Hip FlexionIliopsoasIliacusPsoas Majorsartoriusquadricep muscles

    2. Abduction gluteus mediusgluteus minimustensor fasciae latae

    3. Adductionadductor longusadductor magnus adductor brevisgracilispectineus

    4. Hip Extensionhamstringsgluteus maximus

  • Muscles of the Pelvic and HipMuscles of the Pelvic and Hip

  • IdentificationIdentify the following:IlliumIschiumPubisSacrumSacroiliac jointPubis symphasisIliac crest

  • IdentificationIdentify the following:Psoas MajorIliacusTensor Fasciae LataeAdductor MagnusAdductor BrevisAdductor Longus GraciliasPectineusPiriformis

  • IdentificationIdentify the following:Gluteus MaximusGluteus MinimusGluteus Medius

  • Blood Supply to Lower ExtremitiesArteriesIliac femoral poplitealtibialperonealVeinsiliacfemoralsaphenouspoplitealtibialperoneal

  • Blood Supply to PelvisPelvic Blood SupplyIliac arteryInternalExternal

  • Injuries to Pelvic RegionFractures in Pelvic RegionVery rare in sportsMost common1. stress2. avulsionSymptoms1. altered gait2. localized pain

  • Stress FracturesStress FxSmall crack in boneOveruse injuryUncommon in pelvic area (1 to 7% of reported stress fx)Seen mainly in distance runnersMore common in females

  • Stress FracturesStress FxSymptomsChronic pain in pelvis areaGets worse with activityDiagnosisX-rays and bone scansTreatmentRest / no activitySome may need crutches for few days

  • Stress Fracture

  • Avulsion Fracture Avulsion FxPiece of bone pulls away at tendon attachment siteCaused when muscle contracts too rapidly or quickly (sudden stops, starts or jumping)SymptomsMay hear or feel a popImmediate painDecreased ROMLimping

  • Avulsion FracturesAvulsion FractureTreatment4 to 6 weeks of restPhysical TherapyIncidencesRare but seen in sports that require sprinting or rapid changes in movementBasketball, track and soccer

  • Avulsion FracturesCan occur at many points along pelvisIliac crestAnterior superior iliac spine (ASIS)Anterior inferior iliac spine (AIIS)Ischial tuberosityPubic symphysis

  • Common Avulsion Fracture Sites

  • Avulsion fx of left ischiumAvulsion fx of anterior superior iliac spine

  • Avulsion Fracture

  • Hip PointersHip PointersBlow to the iliac crestCauses bone bruiseSymptomsPoint tenderness along iliac crest/spineLoss of ROMTreatmentRestIceROM exercisesDonut shaped padding

  • Hip Pointers

  • Hip Pointers

  • Injuries to Pelvic RegionStrains (Adductors or Hip Flexors)Mechanism of Injury 1. extreme rotation2. excessive abductionTreatment1. ice2. stretch3. leg strengthening

  • Anatomy of Hip and ThighBones1. Femur2. Pelvic bone

    Articulations (Hip Joint)1. Head of femur2. Acetabulum of pelvis bone** ball and socket joint

  • Bony Landmarks of HipHip JointAcetabulumsocket for hip jointFemoral Headball for hip jointGreater trochanterLesser trochanterFemoral neckFemur

  • ROMS of Hip JointFlexionExtensionAbductionAdductionMedial RotationLateral Rotation

  • Major Muscles of HipHip flexion & Knee extensionAnterior thigh musclesQuadriceps Group rectus femoris, vastus medialus, vastus lateralis, vastus intermedius

  • Major Muscles of HipHip extension & Knee flexionPosterior thigh musclesHamstring Group SemitendinosusSemimembranosusBiceps femoris

  • Injuries to the Hip and ThighFractures of FemurGreat force required to break femurContact sports, BMX, skateboarding, motorcross increase riskSplint, send to physician, or call EMS

  • Femur Fracture

  • Femoral Neck Fracture Repair

  • Injuries to the Hip and ThighSubluxation / DislocationSymptoms1. complete loss of function2. severe pain3. deformity

    Mechanism of Injury1. direct blow2. twisting force

  • Dislocated Hip

  • Subluxation of the hip

  • Injuries to the Hip and ThighContusions Charley Horse = bruise to the quad muscles

    Mechanism of InjuryDirect blow to thigh causing bleeding in the muscle tissue

    Treatment1. ICE2. keep knee flexed while applying ice3. mild stretching through pain free ROM** if stretching is not done, blood will pool and leave area vulnerable to myositis ossificans

  • Injuries to the Hip and ThighSprainsMechanism of injury1. sudden jerking or twisting motions2. more frequent in non or poor conditioned athletes

    TreatmentPRICEStretching & ROM exercisesIf injury doesnt improve within 3 days, send to physician

  • Injuries to the Hip and ThighStrainsMost common = hamstrings, hip flexor, adductors and quad


  • Injuries to the Hip and ThighBursitis / SynovitisMost common is inflammation of the trochanter bursa

    Mechanism of Injury1. direct blow2. repeated stress

    Symptoms1. slight swelling2. persistent ache

    Treatment1. rest2. stretching

  • Special Tests for Hip and PelvisThomas Test hip flexor flexibility



  • Special Tests for Hip and PelvisObers Test Iliotibial (IT) band flexibility

  • Iliotibial (IT) Band

  • Stretches for IT Band

  • Special Tests for Hip and PelvisPatricks or Faber Test deformity or weakness of the iliopsoas muscle and sacroiliac pain

  • Special Tests for Hip and PelvisTrendelenburg Test hip abductor weakness

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