Download Anatomy

Care & Prevention
Chapter
Hip & Pelvis
The arrangement of bones, ligaments, muscles,
and tendons make the hip the strongest joint
in the body.
The hip joint is a ball and
socket joint.
• Note the
femoral head
of the femur
sits in the
socket of the
hip.
There two fused vertebrae known as the:
• Sacrum
• coccyx
Groin & torso muscles are involved in supporting
and moving the trunk, upper, and lower
extremities.
The hip and pelvis are supported by the
following ligaments:
• Ligamentum teres
• Transverse acetabular
• Iliofemoral
• Pubofemoral
• Inguinal
The bones of the hip and pelvic region provide
the structure to transfer weight between the
torso and the lower extremities.
Important Muscle groups:
• Gluteal Muscles (Largest)
– Gluteus Medius
– Gluteus Minimus
– Gluteus Maximus
Assist in hip
extension,
internal
rotation,
external
rotation
abduction
• Hip Flexors:
–
–
–
–
Iliopsoas
Sartorius
Pectineus
Rectus Femoris
• Hip Adductors:
–
–
–
–
Adductor Longus
Adductor Brevis
Adductor Magnus
Gracilis
Quadriceps
Hip Flexion
Hamstrings
Hip Extension
Dermatome: the sensory distribution of a nerve
root, which produces feeling in a
certain area.
Myotome: A single nerve root that produces
movement in an area.
Other Structures:
• Fat Pads – Specialized soft tissue for weight
bearing and absorbing impact.
• Bursa – Synovial sacs generally located over
bony prominences through the body.
Bones
• Femur
• Pelvis (Illium, Ischium, Pubis)
• Sacrum
• Coccyx
Pelvic Girdle – the bony ring of the 2 innominate
bones, the sacrum and the coccyx
Muscles
Although all important a few stand out:
• Gluteus Maximus – extension & adduction of hip
• Gluteus Medius – abduction & external rotation of hip
• Gluteus Minimus – abduction & internal rotation of hip
• Tensor Fascia Latae: flexion & internal rotation of hip
• Adductor (Longus/Brevis/Magnus) - adduction & flexion of
the knee
Muscles cont.
Hamstrings:
Biceps Femoris – Flexion of knee / external rotation of leg
Semimembranosus – Flexion of knee/internal rotation of leg
Semitendinosus – Flexion of knee/internal rotation of leg
Quadriceps:
Rectus Femoris – Extension of knee / flexion of hip
Vastus Medialis / Vastus Lateralis / Vastus Intermedius
Extension of knee
Sagittal Plane – bisecting body into right and left halves
Frontal Planes - bisecting body into front & back halves
Transverse Planes - bisecting body into upper & lower halves
Adduction – moving leg toward the midline in the
frontal plane
Abduction – moving leg away from the midline of
body in frontal plane
Flexion – decreasing angle between anterior thigh
& abdomen through the sagittal plane
Extension – increasing the angle between anterior
thigh and abdomen through the sagittal plane
Internal Rotation – rotation of femur toward the
midline
External Rotation – rotation of femur away the
midline
Flexion – moving the torso forward through the
sagittal plane
Extension – moving the torso backward through
the sagittal plane
Lateral Flexion – moving the torso laterally (side
to side) in the frontal plane
Rotation – rotating the torso in the transverse
plane
Dermatome: a segment of the skin that is
innervated by a spinal nerve
Innervated: nerve stimulation (usually of a
muscle
Both terms are used when inferring about the
nerve innervations of the body
Injuries to the coccyx:
Coccyx – A 4 fused vertebrae on the lower end
of the spine.
• AKA – Tail Bone
Area can be bruised by falling or struck by a hard
surface
• Severe trauma can cause fracture of dislocation
Treatment – Protection, rest, ice
Hip Strains
• Commonly occur when the joint received
violent twisting motion of the torso
accompanied by stationary/fixed feet
Evaluating – have athletes perform various ROM
(flexion, extension, adductions, abduction,
circumduction)
Hip Pointer
• Some muscles that control trunk movement
attach to the iliac crest.
• Due to limited natural protection, injuries to
the iliac crest result from direct blow,
(contusion) and can disable an athlete.
– Immediate pain & swelling may of
may not be present initially.
Trauma to the genitalia
• Result from direct blow or testicular torsion
– Causes excruciating pain and temporary disability
• Same physiological tissue reaction as contusions to
other body parts
– Hemorrhaging, fluid effusion, and muscle spasm
• 1 method to relieve this spasm is to have the athlete
lie on the ground and flex thighs to chest. Loosen
clothing, Ice, & see physician.
• Can occur to a female as well
Trochanteric Bursitis
• Occurs at the bursa at the gluteus
medius/iliotibial band insertion at greater
trochanter.
• Running technique
should be examined
• Common in dance
Hip Dislocation
• Should be handled by emergency personnel
• In most cases the athlete will be lying on their
backs with the injured extremity flexed and
externally rotated.
• Injury caused by abnormal
stress to the joint.
– Can dislocate either anteriorly
or posteriorly
Hip Dislocation cont.
• The head of the femur could permanently
damage nerves and blood supply
*These athletes need to be transported.
•
•
•
•
Athlete Publgia
Iliotibial Bans Syndrome
Osteitis Pubis
Piriformis Sysndrome
Sending an athlete back to competition before
healing is complete leaves the player
susceptible to further injury.
The best way to determine when healing is
complete is by the absence of pain during
stressful activity.
Followed by Full pain free ROM
Before the return to competition the following
guidelines must be met:
• Full Range of Motion
• Strength, Power, and endurance are
proportional to the athlete’s size, and sport
• No pain during running, jumping, or cutting
Before the beginning of any rehabilitation
exercise program, the athletic trainer should
consult with all members of the sports
medicine team.
Establish an individual program tailored for each
athlete and their injury.
Include in any Rehabilitation Protocol are the
following:
Range of Motion Exercise
Resistance Exercise
Cardiovascular/Fitness Activities
(Walking, stairs, climbing, running, swimming, cycling)
Sport Specific
Activities
(jumping, figure eights, Swimming, Jumping Rope)