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The Thigh and Hip MusclesThe Thigh and Hip MusclesAnatomy, Injuries and AssessmentAnatomy, Injuries and Assessment
Sports Medicine Camp
Quadriceps Muscles
• Vastus Medialis• Vastus Intermedius• Vastus Lateralis• Rectus Femoris
Ely’s Test or Prone Knee Bend
• Rectus Femoris tightness– Athlete prone– Passive knee flexion– Positive test indicated by hip flexion
Quadriceps MMT
• Manual Muscle Test– Athlete seated– Examiner apply resistance at lower leg
Rectus Femoris Strain• Mechanism of Injury
– Sudden stretch– Sudden contraction
• Signs and Symptoms– Pain– Point tenderness– Spasm– Loss of function– Deformity
• Treatment– RICE– NSAIDS– Modalities– Stretching– Strengthening
Thigh Contusion
Hamstrings Muscles
• Medial side– Semitendinosus– Semimembranosus
• Lateral side– Biceps Femoris Long Head– Biceps Femoris Short head
Hamstrings MMT• Medial hamstrings
– Semitendinosus– Semimembranosus– Internally rotate tibia – (foot points in)
• Lateral Hamstring– Biceps Femoris– Externally rotate tibia – (foot points out)
Hamstring Strains• Mechanism of Injury
– Unknown– 1st Theory
• Hamstrings contract same time as quadriceps• Deficiency in complementary action of opposing muscles
– 2nd Theory • Quick change of function from
– Role as knee stabilizer– To– Hip extensor
– Possible reasons• Muscle fatigue• Faulty posture• Leg length discrepancy• Tight hamstrings• Improper form• Imbalance of strength between hamstrings• Hamstring strength ratio to quads normal 60 - 70 %
Hamstring Strains
• 1st Degree injury– Muscle soreness during
movement• Due to muscle spasm rather
then tearing of tissue• Fewer then 20% fibers torn
– Point tenderness– Stiffness after cool down
• 2nd Degree injury– Partial tear– Fewer then 70% fibers torn– Sudden snap or tear of muscle– Severe pain– Loss of function
Hamstring Strains
• 3rd Degree injury– Rupture of tendon – Tear of > 70% fibers– Severe swelling– Tenderness– Loss of function– Discoloration– Palpable mass or gap
Hamstring Strains– Treatment
• Grade 2 & 3– Extremely conservative
• RICE – Grade 2: 24 - 48 hrs.– Grade 3: 48 - 72 hrs.
• Stretching• Strengthening
– Emphasize eccentric exercise
– Complications• Recurrent as result of
– Inelastic fibrous scar tissue
Hip Flexors– Iliopsoas
• Psoas Major• Psoas Minor• Iliacus – MMT
Thomas Test
– Normal length of hip flexors– With low back flat – Posterior thigh touches table– Knee flexes approximately 80°– The pelvis is in 10 ° posterior tilt
– Abnormal length of hip flexors– With low back flat – Posterior thigh does not touch
table– Knee flexes < 80°
Hip Flexor Support
Adductor Muscles• Adductor Magnus• Adductor Longus• Adductor Brevis• Pectineus• Gracilis
• MMT Adduction• Athlete sidelying• Examiner supports top leg• Give resistance above knee joint
8-4
Adductor Support
21-34
Hip Pointer• Mechanism of injury
– Direct impact
• Signs and Symptoms– One of the most handicapping injuries– Immediate pain– Muscle spasm– Transitory paralysis – Inability to
• rotate trunk• Flex thigh
– Discoloration– Swelling
• Treatment– PRICE
• Bed rest as needed• Crutches as needed
– ROM exercises– Strength exercises– Severe cases MD referral