Transcript
Page 1: Chapter 13 Hip, Pelvis, and Thigh Injuries

Chapter 13Hip, Pelvis, and Thigh Injuries

Page 2: 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

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Anatomy 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.

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Anatomy 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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Anatomy of the Thigh Pelvis

Ilium Ischium Pubis

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Muscles of the Hip Most powerful

in the body Hip Flexors

Rectus femoris Sartorius Iliopsoas

Psoas major Psoas minor iliacus

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Muscles of the Hip

Hip Extensors Hamstrings

Biceps femoris Vastus lateralis Vastus medialis

Gluteus maximus

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Muscles of the Hip Abductors

Gluteus medius

Gluteus minimus

Tensor fascia latae

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Muscles of the Hip/Thigh Medial Thigh

Muscles (Groin) Primary function:

adduction Gracilis Adductor magnus Adductor brevis Adductor longus Pectineus

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Thigh Injuries Very few sprained

ligaments or dislocations in this area

Proper flexibility and strength prevents most hip injuries

Proper equipment also important

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Thigh 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

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Thigh 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...

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Thigh 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

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Thigh 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

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Thigh 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

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Femur Fractures

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Anatomy 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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Hip 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

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Hip 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

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Hip 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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Hip 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

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Hip 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

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Hip snapping

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Hip injuries – Hip snapping

Management Cryotherapy Ultrasound to stretch tight muscles and

strengthen weak muscles in the hip region Resume activity when the pain subsides

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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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Avascular 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

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Avascular 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

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Groin Strains and Avulsions

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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

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Groin 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

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Hip, Thigh, and Groin Stretches

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Hip, Thigh, and Groin Stretches


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