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CHAPTER 7 THE LOWER EXTREMITY: HIP REGION KINESIOLOGY Scientific Basis of Human Motion, 12th edition Hamilton, Weimar & Luttgens Presentation Created by TK Koesterer, Ph.D., ATC Humboldt State University Revised by Hamilton & Weimar McGraw-Hill/Irwin Copyright © 2012 by The McGraw-Hill Companies, Inc. All rights reserved. OBJECTIVES 1. Name, locate, & describe the structure & ligamentous reinforcements of the pelvic girdle and hip joints. 2. Name & demonstrate movements possible. 3. Name & locate muscles & muscle groups, and name their primary actions. 4. Analyze the fundamental movements with respect to joint & muscle actions. 5. Describe common athletic injuries. 7-2 THE PELVIC GIRDLE STRUCTURE Pelvic bones Illium Ischium Pubis Sacrum Fig 7.1 7-3 MOVEMENTS OF THE PELVIS Fig 7.4 Neutral Posterior Tilt Anterior Tilt 7-4 MOVEMENTS OF THE PELVIS Right Lateral Tilt Right Rotation Fig 7.5 7-5 MUSCLES OF THE PELVIS Anterior tilt Hip Posterior tilt Hip flexors & lumbosacral spinal extensors. extensors & lumbosacral spinal flexors. Lateral Tilt to Right Left lateral lumbosacral flexors, right hip abductors, & left hip adductors. Rotation to Right Left lumbosacral rotators, left hip external rotators, & right hip internal rotators. 7-6 RELATIONSHIP OF PELVIS TO TRUNK & LOWER EXTREMITIES Link between the trunk and lower extremities. Must cooperate with motion, yet contribute to stability. Primary movements of pelvis are initiated in the pelvis itself. Secondary movements are associated with motion of trunk or thighs. 7-7 PRIMARY MOVEMENTS OF PELVIS Spinal Joints Hyperextension Anterior tilt Slight flexion Posterior tilt Lateral tilt left Slight lateral flexion right Hip Joints Slight flexion Rotation left R: Slight external rotation L: slight internal rotation Pelvis Rotation right * Don’t forget that rotation and lateral tilt can also occur to the right! Complete extension R: Slight adduction L: Slight abduction 7-8 SECONDARY MOVEMENTS OF PELVIS Spine Flexion Hyperextension Lateral flexion left Rotation left Pelvis Posterior tilt Anterior tilt Lateral tilt left Rotation left 7-9 THE HIP JOINT: STRUCTURE Ball-and-socket joint. Articulation of spherical head of femur with deep cup-shaped acetabulum. Head of femur covered with hyaline cartilage, except fovea capitis. Femoral neck at 126°131° angle w/shaft. Femoral neck has slight anteversion. Neckshaft Angle Femoral neck Fig 7.8 7-10 THE HIP JOINT: STRUCTURE Acetabulum is lined with hyaline cartilage. Acetabular labrum (fibrocartilage) adds depth to joint and cushions femoral head. Acetabular notch at junction of three pelvic bones. Fig 7.9 7-11 LIGAMENTOUS REINFORCEMENTS Transverse acetabular ligament A strong flat band. Bridges acetabular notch & completes acetabular ring. Fig 7.9 7-12 LIGAMENTOUS REINFORCEMENTS Teres femoris ligament Ties head of femur to lower part of acetabulum. Provides reinforcement from within. Fig 7.10 7-13 LIGAMENTOUS REINFORCEMENTS Iliofemoral ligament Extraordinarily strong band. Checks extension & rotation. Pubofemoral ligament Prevents excessive abduction. Fig 7.11 7-14 LIGAMENTOUS REINFORCEMENTS Ischiofemoral ligament Strong triangular ligament. Limits rotation & adduction in the flexed position. Fig 7.12 7-15 MOVEMENTS OF THE FEMUR AT THE HIP JOINT Fig 7.13a&b 7-16 MOVEMENTS OF THE FEMUR AT THE HIP JOINT Fig 7.13c&d 7-17 MUSCLES OF THE HIP JOINT Anterior Posterior Iliopsoas Pectineus Rectus femoris Sartorius Tensor fasciae latae Biceps femoris Semimembranosus Semitendinosus Gluteus maximus Six deep outward rotators Hamstrings 7-18 MUSCLES OF THE HIP JOINT Medial Lateral Adductor brevis Adductor longus Adductor magnus Gracilis Gluteus medius Gluteus minimus 7-19 MUSCLES OF THE HIP JOINT Iliopsoas Psoas minor & major, & iliacus Function: Strong hip flexor. Pectineus Function: Flexes femur at hip. Assists in adduction. Fig 7.14 7-20 MUSCLES OF THE HIP JOINT Rectus Femoris Function: Flexes femur at hip. Assists adduction. Sartorius Fig 7.15 Function: Flexes femur at hip. Abducts & externally rotates. Tensor Fasciae Latae Function: Flexes & abducts femur. Tenses fascia latae. 7-21 MUSCLES OF THE HIP JOINT Biceps Femoris Semimembranosus Semitendinosus Function: Extend hip Fig 7.16 7-22 MUSCLES OF THE HIP JOINT Gluteus Maximus Function: Powerful hip extensor against resistance. Lower portion assists in adduction. Upper portion abducts against strong resistance. Six Deep Outward Rotators Function: External rotation. Fig 7.19 7-23 MUSCLES OF THE HIP JOINT Adductor brevis Function: Adducts & aids in flexion. Adductor Longus Function: Adducts & flexes. Fig 7.21 7-24 MUSCLES OF THE HIP JOINT Adductor Magnus Function: Adducts Extends hip. Lower portion assists internal rotation. Gracilis Function: Adducts & flexes. Fig 7.21 7-25 MUSCLES OF THE HIP JOINT Gluteus Medius Function: Abducts Anterior fibers internally rotate. Gluteus Minimus Function: ⨯ Internal rotation & abduction. Fig 7.22 7-26 MUSCULAR ANALYSIS OF FUNDAMENTAL MOVEMENTS OF THE THIGH AT THE HIP Flexion: tensor fasciae latae, pectineus, iliopsoas, rectus femoris, & sartorius. Extension: Hamstring muscles. Abduction: Gluteus medius & minimus. Adduction: adductor longus is primary, adductor magnus & brevis, and gracilis. Lateral Rotation: Six deep outward rotators, biceps femoris, and gluteus maximus. Medial Rotation: gluteus medius & minimus. 7-27 COMMON INJURIES OF THE THIGH, HIP, AND PELVIS Contusions Results from a direct blow. Pinches muscle between bone and external force. Blow to Iliac crest - “hip pointer”. Myositis ossificans may result. 7-28 COMMON INJURIES OF THE THIGH, HIP, AND PELVIS Myositis Ossifican Calcification following repeated traumas or serious contusions. Improper treatment of contusions. Hamstring Strains Muscular imbalance, fatigue, sudden change in direction or speed. Occurs at myotendinous junctions. 7-29 COMMON INJURIES OF THE THIGH, HIP, AND PELVIS Hip Fracture Usually fractures of femoral neck. Often caused by impact or falls. Hip replacement often the only option. 7-30
